Like so many of my fellow OT practitioners, I find the need to frequently explain or justify the value of occupational therapy to organizations, colleagues from other disciplines, referral sources, and clients. I have found two strategies that seem to be the most effective. The first is to explain the specific value occupational therapy can provide to meeting the needs of the individual or organization in which I am addressing. The second is to provide specific information, preferably data from research or guidelines, that objectively demonstrates why OT services are indicated.
Due to reimbursement changes over the last couple of years, many OTs and OTAs are concerned about the limitations placed on treatment visits and treatment time. For some practitioners, they may find it difficult to get approval to extend services when they feel it is needed. I am so glad that the American Occupational Therapy Association (AOTA) and the American Physical Therapy Association (APTA) collaborated to study the impact of therapy frequencies and durations. The Therapy Outcomes in Post-Acute Care Settings (TOPS) study provides hard data that supports higher intensities of occupational therapy and physical therapy services.
There were 2 key findings that I feel are most relevant to my practice in home health:
Key Finding #2: "The intensity of occupational therapy and physical therapy services is associated with improved ability to perform everyday functional activities such as bathing, dressing and transferring".
Key Finding #3: "People who received the fewest minutes of physical therapy and occupational therapy were at the highest risk for hospital readmission across all post-acute care settings".
I think this information could be used to justify longer treatment durations and intensities for individuals with impairments in self care and mobility, maybe even in cases where progress may be slow. In my practice, this study is probably most relevant to my clients with chronic conditions. In my experience, many clients who have multiple hospital readmissions lack effective self-management of their chronic conditions. Working to develop new habits and routines to improve self-management often takes time, this study may justify the need for OT services for longer durations in these cases.
As OT practitioners we are often challenged to advocate and promote the value of our services. The challenge becomes easier when we have effective tools. Using data and information can ensure we are successful. As I have said before, "INFORMATION IS POWER".
You can find the Therapy Outcomes in Post-Acute Care Settings (TOPS) Study Chartbook at: https://www.aota.org/-/media/Corporate/Files/Advocacy/Federal/tops/TOPS-Study-Chartbook.pdf
You can find the Therapy Outcomes in Post-Acute Care Settings: Study Summary at: https://www.aota.org/-/media/Corporate/Files/Advocacy/Federal/tops/TOPS-Study-Summary.pdf
Therapy Outcomes in Post-Acute Care Settings, 2021 | www.aota.org/TOPS | www.apta.org
Written by: Kimberly Breeden, MS, OTR/L, Life Coach, Instructor, Founding Partner
Therapy Outcomes in Post-Acute Care Settings, 2021 | www.aota.org/TOPS | www.apta.org
Written by: Kimberly Breeden, MS, OTR/L, Life Coach, Instructor, Founding Partner
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