What frequent interventions are performed within the scope of an OT’s work in emergency departments?
In 2007, Veillette, Demers and Dutil published an article regarding the professional practice of occupational therapy in Quebec’s emergency departments. This article published in French is based on data collected using a postal questionnaire in 2003 to all members of the Ordre des ergothérapeutes du Québec. The results show that interventions in emergency departments consisted mainly in assessing various areas of functioning of persons who visit emergency departments, by focusing more on safety than autonomy. The respondents have confirmed the upsurge of occupational therapy in emergency departments and the need to develop better tools in order to address the problems met in their practice.
- Veillette, N., Demers, L. & Dutil, E. (2007). Description de la pratique des ergothérapeutes du Québec en salle d'urgence. Revue Canadienne d’Ergothérapie, 74(4), 348-358. http://dx.doi.org/10.2182/cjot.07.006
In 2013, the data gleaned thanks to the survey were updated as part of a master degree student’s project regarding the professional command of occupational therapy (Bellamare and Veillette, 2013). In response to the question regarding the roles they play in emergency departments, the majority of respondents (53%) stated that they are asked to play several overlapping roles, including roles related to assessment/consultation and assessment/intervention. Assessments make up the largest part of OTs work in emergency departments; OTs dedicate 85.82% of their time to assessments versus 14.77% to interventions.
- Bellemare, J. (2013). Description de la pratique des ergothérapeutes dans les départements d’urgence au Québec (M.Sc., Université du Québec à Trois-Rivières). Retrieved from http://depot-e.uqtr.ca/6883/
Again, according to the data from the 2013 survey (Bellemare and Veillette, 2013), respondents indicated that their means of intervention are varied.
In order of frequency, these are the recommendation of technical aids/therapeutic surfaces (for 28% of respondents), of providing guidance regarding the possibility of a return home (21%), of providing references to community services or other professionals (20%), of acting as a reference to other professionals (18%) and, to a lesser extent, of going on at-home visits (6%). “Other” responses (7%), under which are grouped interventions regarding education provided to personnel, telemonitoring or medical alert system and counselling regarding dysphagia.
A study by Cusick and al. (2009), which focuses on the practice of occupational therapy in Australian emergency departments, mentions a few types of interventions preferred by occupational therapists and that are common practice, according to the authors. These interventions involve prescribing technical aids, patient and close-relative education, partnerships with community services and visits to and adaptation of the home.
- Cusick, A., Johnson, L. & Bissett, M. (2009). Occupational therapy in emergency departments: Australian practice. Journal of Evaluation in Clinical Practice, 15(2), 257-265. http://dx.doi.org/10.1111/j.1365-2753.2008.00991.x
Armstrong (2010) also suggests that home visits play an important role in ensuring patient safety and in preventing readmissions, particularly when the main reason for consultation is a fall.
- Armstrong, C. (2010). Welcome to emergency medicine at the Royal Victoria Infirmary occupational therapy department. Retrieved from https://www.northumbria.ac.uk/static/5007/hces/rviemergmed_otpolo.pdf
Discharge planning is a key element and is one of the goals OTs pursue in the emergency department. Moats (2007) was interested in the way client-centered practice can be maintained during the discharge decision-making process. In light of the results, occupational therapists would use home visits as a way to help the decision-making process regarding discharge and make it easier to better understand the identity, roles and activities of clients. Also, home visits give both a holistic and realistic view of people’s functional status, the primary goal of pre-discharge home visits being to assess the safety of the environment.
- Moats, G. (2007). Discharge decision-making, enabling occupations, and client-centred practice. Canadian Journal of Occupational Therapy, 74(2), 91-101. http://dx.doi.org/10.1177/000841740707400203