The document discusses the development of occupational therapy pathways in London mental health trusts. It provides an overview of how OT leads have collaborated on a pathways project to develop standardized pathways across trusts and share best practices. The pathways are intended to clearly outline OT's role in a patient's care and support the use of evidence-based practice.
The document discusses the implementation of the Model of Human Occupation (MOHO) across multiple mental health trusts in the UK. It summarizes the following key points:
1) MOHO was chosen as the primary occupational therapy model due to its strong evidence base and standardized assessment tools. Infrastructure was established, including purchasing assessment tools and appointing a practice development occupational therapist.
2) Training workshops were held to educate therapists on applying MOHO in practice. Ongoing support mechanisms like clinical forums and the UK Centre for Outcomes Research & Evaluation were also provided.
3) Preliminary results showed over 500 MOHO assessments were completed across multiple services. Outcome measurement tools demonstrated improvements in clients' scores from
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Position Paper - a case for change - restrictive practices in mental healthJackie Crowe
This document provides recommendations for reducing and eliminating the use of seclusion, restraint, and restrictive practices in mental health services. It begins with definitions of seclusion, restraint, and restrictive practices. It then outlines 4 recommendations: 1) educate practitioners about alternative strategies; 2) agree on uniform definitions, targets, and reporting; 3) evaluate seclusion and restraint interventions; and 4) take a national approach to regulating seclusion and restraint. Background information is also provided on the incidence of seclusion and restraint, the complexity of issues around their use, and contributions from those with lived experience.
Final Progress Report on the Implementation of the Government‟s Response to the Special Commission of Inquiry into Acute Care Services in NSW Hospitals
October 2011
Building a portfolio of research findings for use by healthcare managers and ...HTAi Bilbao 2012
The document summarizes research conducted by the NIHR Health Services and Delivery Research programme on integrated care. It outlines several research projects funded through specific calls on integrated care between 2009-2011, including evaluations of case management initiatives, self-care support, and virtual wards. The research aims to identify healthcare managers' needs and generate evidence to improve services. The programme commissions applied health research to benefit the NHS based on both need and scientific merit.
Empowering and enabling charities to become trusted partners in the commissio...CharityComms
This document discusses Neurological Commissioning Support (NCS), a partnership between neurological charities that aims to empower charities and enable them to become trusted partners in the healthcare commissioning process. NCS provides consultancy services to health and social care commissioners, helping them design and redesign neurological services from a patient perspective. Case studies are presented showing how NCS has worked with commissioners in Cornwall and Surrey to map services, identify gaps, and prompt service improvements through data analysis and input from patients and professionals. Tools that NCS and voluntary organizations can provide to commissioners are also outlined.
An integrated approach: the transferability of the winning principles: sharin...NHS Improvement
An integrated approach: The transferability of the Winning Principles - Sharing the learning
Highlights the learning from the integrated test sites demonstrated that the principles are appropriate, relevant and transferable across the health and social care setting (Published July 2010).
The document discusses the implementation of the Model of Human Occupation (MOHO) across multiple mental health trusts in the UK. It summarizes the following key points:
1) MOHO was chosen as the primary occupational therapy model due to its strong evidence base and standardized assessment tools. Infrastructure was established, including purchasing assessment tools and appointing a practice development occupational therapist.
2) Training workshops were held to educate therapists on applying MOHO in practice. Ongoing support mechanisms like clinical forums and the UK Centre for Outcomes Research & Evaluation were also provided.
3) Preliminary results showed over 500 MOHO assessments were completed across multiple services. Outcome measurement tools demonstrated improvements in clients' scores from
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Position Paper - a case for change - restrictive practices in mental healthJackie Crowe
This document provides recommendations for reducing and eliminating the use of seclusion, restraint, and restrictive practices in mental health services. It begins with definitions of seclusion, restraint, and restrictive practices. It then outlines 4 recommendations: 1) educate practitioners about alternative strategies; 2) agree on uniform definitions, targets, and reporting; 3) evaluate seclusion and restraint interventions; and 4) take a national approach to regulating seclusion and restraint. Background information is also provided on the incidence of seclusion and restraint, the complexity of issues around their use, and contributions from those with lived experience.
Final Progress Report on the Implementation of the Government‟s Response to the Special Commission of Inquiry into Acute Care Services in NSW Hospitals
October 2011
Building a portfolio of research findings for use by healthcare managers and ...HTAi Bilbao 2012
The document summarizes research conducted by the NIHR Health Services and Delivery Research programme on integrated care. It outlines several research projects funded through specific calls on integrated care between 2009-2011, including evaluations of case management initiatives, self-care support, and virtual wards. The research aims to identify healthcare managers' needs and generate evidence to improve services. The programme commissions applied health research to benefit the NHS based on both need and scientific merit.
Empowering and enabling charities to become trusted partners in the commissio...CharityComms
This document discusses Neurological Commissioning Support (NCS), a partnership between neurological charities that aims to empower charities and enable them to become trusted partners in the healthcare commissioning process. NCS provides consultancy services to health and social care commissioners, helping them design and redesign neurological services from a patient perspective. Case studies are presented showing how NCS has worked with commissioners in Cornwall and Surrey to map services, identify gaps, and prompt service improvements through data analysis and input from patients and professionals. Tools that NCS and voluntary organizations can provide to commissioners are also outlined.
An integrated approach: the transferability of the winning principles: sharin...NHS Improvement
An integrated approach: The transferability of the Winning Principles - Sharing the learning
Highlights the learning from the integrated test sites demonstrated that the principles are appropriate, relevant and transferable across the health and social care setting (Published July 2010).
The document discusses unleashing dynamism in healthcare through integrated care. It describes Trafford's principles of integrated care, which focus on general practice as the locus of integration and involving social care. Clinical panels are discussed as a way to build relationships between primary and secondary care clinicians around patient care. Shared information and risk stratification of patients are presented as ways to support integrated care. Program management, communication, and addressing unscheduled care are also discussed as important elements of unleashing dynamism.
The document discusses implementing a strategic plan and performance measurement framework for an oncology program. It outlines establishing goals across five key dimensions: patient experience, clinical outcomes, financials, workforce, and system integration. A strategy map and balanced scorecard will be used to link goals, monitor progress, and enhance accountability. Regular performance reporting is needed to effectively manage processes and clinical/operational outcomes toward achieving excellence in cancer care.
Increasing Capacity for Meaningful EngagementCFHI-FCASS
The document discusses the Patient Engagement Projects (PEP) run by the Canadian Health Services Research Foundation (CHSRF). The PEP aims to 1) support development of patient engagement interventions to improve care, 2) enhance organizational capacity for patient engagement, and 3) increase knowledge of effective patient engagement strategies. It provides an overview of funded projects in 2010-2011 and the accompanying research to evaluate the projects. The document also discusses the need to close the gap between public engagement efforts and evaluating their effectiveness, and identifies patient engagement as a key lever for transforming healthcare systems.
Reshaping Care for Frail Older People in Scotland (WS34)Iriss
Falkirk Council – Reshaping Care for Frail Older People in Scotland: an outcomes focused evaluation of Telehealthcare in Falkirk. Contributor: Falkirk Council
Breakout 2.2 Commissioning Quality Care: Tools to support the commissioning p...NHS Improvement
Breakout 2.2 Commissioning Quality Care: Tools to support the commissioning process - Stephen Callaghan:
Principal Consultant, EQE Health.
Associate Consultant, Hope Street Centre.
Visiting Lecturer, University of Chester.
ANP, A&E University Hospitals Aintree
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
The document summarizes a talk about using design-led approaches in the NHS. It discusses how the NHS needs to transform to become more proactive and reduce costs by £15 billion in three years. It promotes using experience-based design to understand patients' and staff experiences better in order to identify opportunities for improvement. It provides examples of how experience-based design has led to improved services and cost savings. However, it notes that further capabilities still need to be developed and the impact of these methods needs to be measured more effectively.
This document discusses integrated care in Redbridge and the development of "polysystems" to improve care coordination and outcomes. It notes that Redbridge has many primary care providers, acute trusts, community providers and voluntary organizations. It proposes establishing several "polysystems", centered around GP practices, to function as local care delivery networks. These polysystems will promote population health, maximize independence for those with long-term needs, and improve acute care. They will be accountable for quality, access and costs and incentivized through aligned data and governance structures integrating primary, community and social care.
Rebecca Rosen: Integrated care: Accelerating pace of changeNuffield Trust
This document summarizes the aims and agenda for a workshop on accelerating integration in the NHS. The workshop aims to understand experiences with integration, present preliminary findings from Nuffield Trust work, and test those findings. The document reviews the long history and overlapping terminology around integration efforts in the UK. Evidence suggests payer-provider and provider integration can improve partnerships and capacity but has mixed effects on outcomes and costs. Networks show improved communication and care provision but little evidence of improved outcomes or reduced costs. Large organized medical groups in the US achieve higher quality and lower mortality. The document outlines assumptions that integration and integrated care are distinct, that current initiatives share common goals, and that progress requires adapting to organizational and local contexts.
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
This document outlines a project to develop national standards for meaningful involvement of service users and carers in health and care services. The project will be led by four partner organizations representing service users and carers. It aims to promote user-carer leadership, empowerment, and a vision of "nothing about us without us." By establishing standards and infrastructure, the project seeks to hardwire the direct experiences of users and carers into services to make them more responsive and cost-effective.
The document outlines an agenda and proposed next steps for the Information Exchange Workgroup. Key points include:
- Establishing two task forces focused on provider directories and public health transactions.
- Developing work plans and timelines for each task force to assess current issues, identify barriers, and make recommendations.
- Prioritizing initial areas like laboratory results, electronic prescribing, and patient summary exchange in relation to Meaningful Use.
- Coordinating activities with the HIT Policy Committee and ensuring alignment with other national health IT initiatives.
The workgroup aims to address specific challenges to information exchange and make policy recommendations to facilitate interoperability goals.
The document discusses meaningful use attestation and the process for receiving EHR incentive payments from the government. It outlines the three main steps: 1) registration in the EHR incentive program, 2) meeting meaningful use criteria using certified EHR technology, and 3) attesting that meaningful use criteria have been met. The document provides an overview of meaningful use goals and stages, EHR certification, eligibility for incentives, and the registration process.
Evidence in to practice through IMPACTE groupsAnne Gray
An outline of the IMPACTE model of journal clubs developed in Milton Keynes (UK) to support evidence based quality improvement of patient care in primary care.
Dr Jennifer Dixon: Commissioning and integrated careNuffield Trust
Commissioning and integrated care aims to improve coordination and alignment of incentives across health and social care. Integrated care organizations bring together providers from different sectors to provide seamless, patient-centered care. Emerging models in the UK include integrated primary, community, and secondary care organizations, as well as partnerships between health and social care providers. While evidence on outcomes is still limited, integrated models show promise for improving efficiency and care for patients with complex needs. National policies on payment systems, provider competition, and performance measurement will influence how integrated care continues to evolve in the UK.
Long term conditions like diabetes place a large burden on healthcare systems. A study in Yorkshire examined experiences providing care for long term conditions. It found that telehealth interventions can reduce hospital admissions, bed days, and costs while improving patients' quality of life. The Whole System Demonstrator Programme trial of telehealth and telecare in various UK regions showed a 45% reduction in mortality rates and 20% fewer emergency admissions among other benefits. Telehealth represents an opportunity to deliver more specialized care while reducing strain on hospitals and caregivers.
Sian Davies & Suzanne Robinson: Functions and mechanisms of priority settingNuffield Trust
Here are some suggestions for each scenario:
CCGs developing priority setting:
1. Engage all key stakeholders including public/patients
2. Establish transparent decision making processes
3. Build strong clinical leadership and ownership
4. Ensure sufficient resources and expertise are available
5. Collect and use high quality data and evidence
Department of Health developing national policies:
1. Provide guidance on minimum standards for priority setting processes
2. Support development of tools and methods for priority setting
3. Ensure adequate public health expertise is available locally
4. Allow flexibility for local decision making and innovation
5. Develop mechanisms for sharing best practices across areas
Actions for David Nicholson at the NHSCB:
1
This document outlines a proposal for establishing "PolySystems" as integrated local healthcare delivery networks in Redbridge. The PolySystems would:
1) Promote the health and wellbeing of local communities and maximize independence for those with long-term needs.
2) Improve services for non-critical acute care needs by reducing emergency admissions, wait times, and costs while improving patient satisfaction.
3) Be governed by a Clinical Commissioning Board and accountable for pathway development, budgets, and delivering high-quality cost-effective services.
This document discusses end of life care and provides definitions and guiding principles. It notes that end of life care aims to help those with advanced illnesses live as well as possible until death, through management of pain and other symptoms as well as psychological, social, spiritual and practical support for both patients and families. The document also outlines key policies and guidance related to end of life care in the UK, and discusses considerations around strategic planning, community engagement, and positioning an organization to provide high quality end of life care services.
General Outcomes and Measures for SNOMED OTs are interested in collaborating with clients, understanding them holistically, and facilitating independence and occupational performance. There are many available outcome measure tools, but no national framework, making it difficult to compare tools. The document discusses developing SNOMED subsets to code outcome measures routinely for secondary purposes like research and audit. It describes mapping outcome measures to the ICF and extracting outcome terms to create a draft national subset of outcomes recorded by OTs.
Conor Burke & Lucy Moore: Learning from an integrated care organisationNuffield Trust
This document discusses integrated care and the role of an integrated care organization called Whipps Cross University Hospital Trust. It notes that Whipps Cross aims to reduce outpatient appointments by 20% and elective procedures by 6% through decommissioning, while shifting 40% of A&E visits, 12% of electives, and 42% of outpatient appointments to prevent chronic conditions and improve acute quality. The document advocates changing systems rather than changing within systems to drive real improvement. It outlines PolySystems' goals of promoting community health, maximizing independence for those with long-term needs, and improving non-critical acute care. PolySystems aims to achieve improved outcomes using strategies like care navigation, improved coordination, and increased access
A large amount of specialist occupational therapy equipment was being returned to stores without being used due to a lack of expertise among store staff. An occupational therapy technical instructor was appointed to establish an equipment recycling service to maximize recycling. The project aimed to improve communication between occupational therapy and equipment services staff and reduce costs by improving the efficient use and recycling of returned specialist equipment.
This document describes an occupational therapy visual screening tool developed for use in a stroke unit. It provides a brief history of the tool's development and outlines the screening process. An audit of the tool found it identified visual problems in patients, guided appropriate referrals, and provided benefits to patients and occupational therapists by streamlining the screening and intervention process. Future plans include re-auditing the tool, expanding its education and use, and gathering feedback to further improve visual screening for stroke patients.
More Related Content
Similar to OT-Pathways-LLL event-London region-2009-Morley.pdf
The document discusses unleashing dynamism in healthcare through integrated care. It describes Trafford's principles of integrated care, which focus on general practice as the locus of integration and involving social care. Clinical panels are discussed as a way to build relationships between primary and secondary care clinicians around patient care. Shared information and risk stratification of patients are presented as ways to support integrated care. Program management, communication, and addressing unscheduled care are also discussed as important elements of unleashing dynamism.
The document discusses implementing a strategic plan and performance measurement framework for an oncology program. It outlines establishing goals across five key dimensions: patient experience, clinical outcomes, financials, workforce, and system integration. A strategy map and balanced scorecard will be used to link goals, monitor progress, and enhance accountability. Regular performance reporting is needed to effectively manage processes and clinical/operational outcomes toward achieving excellence in cancer care.
Increasing Capacity for Meaningful EngagementCFHI-FCASS
The document discusses the Patient Engagement Projects (PEP) run by the Canadian Health Services Research Foundation (CHSRF). The PEP aims to 1) support development of patient engagement interventions to improve care, 2) enhance organizational capacity for patient engagement, and 3) increase knowledge of effective patient engagement strategies. It provides an overview of funded projects in 2010-2011 and the accompanying research to evaluate the projects. The document also discusses the need to close the gap between public engagement efforts and evaluating their effectiveness, and identifies patient engagement as a key lever for transforming healthcare systems.
Reshaping Care for Frail Older People in Scotland (WS34)Iriss
Falkirk Council – Reshaping Care for Frail Older People in Scotland: an outcomes focused evaluation of Telehealthcare in Falkirk. Contributor: Falkirk Council
Breakout 2.2 Commissioning Quality Care: Tools to support the commissioning p...NHS Improvement
Breakout 2.2 Commissioning Quality Care: Tools to support the commissioning process - Stephen Callaghan:
Principal Consultant, EQE Health.
Associate Consultant, Hope Street Centre.
Visiting Lecturer, University of Chester.
ANP, A&E University Hospitals Aintree
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
The document summarizes a talk about using design-led approaches in the NHS. It discusses how the NHS needs to transform to become more proactive and reduce costs by £15 billion in three years. It promotes using experience-based design to understand patients' and staff experiences better in order to identify opportunities for improvement. It provides examples of how experience-based design has led to improved services and cost savings. However, it notes that further capabilities still need to be developed and the impact of these methods needs to be measured more effectively.
This document discusses integrated care in Redbridge and the development of "polysystems" to improve care coordination and outcomes. It notes that Redbridge has many primary care providers, acute trusts, community providers and voluntary organizations. It proposes establishing several "polysystems", centered around GP practices, to function as local care delivery networks. These polysystems will promote population health, maximize independence for those with long-term needs, and improve acute care. They will be accountable for quality, access and costs and incentivized through aligned data and governance structures integrating primary, community and social care.
Rebecca Rosen: Integrated care: Accelerating pace of changeNuffield Trust
This document summarizes the aims and agenda for a workshop on accelerating integration in the NHS. The workshop aims to understand experiences with integration, present preliminary findings from Nuffield Trust work, and test those findings. The document reviews the long history and overlapping terminology around integration efforts in the UK. Evidence suggests payer-provider and provider integration can improve partnerships and capacity but has mixed effects on outcomes and costs. Networks show improved communication and care provision but little evidence of improved outcomes or reduced costs. Large organized medical groups in the US achieve higher quality and lower mortality. The document outlines assumptions that integration and integrated care are distinct, that current initiatives share common goals, and that progress requires adapting to organizational and local contexts.
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
This document outlines a project to develop national standards for meaningful involvement of service users and carers in health and care services. The project will be led by four partner organizations representing service users and carers. It aims to promote user-carer leadership, empowerment, and a vision of "nothing about us without us." By establishing standards and infrastructure, the project seeks to hardwire the direct experiences of users and carers into services to make them more responsive and cost-effective.
The document outlines an agenda and proposed next steps for the Information Exchange Workgroup. Key points include:
- Establishing two task forces focused on provider directories and public health transactions.
- Developing work plans and timelines for each task force to assess current issues, identify barriers, and make recommendations.
- Prioritizing initial areas like laboratory results, electronic prescribing, and patient summary exchange in relation to Meaningful Use.
- Coordinating activities with the HIT Policy Committee and ensuring alignment with other national health IT initiatives.
The workgroup aims to address specific challenges to information exchange and make policy recommendations to facilitate interoperability goals.
The document discusses meaningful use attestation and the process for receiving EHR incentive payments from the government. It outlines the three main steps: 1) registration in the EHR incentive program, 2) meeting meaningful use criteria using certified EHR technology, and 3) attesting that meaningful use criteria have been met. The document provides an overview of meaningful use goals and stages, EHR certification, eligibility for incentives, and the registration process.
Evidence in to practice through IMPACTE groupsAnne Gray
An outline of the IMPACTE model of journal clubs developed in Milton Keynes (UK) to support evidence based quality improvement of patient care in primary care.
Dr Jennifer Dixon: Commissioning and integrated careNuffield Trust
Commissioning and integrated care aims to improve coordination and alignment of incentives across health and social care. Integrated care organizations bring together providers from different sectors to provide seamless, patient-centered care. Emerging models in the UK include integrated primary, community, and secondary care organizations, as well as partnerships between health and social care providers. While evidence on outcomes is still limited, integrated models show promise for improving efficiency and care for patients with complex needs. National policies on payment systems, provider competition, and performance measurement will influence how integrated care continues to evolve in the UK.
Long term conditions like diabetes place a large burden on healthcare systems. A study in Yorkshire examined experiences providing care for long term conditions. It found that telehealth interventions can reduce hospital admissions, bed days, and costs while improving patients' quality of life. The Whole System Demonstrator Programme trial of telehealth and telecare in various UK regions showed a 45% reduction in mortality rates and 20% fewer emergency admissions among other benefits. Telehealth represents an opportunity to deliver more specialized care while reducing strain on hospitals and caregivers.
Sian Davies & Suzanne Robinson: Functions and mechanisms of priority settingNuffield Trust
Here are some suggestions for each scenario:
CCGs developing priority setting:
1. Engage all key stakeholders including public/patients
2. Establish transparent decision making processes
3. Build strong clinical leadership and ownership
4. Ensure sufficient resources and expertise are available
5. Collect and use high quality data and evidence
Department of Health developing national policies:
1. Provide guidance on minimum standards for priority setting processes
2. Support development of tools and methods for priority setting
3. Ensure adequate public health expertise is available locally
4. Allow flexibility for local decision making and innovation
5. Develop mechanisms for sharing best practices across areas
Actions for David Nicholson at the NHSCB:
1
This document outlines a proposal for establishing "PolySystems" as integrated local healthcare delivery networks in Redbridge. The PolySystems would:
1) Promote the health and wellbeing of local communities and maximize independence for those with long-term needs.
2) Improve services for non-critical acute care needs by reducing emergency admissions, wait times, and costs while improving patient satisfaction.
3) Be governed by a Clinical Commissioning Board and accountable for pathway development, budgets, and delivering high-quality cost-effective services.
This document discusses end of life care and provides definitions and guiding principles. It notes that end of life care aims to help those with advanced illnesses live as well as possible until death, through management of pain and other symptoms as well as psychological, social, spiritual and practical support for both patients and families. The document also outlines key policies and guidance related to end of life care in the UK, and discusses considerations around strategic planning, community engagement, and positioning an organization to provide high quality end of life care services.
General Outcomes and Measures for SNOMED OTs are interested in collaborating with clients, understanding them holistically, and facilitating independence and occupational performance. There are many available outcome measure tools, but no national framework, making it difficult to compare tools. The document discusses developing SNOMED subsets to code outcome measures routinely for secondary purposes like research and audit. It describes mapping outcome measures to the ICF and extracting outcome terms to create a draft national subset of outcomes recorded by OTs.
Conor Burke & Lucy Moore: Learning from an integrated care organisationNuffield Trust
This document discusses integrated care and the role of an integrated care organization called Whipps Cross University Hospital Trust. It notes that Whipps Cross aims to reduce outpatient appointments by 20% and elective procedures by 6% through decommissioning, while shifting 40% of A&E visits, 12% of electives, and 42% of outpatient appointments to prevent chronic conditions and improve acute quality. The document advocates changing systems rather than changing within systems to drive real improvement. It outlines PolySystems' goals of promoting community health, maximizing independence for those with long-term needs, and improving non-critical acute care. PolySystems aims to achieve improved outcomes using strategies like care navigation, improved coordination, and increased access
Similar to OT-Pathways-LLL event-London region-2009-Morley.pdf (20)
A large amount of specialist occupational therapy equipment was being returned to stores without being used due to a lack of expertise among store staff. An occupational therapy technical instructor was appointed to establish an equipment recycling service to maximize recycling. The project aimed to improve communication between occupational therapy and equipment services staff and reduce costs by improving the efficient use and recycling of returned specialist equipment.
This document describes an occupational therapy visual screening tool developed for use in a stroke unit. It provides a brief history of the tool's development and outlines the screening process. An audit of the tool found it identified visual problems in patients, guided appropriate referrals, and provided benefits to patients and occupational therapists by streamlining the screening and intervention process. Future plans include re-auditing the tool, expanding its education and use, and gathering feedback to further improve visual screening for stroke patients.
The Home-Based Memory Rehabilitation Programme (for persons with mild Alzheimer’s disease and other dementias)
Mary McGrath, Advanced Clinical Specialist Occupational Therapist
Memory Clinic, Belfast City Hospital
The document discusses reablement, a service model that aims to help older people regain independence through daily living skills. It proposes establishing reablement teams in localities, each consisting of an occupational therapist and support workers. A pilot in two localities saw 82% of referrals accepted, and 59% of users discharged with no ongoing support needed after an average of 9.85 days. User feedback praised the staff as caring, supportive and helpful in regaining independence. The goal is to continue expanding reablement services across localities.
This document discusses occupational therapy initiatives to help people with disabilities and mental health issues find and maintain employment. It describes programs like Individual Placement Support that help people find competitive jobs and the Acute Care Job Clinic that assists those receiving mental health treatment to retain their current jobs. The document also discusses the benefits of work for recovery and presents case studies of individuals who found employment through these programs.
The slideshow introduces the British Association and College of Occupational Therapists (BAOT/COT), the professional body and trade union for occupational therapists in the UK. It discusses the structure and roles of the BAOT and COT. The BAOT/COT sets educational requirements, standards for practice, and provides resources like professional indemnity and journals for members. Members can influence the organization through councils, boards, committees, and special interest sections. The slideshow provides information on decision making processes and resources available to members.
This document provides information about Glasgow City Council's telecare services. It defines telecare as using telecommunications to remotely deliver care services to people in their homes. The basic telecare system includes an alarm unit and pendant that connects people to a response center for assistance. Additional devices monitor for specific risks like seizures or falls. Over 15,000 people have basic systems, while 3,000 have enhanced systems with movement sensors. The response center handles over 50,000 emergency calls per month. Social workers currently refer clients for extra devices. Future plans include staff training and new assessment tools.
This application form requests information for a lifelong learning grant such as the applicant's name, address, membership number, course details, cost, and relevance to practice. The applicant must explain how the course will benefit their clients, themselves, their employer, and the profession. They also must agree to write a minimum 500-word report for a regional newsletter within 4 weeks of the event.
Green care uses nature-based activities to promote health and well-being. It has a long history dating back to the 13th century where farms and gardens were used to care for those with mental illnesses. While hospital farms declined in the mid-20th century due to new drug treatments, various nature-based therapies have since developed and consolidated, including horticultural therapy, care farming, animal-assisted therapy, and ecotherapy. Green care provides benefits such as social inclusion, structure, identity and attention restoration through experiences with and activities in nature.
The document summarizes background information on healthcare inequalities faced by people with learning disabilities. It then outlines the work of the "Getting it Right" group, which aims to improve healthcare professionals' ability to treat people with learning disabilities. The group is made up of various organizations and produces guidance on communicating effectively with people with learning disabilities and understanding their rights. It concludes by mentioning an update on challenging behavior.
The document discusses guidance from the College of Occupational Therapists on the specialist learning disability occupational therapy role. It outlines principles for occupational therapy services for adults with learning disabilities, including that they should provide services related to how a learning disability affects occupational performance. It also discusses current issues like pressure on occupational therapists to provide both minor and major adaptations. Recommendations include developing close working relationships with mainstream services to facilitate access. The document also summarizes new Scottish guidance on equipment and adaptations provision and implications for occupational therapy, including identifying assessors and developing specialist roles in major adaptations.
The document discusses making healthcare more environmentally sustainable. It notes that climate change causes significant harm and economic losses worldwide. The document calls for occupational therapists to help make the NHS carbon footprint smaller by using more sustainable transportation, virtual meetings, and electronic records. Occupational therapists are also encouraged to support service users in environmentally-friendly activities like community gardening, composting, recycling, and using more sustainable modes of transportation.
This document summarizes a workshop on ICT services for people with learning disabilities presented by Chris Austin in Edinburgh, Scotland in September 2010. The workshop aimed to optimize independence, safety, choice, and participation in the community through ICT. It covered what ICT and related services are, including electronic care records, telecare, telehealth, and mobile health and social care. Future possibilities with ICT were discussed, such as integrated shared care records and routine outcomes measurement. The presenter suggested ways attendees could help advance these services through networking, piloting projects, research, and education.
Occupational therapists can help people with learning disabilities and their families in several key ways: (1) They should take a person-centered approach and focus on helping individuals achieve life outcomes like employment, housing, health, and social relationships. (2) Therapists should use their skills to assist people with learning disabilities in getting and participating in a full life. (3) It is important that therapists work to include everyone and remember those who are often excluded.
The document discusses the development of a new screening tool. It describes various professionals collaborating to generate ideas and criteria for personal skills and environmental supports. Draft versions were created and piloted, with feedback indicating it showed strengths and could be useful for therapy and tracking changes. Additional feedback was incorporated and links to occupational therapy theory were explored, with the goal of further development and testing of the screening tool.
Waiting list targets were introduced in the UK to improve access to healthcare services but have unintended consequences. Occupational therapists feel the targets limit the scope of their work and focus more on quantity over quality. A data collection tool is being developed to gather evidence on the impact of waiting list targets on occupational therapy services, such as larger caseloads and pressure to accept more referrals regardless of appropriateness. Feedback will be collected on the draft tool to finalize it for use by occupational therapists.
1) The document discusses how users feel about the appearance of assistive devices and its impact on their occupational participation and independence.
2) The literature review found that acceptance of assistive devices depends on incorporating them into one's self-image of independence rather than disability, and people feel stigmatized by devices that are very visible as disability aids.
3) More thoughtful design of assistive devices that considers both function and form is likely to lead to greater acceptance and increased occupational participation.
The document discusses developing an evidence-based research and development strategy for occupational therapists. It outlines that such a strategy is needed to meet government policy requirements, professional body requirements, and standards for registration. It recommends auditing current skills and interests, gaining support from trust leadership, and developing a strategy that specifies goals, methods, and required resources to improve research skills and conduct practice-based research.
The document outlines a 5-step process for evidence-based practice (EBP) in healthcare: 1) Asking an answerable question, 2) Searching for the best evidence, 3) Critically appraising the evidence, 4) Integrating the evidence with expertise and patient values, and 5) Evaluating performance. It then provides more details on forming answerable clinical questions using the PICO framework and on critically appraising evidence through activities like journal clubs. Journal clubs aim to help practitioners stay up to date on research, evaluate if practice needs to change, and involve interactive discussion of papers using appraisal tools to assess validity and usefulness.
The document discusses the use of mental practice in occupational therapy for stroke patients. It defines mental practice as the symbolic rehearsal of a physical activity through mental imagery without physical movement. The document reviews the types and effectiveness of mental imagery, and discusses several studies that show mental practice can improve affected limb function for stroke patients when combined with physical therapy. It concludes that mental practice is a promising rehabilitation approach but more research is still needed to establish guidelines and understand its long-term benefits.
More from Royal College of Occupational Therapists (20)
1. 11/17/2009
Occupational Therapy Pathways:
Overview of Presentation
the journey so far
• London Mental Health OTs Leads
programmes
• London adapted pathways project: the
journey so far
• Sharing Tips for Implementing
Dr Mary Morley, South West London and St Georges Mental Health NHS Trust
National Strategy for Occupational
Our journey so far… Therapy
• Individual Trusts with different systems and patchy OT Key messages:
involvement in IM&T agenda
• Phased introduction of RIO electronic healthcare record • Build pathways of care
across 7 London mental health Trusts that highlight what
• Pan-London network of OTs with a special interest of service users can expect
IM&T of their intervention
– Seven MoHO assessments built into RIO
– Shared format for ADL assessment reports
– OT Guide to RIO
• Pathways development network • Provide evidence for
• Collaborating on quality metrics and PROMS commissioners on the
• Representation on local, London-wide and national effectiveness of OT
working groups interventions
• ……..enthusiasts but not experts
COT (2006)
Definition of an
High quality care for all: NHS Next Stage
integrated care pathway
Review final report: 30 June 2008
“A multidisciplinary care plan that give
• Focus on the quality of detailed guidance for each stage in the
care; outcomes not inputs care of a patient with a specific condition,
over a given period of time”.
• Pathways of integrated (Riley,1998)
care
• Change will benefit An ICP is a document that describes a
patients and process within health and social care, and
• Be clinically driven and that collects variations between planned
locally led and actual care.
1
2. 11/17/2009
Benefits of ICP’s - Benefits of Therapy Pathways
a whole systems approach
• To provide a Occupational Therapy pathway of
• Aligned with government and professional guidelines care that is clear to all
• Gives a structure of care that is clear to all and • Supports the use of evidence based tools
underpinned by evidence-based practice
• A tool to analyse what works and what doesn’t
• Outcome–based approach to service delivery
• Promotes occupational therapy’s specific
• Provides a systematic approach to the review and contribution to mental health
improvements of practice
• A tool for teaching, supervision, induction and
• Makes the best use of resources staff satisfaction
Why this matters to service users A Collaborative Pathway Project
• In 2002, 2gether NHS Foundation Trust started to develop OT
pathways with UKCORE
• Includes guidance of best practice, evidence based, • The original pathway was developed by Jane Melton and Jonathan
Hill (2gether NHS Foundation Trust) and Dr. Kirsty Forsyth, (UK
client-centred care used in the everyday setting Centre for Outcomes, Research end Education (UKCORE)
• These were presented at national conferences 2005 and 2008
• Provides better information to service users about • In 2007, OT Leads of London Mental Health Trusts proposed a shared
their care, choices and expected outcomes project adapting the original pathways
• Dr. Mary Morley and Majvor Darnton (South West London & St.
• Provides a more consistent service to those with Georges Mental Health Trust) adapted the pathways on behalf of the
Professional Leads for Occupational Therapy in the London mental
highest levels of occupational need health Trusts.
• 8 occupational therapy pathways have been agreed
• Pathways launched at COT in September 2009
Occupational Therapy Pathways The adapted London OT
Pathways: Process
• Acute adult in-patient • Developed by experienced practitioners across the
• Community mental health nine Trusts who pooled expertise and evidence.
• Rehabilitation
• Forensic
• Older people • Use MOHO and COPM as evidence-based
• Employment theoretical models for outcomes.
• Child and Adolescent mental
health
• Learning disabilities • Include latest policy and guidance.
Melton, Forsyth, Hill, Morley (2009) Occupational Therapy Care Pathway
(adapted version), 2gether NHS Foundation Trust, UKCORE & London
Occupational Therapy Mental Health Professional Leads. (Unpublished).
• High level pathways for adapting into local
contexts.
NB Substance misuse pathway now being
written
• Used process mapping to design the occupational
therapy part of a wider MDT integrated pathway.
2
3. 11/17/2009
Format of
Occupational therapy pathway: a high- Occupational Therapy
level pathway linked to the mental health Pathways
pathway
• Made up of a document
– Background
Multidisciplinary team pathway – Instructions for use
– Narrative with symbols
and explanatory text
OT physical pathway – References
AND
• Flowchart
OT pathway
Mental Health Pathway
The Pathway Folder Getting Staff Engagement
• Copies for each OT • Remember this is a change management
Lead containing: process: To fail to plan is to plan to fail
• Handbook
• Use a phased approach
• Training Materials
• Occupational Therapy • Sell the positives
Pathways Narratives and
Flowchart • Perseverance
• References and resources • Don’t re-invent the wheel
• CD-Rom
– Pdf Versions of narratives • Share workload and ideas with other OT
and flowcharts leads
– Powerpoint presentations of
training materials
Making a difference… It capture’s a lot
about me and it
feels therapeutic to
read. (Service user) How did you get this
…to occupational therapists information? I’ve been
trying for ages
without success.
(Team member)
• I’m newly qualified OT and as the only OT on my That’s me
team I am extremely grateful to have these tools to down to a
tee…can I keep
help structure and guide my practice. (OT) it? (Service
user) I didn’t realise the
value of OT’s, It’s the
• Using the MoHO assessments gives me a clearer best report I’ve seen”
understanding of the clients on my caseload. (OT) (Team member)
If only all reports were as
specific as OT reports
the job of the
And to others……….. accommodation panel
would be so much easier
(Chair of Housing Panel)
3
4. 11/17/2009
Getting Going – where to start?
• Pilot the pathways and allow enough time Pilot Project
• Leadership with pathway experience as well as • Make yourself familiar with the concept of
clinical expertise pathways
• Secure senior stakeholder support, eg service
managers • Identify service
• Link up with other pathway work in the Trust • Set specific aims and objectives
• Remember implementing the pathways will change
what the OTs are doing or not doing • Select a small team to lead the pilot
• Training and introduction
Pilot and Review Occupational Therapy Variances -
• Discuss outcomes of pilot and actions
Start by setting goals for the expected
service….
• Redesign pathway to suit your service
• What are the occupational therapy
• Implementation
objectives?
• What are our standards?
• Variance tracking to monitor and review • How will these be measured?
• What variances might you expect?
• Focus on the long-term benefits and be
generous with ideas and solutions
Example of a variance tracking sheet:
Variance Recording :Complete when recommended interventions do not occur
Information gathered - Date
Activity
Code
Varian
ce
Code
Action to be Taken
(If you need to repeat an intervention then fill in
the blank rows in the appropriate time frame)
Sign
This should:
• provide us with the evidence that we have
met our objectives Variance Source Codes
• be easy to use Patient/carer codes
1.1 Patient unavailable
System codes
2.1 Date and time of
Other agencies
3.1 Accommodation not
1.2 Carer unavailable intervention changed available
• add value to our service users and/or .3 Patient refused
1.4 Carer refused
2.2 Awaiting consultation from others
2.3 Staff/service not available
3.2 Community support not
available
2.4 Lack of time 3.3 Day services not available
1.5Intervention inappropriate
service 1.6 Deterioration of mental state:
1.7 intervention inappropriate
2.5 Intervention
postponed/cancelled
3.4 Funding/benefits not
available
2.6 Information/results not 3.5 Transport not available
1.8 Improvement of mental state: available 3.6 Other (please state)
1.9 intervention inappropriate 2.7 Dept closed/room not
1.10 Patient refused due to poor available
motivation 2.8 appointment not
1.11 Intervention repeated due to available/delayed
lack of understanding or skill 1.12 2.9 Other (please state)
Other (please state)
4
5. 11/17/2009
With thanks to:
Next Steps
• London adapted pathways to be piloted in local services
• London adapted pathways will be included in Assessments Manual • Chairs and members of the work
to be published in next few months groups for each pathway
• Mental Health OTs engaging in London AHP Quality metrics and • Majvor Darnton, Pathway Project
lead – Occupational Therapy,
PROMS work SWLSTG
• OT pathways form an important building block in the OT mental • 2Gether NHS Foundation Trust
health PbR work and UKCORE who generously
shared their pathway
• PbR Core group has embarked on two-phase study in collaboration
• South West London & St
with Kielhofner (UIC) to develop ‘care pathways’ for the 21 PbR Georges Mental Health NHS
clusters: Trust who hosted and funded the
– Data analysis of MOHOST to identify occupational profiles for project
service users And the the London Leads for
Occupational Therapy in Mental
– Action research study to develop care pathways for the profiles Health Trusts for supported this
project (and the next!)
5