Kevin T. Pritchard, Gail Fisher, Kay McGee Rudnitsky, Ricardo D. Ramirez; Policy and Payment Changes Create New Opportunities for Occupational Therapy in Acute Care. Am J Occup Ther 2019;73(2):7302109010. https://doi.org/10.5014/ajot.2018.732002
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© 2019 American Occupational Therapy Association
Importance: Changes in health care policy and payment over the past decade have resulted in a greater emphasis on cost effectiveness, quality outcomes, and the health care consumer’s experience. Payers’ response to the new policies and their expectations have created expanded opportunities for occupational therapy practitioners in health care overall but particularly in acute care hospitals.
Objective: The objective of this article is to empower occupational therapy directors, practitioners, educators, and students to be proactive in a rapidly changing acute care setting.
Evidence Review: Research on policy and payment changes since the passage of the Patient Protection and Affordable Care Act (Pub. L. 111-148) was synthesized with evidence related to occupational therapy practice and education.
Findings: Occupational therapy practitioners in acute care environments are experiencing expanded roles in optimizing patient readiness for safe community discharge, decreasing lengths of stay, and protecting them from hospital-acquired conditions.
Conclusions and Relevance: Policy and payment initiatives reward health care organizations for the added value occupational therapy practitioners bring to acute care teams.
What This Article Adds: This article details how occupational therapy practitioners can advance consumer satisfaction, outcomes, and efficiency in acute care, which can lead to increased recognition of the vital role that occupational therapy can play, thus leading to expanded opportunities.
Include occupational therapy practitioners in organizational committees addressing HACs, patient satisfaction, safe patient handling, and patient education.
Leverage current research demonstrating that occupational therapy reduces LOS or reduces readmissions as justification for staffing.
Move away from evaluating occupational therapy productivity solely on the basis of billable units by incorporating the following value-based metrics:
Academic fieldwork coordinators can promote optimal student matching with acute care sites by means of student self-selection on the basis of understanding acute care demands.
Fieldwork educators can orient students to the broader context regarding the changing role and value of occupational therapy in acute care.
Faculty can better prepare students for the changing acute care environment by incorporating case scenarios, site visits to ICUs and acute care settings, acute care occupational therapy practitioners as guest lecturers, and hands-on lab experiences that mimic acute care demands.
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