Occupational Therapy Program Student Theses, Dissertations and Capstones
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD) in Occupational Therapy
Copyright Statement
All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.
Department
College of Health Care Sciences – Occupational Therapy Department
First Advisor
Ferol Ludwig
Date of original Performance / Presentation
2016
Publication Date / Copyright Date
4-19-2016
Publisher
Nova Southeastern University
NSUWorks Citation
Helene Smith-Gabai. 2016. Occupational therapy discharge planning and recommendations in acute care: An action research study. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences – Occupational Therapy Department. (54)
https://nsuworks.nova.edu/hpd_ot_student_dissertations/54.
Abstract
In today’s health care environment of quick discharges and shortened hospital stays discharge planning has become increasingly important in acute care occupational therapy practice. Discharge planning is a complex process and an important aspect of patient care as poor discharge planning has been associated with poor patient outcomes and increased risk of adverse events and readmission. This study addressed the following research questions: (a) How do acute care occupational therapists describe their role in the discharge planning process? (b) What guides acute care occupational therapists discharge decisions and recommendations? (c) How do acute care occupational therapists define optimal discharge planning? and (d) What actions can acute care occupational therapists take to optimize the effectiveness of their discharge planning skills within the current health care system? Using an action research methodology, two groups of five occupational therapists met online to discuss acute care occupational therapy discharge planning practices, and actions that could be taken to strengthen their practice. Action plans generated, implemented, and evaluated focused on improving communication with discharge planners, language used in documentation, and incorporating the use of standardized assessments to assist with discharge planning. Schell’s ecological model of professional reasoning as the theoretical model underlying this study was used to examine factors that influence occupational therapy discharge decision making. Data were collected from audio chat transcripts, survey responses, and researcher notes, and analyzed using Stringer’s action research sequential data analysis and interpretation methodology. Five themes emerged including (a) the role of occupational therapy, (b) the complexity of discharge planning, (c) pragmatics of practice, (d) why don’t they pay attention, and (e) the importance of stakeholder communication. Participants felt that discharge planners were not reading occupational therapy documentation, occupational therapy consults were late so that occupational therapy discharge recommendations were just a formality, and physical therapy discharge recommendations had more weight than occupational therapy recommendations. Participants felt that if patients were discharged without benefit of occupational therapy recommendations they could be at increased risk for an adverse event and compromised safety. Good communication among stakeholders was seen as essential for optimal discharge planning.
Disciplines
Occupational Therapy
Keywords
Health and environmental sciences, Action research, Acute care, Discharge planning, Schell's ecological model of professional reasoning