Leadership Final

Who are our customers/stakeholders who determines quality

Patients/clients

Families/caregivers

Payers/insurance companies

Administrators/supervisors

Referrals (e.g. MDs)

Regulators

Relationship of quality improvement, evidence-based practice and outcome studies

Research creates evidence-based objectives

research is used to determine if you meet your objectives

Outcome studies are...

reality-based with the purpose of improving client care

Outcome studies and OT

outcome studies enhance OT ability to participate in EBP and the profession's influence in health and healthcare funding- validates the impact and cost-benefit analysis of OT

Why are accreditation organizations important?

Outline the standards... places work, go to school, what standards need to be kept, can be helpful for consumers to understand quality of places they are going and getting services, etc

Patient safety

Efficient and effective patient care

Joint Commission Accredits...

General, psychiatric, children, and rehab hospitals

Healthcare networks'

Home care organizations

Nursing homes and other long term care facilities

Assisted living

Behavioral health care organizations

Ambulatory care providersClinical laboratories

Joint Commission accreditation is based on...

Compliance with consensus based national standards

Effective use of established clinical practice guidelines to manage and optimize care

Performance measurements and improvement activities

CARF stands for...

Commission on Accreditation of Rehabilitation Facilities

CARF accredits _____________

medical rehabilitation facilities

adult day services

assisted living

behavioral health

employment and community services

CARF is an...

international, private, not-for-profit organization that accredits human service oganizations

Accreditation outcomes CARF

o 3 years

o 1 year

o Provisional

o Non accreditation

Council on Quality and Leadership

Measures the quality of organizations for people with developmental disabilities, mental disabilities, or physical disabilities

ACOTE

Accreditation council for occupational therapy education

Determines accreditation of programs- initially granted for 5 years at initial visit and then 7 or 10 with subsequent visits

# units eval

1, regardless of length

0-7 min

0 units

8-22 mins

1 unit

23-37 mins

2 units

38-52 min

3 units

53-67 mins

4 units

Jimmo settlement

Therapy can be provided even if to only maintain function (prevent or slow decline)

What matters is whether skilled services are needed, not whether the client will improve

If you can document the NEED for services, then you can get them - opens OT up to many more people

"Skilled" therapy

"Skilled"= requires professional training, clinical judgment, and expertise of qualified OT

What is included in an environmental assessment for marketing

Community needs, demographics, competitors, funding, economic factors, and political/legal trends.

Differences between leaders and managers

A leader focuses on vision, inspiration, and long-term change; a manager focuses on organizing, process, and stability.

What is a transformational leadership style aimed at?

Inspiring change, fostering innovation, and developing both individuals and organizations.

What is a transactional leadership style focused on?

Structure, clear tasks, and rewards or penalties based on performance.

What is a democratic (participative) leadership style?

Team members help make decisions, promoting collaboration and engagement.

What is a laissez-faire leadership style?

Minimal supervision, with employees working independently, effective when staff are experienced.

What are the top challenges for leadership in the next decade?

Changing technology, client diversity, competition, and societal complexity.

What are the steps of the PDCA cycle?

Plan: identify what needs improvement; Do: implement the change; Check: analyze results; Act: adopt or adjust the improvement.

Why is personal leadership vision important?

It aligns your actions with your values, clarifies your purpose, and guides your leadership journey.

What is "self-work" in leadership?

Self-work is engaging in personal growth, staying open to learning, and being reflective about one's leadership style.

What does balancing inward and outward focus mean for a leader?

Inward focus means self-awareness; outward focus means understanding others, the environment, and context. Leaders need both.

What is a personal leadership vision?

It is a leader's vision of their desired future, guided by their values, aspirations, and sense of purpose.

What are the main components of quality management?

Quality management includes quality control, quality assurance, and quality improvement.

How many units would you bill for a 30 minute evaluation and 30 minutes of treatment?

Evaluation = 1 unit

30 minute treatments = 2 treatment unitsTotal = 3 units

How many units would you bill for a 40 minute evaluation and 20 minutes of treatment?

Evaluation = 1 unit

20 minutes treatment = 1 treatment unit

Total = 2 units

Who does the Jimmo Settlement apply to?

It applies to all diagnoses and to Medicare Part A, B, and C for anyone who requires skilled services to maintain function or slow deterioration.

Purpose and process of writing a job description

- Clarifies the role- what the position is and what the person is expected to accomplish

- Anchors evaluation: pinpoints areas for growth and focuses training where it is needed

- Sets the agreement- the shared understanding between supervisor and employee on expected results

a job description must communicate...

- Basic requirements- the non-negotiables to do the job

- Key qualifications- licensure, experience, credentials

- Desired performance attributes- what distinguishes great from adequate

What are performance appraisals?

structured job-related, collaborative, recurring

Purpose of job appraisals for employees

· Clarifies strengths and growth areas

· Supports development and skill building

· Can influence promotion, pay, advancement

purpose of job appraisals for employers

· Highlights where coaching or support is needed

· Confirms performance expectations are being met

Process of the productive evaluation

· Review strengths and weaknesses in a fair, balanced way

· Look for recurring patterns, not isolated examples

· Ground observations in objective information

· Reframe "weaknesses" as "areas for growth"

FMLA

Family medical leave act

What if FMLA

- Federal law allows up to 12 weeks of unpaid, job-protected leave per year for qualifying family and medical reasons

What CAN you ask when hiring for a job - under ADA

"can you perform the essential functions of this position with or without reasonable accommodations?"

What CAN'T you ask when hiring for a job - under ADA

disabilities, medical diagnoses, workers' comp history, pregnancy, mental health history

three steps in the job recruitment process

1. identify - define who you want

2. advertise

3. screen and interview

what do managers look for when hiring?

1. can this person learn?

2. do they seem genuine and trustworthy?

3. can they communicate professionally?

4. do they accept feedback?

5. would i enjoy working with them?

what counts as reasonable accommodations?

modified schedule

flexible break schedule

ergonomic work station

adaptive equipment

temporary light duty work

progressive discipline - firing

1. coaching

2. verbal feedback

3. written documentation

4. performance improvement plan

5. termination

SBI model feedback

S: situation. Describe the event. objective and specific

B: behavior. describe the observable behavior. actions, not personality

I: impact. explain the effect on patients, families, coworkers, or organization

resource: O*Net

help with job descriptions

job duties, knowledge, skills, physical demands

resource: JAN

guidance on specifc workforce accommodations for different conditions

What does NBCOT regulate?

Grants credentials (OTR or COTA) upon passing the national exam and oversees ongoing professional development standards.

Ensures you have baseline competency, its certification alone does not legally permit you to treat patients

What does the state regulate?

Holding an active license is the only way to legally practice in a specific jurisdiction. States typically require you to pass the NBCOT exam to get this license. Continuing ed

What does AOTA regulate?

Does not regulate, certify, or license anyone. Is a professional association that advocates for the field, provides continuing education, handles professional ethics guidelines for its members, and works to advance the profession at the state and federal levels

What infractions should be reported to NBCOT?

broader ethical issues... relating to "safe, proficient OT practice"

sexual misconduct, fraud, criminal convictions, client abuse, etc

NBCOT Scope

Has jurisdiction over all people certified by NBCOT OR eligible to take certification exam

What infractions should be reported to AOTA?

handles ethical infractions

infractions made by members of AOTA

professional misconduct

harm and neglect

billing and legal violations

documentations failures

What infractions should be reported to the state?

violations that occur within that state. failure to renew license, practice act violations, etc.

more related to STATE LAWS and PROFESSIONAL REGULATIONS

true or false: renewing your NBCOT is the same as renewing your license?

false

why do we have licensing requirements?

to protect clients

to protect you

to protect OT profession

examples of continuing competency

academic coursework

continuing ed

presentations

publications

research

peer review

work experience

advanced certification

OT practice act components

outlines scope of practice- what can and cannot do

licensing / renewal requirements

supervision of OTAs, Aides

disciplinary action

OT practice act

laws passed by state legislators that establish regulation for healthcare professionals

protects OT titles

defines scope

provides consumers and others with important information about minimum requirements for OTs

Continuous supervision

For development of skills

Type of supervision for aide/paraprofessional

continuous

close supervision

daily, direct contact at site of work

type of supervision for entry-level OT and OTAs

close

routine supervision

Direct contact at least every 2 weeks at site of work with interim supervision occurring by other methods

type of supervision for intermediate-level OT and OTA

routine

general supervision

At least monthly direct contact with supervision available at needed

general supervision is best for

Intermediate-level OT

High-proficiency OTA

minimal supervision

Only as needed basis

Maybe less than monthly

minimal supervision is best for

high-proficiency OT

Both OT and OTA students must be supervised by....

OT with at least 1 year experience after passing NBCOT

OT students can ONLY be supervised by _______

OT

OTA students can be supervised by

OT or OTA (If an OTA is supervising, it is assumed the OTA is also supervised by an OT)

· Determining needs for services

· Choosing assessments

· Creating goals

OT

· Defining problems

· initiate and direct eval process

· choose what to delegate to OTA

OT

· select, measure, and interpret outcomes related to client ability to engage in meaningful occupations

· overall responsibility of implementing intervention

· determine needs to continue services, modify, or discontinue

OT

- Do delegated tasks- some assessments, elements of interventions (OTAs mostly seen in intervention stage)

- Share observations with OT

- Can provide with discharge resources

OTA

- Can implement outcome measurements

- Collaborate with OT for developing intervention plan

- provide documentation to OT about client responses to and communication during intervention

OTA

type, frequency, style supervision of OTA depends on

state and practice setting

outcome studies

evaluates the end results of a specific healthcare practice, treatment, or intervention

measures real-world impact, including clinical effectiveness, cost, and the patient's overall quality of life

elements of a joint commission review

interviews

document reviews

site visits

oldest accreditation agency

joint commission

#1 reason for OT insurance claim denials

not having clear evidence for why need skilled OT services

moral distress

you know the right thing to do, but there is a barrier preventing you from doing something

moral dilemma

there are two courses of action that are morally defensible but cannot do both

step 1 of ethical decision making

Get the story straight—gather relevant information

step 2 of ethical decision making

Identify the type of ethical problem

step 3 of ethical decision making

Use ethical theories or approaches to analyze the problem

step 4 of ethical decision making

Explore the practical alternatives

step 5 of ethical decision making

Complete the action

step 6 ethical decision making

Evaluate the process and outcome

what is an ombudsperson?

help with resources

neutral third party

help people have conversations when they are uncertain about ethical dilemmas or pt care

ethics resources

know the code of ethics

be familiar with ethics language and use in practice

review specific workplace rules