Daniel G. Craig; Current Occupational Therapy Publications in Home Health: A Scoping Review. Am J Occup Ther 2012;66(3):338-347. doi: 10.5014/ajot.2012.003566.
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PURPOSE. Recently, home health services have been a topic of increasing interest. Occupational therapy practice and utilization patterns in home care have not been the subject of recent research.
METHOD. I examined 65 publications addressing current occupational therapy practice in U.S. home health. Articles were analyzed to uncover factors influencing occupational therapy utilization and practice.
RESULTS. Results indicate that research has looked at a variety of typologies and efficacy measures for occupational therapy in home care. However, occupational therapy utilization and practice patterns in home health do not appear to be entirely consistent with research. I identify factors explaining this inconsistency and make research and practice recommendations.
CONCLUSION. Results suggest that system challenges limit the utilization and practice of occupational therapy to deliver expected outcomes in home health practice.
What is known from the existing literature regarding occupational therapy utilization and practice in home health, including
What types of articles and studies exist, and what is their general content?
What characterizes occupational therapy interventions and practice in home health?
What factors might be related to current use?
What gaps in knowledge exist, and what potential research and practice recommendations can be made?
Mention home care or home health services or use home health or home care as a key word,
Be applicable to rehabilitation practices under Medicare home health services, and
Include occupational therapy as a major focus.
Focused on community-based practice, outpatient therapy, prevention, or home visits conducted from an inpatient setting;
Concerned pediatric-, adolescent-, or psychiatric-only services;
Were a book, book review, or e-newsletter;
Provided psychometric data for an evaluation or assessment; or
Reported utilization without describing factors related to access or utilization.
Occupational therapy interventions in home health should fall into the basic domain of ADLs and IADLs; can use both a remediation and compensation approach; and should involve the patient, caregiver, and environment.
Occupational therapists working in or desiring to work in home health will likely need to provide education on the role and scope of occupational therapy to potential home health clients, physicians, home health agencies’ administration, and staff within home health agencies who complete the OASIS and serve as gatekeepers for service provision
Education regarding the role and scope of occupational therapy in home health might include ability to address ADLs and IADLs; ability to address OASIS outcomes in ADLs, IADLs, and other areas; ability to provide remediation and compensation interventions; ability to provide interventions to the patient, caregiver, and environment; and ability to collaborate with and provide supervision and education to home health aides.
Occupational therapists should be encouraged to seek work in home health settings to attempt to meet unmet client needs. Therapists working part-time or per diem could also seek to increase their hours.
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