presented by Helene Smith-Gabai PhD & Suzanne Holm OTD
This course sets the stage for understanding occupational therapy’s role in the acute care setting, and how discharge planning and recommendations have evolved as an essential part of a patient’s road to recovery and rehabilitation. The paradigm shift in OT services from Assessment-Intervention-Discharge Planning to Assessment-Discharge Planning is discussed. Occupational therapy practitioners must consider both the internal and external factors when making discharge recommendations to minimize the risk of adverse events and readmissions. Finally, this course reviews the different types of settings that patients may be transferred to after discharge along with their criteria, to help the OT practitioner effectively problem solve in making the most appropriate recommendation.
Helene Smith-Gabai is currently working as an assistant professor in a master’s level occupational therapy program at Brenau University. She earned her OTD in 2004 and her Ph.D. in 2016 at Nova Southeastern University. Her dissertation study was on the discharge planning practices of occupational therapists who practice in the acute care setting. She is also a co-editor and one of the authors of the textbook Occupational Therapy in Acute Care. She is an AOTA board certified in physical rehabilitation and is a board certification application reviewer. The bulk of her clinical experience has been in the acute care setting.
Suzanne E. Holm, OTD, OTR/L, BCPR is a licensed occupational therapist, board certified in Physical Rehabilitation, and educator with more than twenty-five years of clinical experience in adult rehabilitation and acute care settings. She is the Occupational Therapy Academic Program Coordinator and Assistant Professor at Regis University in Denver, Colorado and oversees Creighton University’s entry-level Doctor of Occupational Therapy program-Regis pathway. She earned her bachelor’s degree at the University of Texas Medical Branch in Galveston, Texas, her master’s degree at Texas Woman’s University in Denton, Texas, and her doctorate at Creighton University in Omaha, Nebraska. Formally, she was a senior Occupational Therapist at Baylor Institute for Rehabilitation in Dallas, Texas and specialized in brain injury and dysphagia management. Her clinical practice also included the University of Colorado Health Care System in Northern Colorado where she had a special focus in the intensive care units. She has been actively involved with the American Occupational Therapy Association for over twenty years, including serving as the liaison for Feeding, Eating, and Swallowing and Physical Rehabilitation Specialty and Board Certification development and as a reviewer on the Fellowship Program Committee. She has presented at local and national conferences and published on dysphagia, acute care practice, discharge planning for the elderly, and interprofessional education. She is the co-editor of the textbook, Occupational Therapy in Acute Care. She is the recipient of the Occupational Therapy Association of Colorado’s Marjorie Ball Award of Merit and Poudre Valley Health System’s Employee of the Year. Outside of occupational therapy, Suzanne enjoys traveling and exploring with her husband and their German Shorthaired Pointer, Butters.
Chapter one provides a brief historical review of how the profession of occupational therapy became part of the services provided to hospitalized patients. There is also discussion of how the advent of managed care significantly changed the way services are provided in the acute care setting, and why there has been a paradigm shift in OT services from Assessment-Intervention-Discharge Planning to Assessment-Discharge Planning. What is meant by discharge planning is also reviewed.
This chapter describes the general OT process, benefits, and goals of discharge planning within the acute care setting, including factors both internal and external practitioners consider when making discharge recommendations. It also describes the general knowledge, abilities, and clinical reasoning skills needed to make appropriate and effective discharge recommendations. Also reviewed are Medicare’s list of 13 diagnoses that qualify for an acute inpatient rehabilitation stay.
To make an appropriate discharge recommendation, practitioners need to have a good understanding of the different discharge dispositions that are available, including their requirements for admission. Practitioners also need to be aware of the activity demands of each practice setting and potential impact on a patient’s occupational performance, progress, and prognosis. This chapter reviews the different types of settings that patients may be transferred to after discharge, and their specific criteria in order to help practitioners effectively make the most appropriate recommendation.