Expectations of the Profession, Practice Settings, and Career Pathways

What are three questions that help us understand OT practice settings?

- who runs the facility?

- what level of care is provided?

- who do we serve?

What are the three administration types?

**EXAM Q** and know what they provide and examples

- Public

- Private nonprofit

- Private for-profit

What is included in a public administration and what are some examples?

- federal (VA) **KNOW THIS**

- state

--> Cherry Hospital, Caswell Developmental Center, N.C. Dept. of Adult Correction

- county

--> local health department

What is included in a private nonprofit administration and what are some examples?

- reinvests revenue into services

- ECU Health, Atrium Health, etc.

- uninsured, underinsured, big traumas

What is a private for-profit administration and what are some examples?

- generates profit while providing healthcare

- HCA Healthcare-owned hospitals

Ex: Mission Hospital (Asheville), Blue Ridge Regional Hospital

Levels of Care (visual from slides)

Where do occupational therapists work across the continuum of care/what are the traditional settings?

- Early Intervention

- School

- Acute

- Inpatient Rehab

- SNF/Subacute

- LTAC

- Home Health

- Outpatient

- Long-term care

Early Intervention:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: infants and toddlers (birth-3yrs) with developmental delays or disabilities

- OT focus: development through play, daily routines, feeding, sensory processing, caregiver coaching

- primary goal: support participation in everyday family routines

*usually in home*

School:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: students receiving special education services

- OT focus: classroom participation, handwriting, self-care at school (feeding, toileting, etc.), assistive technology, environmental modifications, equipment management

- primary goal: support access to the educational environment

Acute Care:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: medically unstable or newly hospitalized patients

- OT focus: early mobilization, ADLs (usually basic ADLs), functional cognition, discharge planning

- primary goal: prepare for the next level of care

--> usually only a few goals

--> helping with immediate needs and determining what patient needs next

--> medical stability

Inpatient Rehab:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: medically stable patients with potential for significant functional improvement

- OT focus: intensive rehabilitation, ADLs, functional mobility, caregiver education

- primary goal: return home safely

*CAN TOLERATE AT LEAST 3 HOURS OF THERAPY PER DAY (OT, PT, SLP)*

Subacute Rehab:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: medically stable adults who still need rehabilitation but cannot tolerate inpatient rehab

- generally older patients

- OT focus: ADLs and functional mobility, strength and endurance, fall prevention, caregiver education, safe discharge planning

- primary goal: improve function to maximize independence and return to the least restrictive environment whenever possible

*don't quite have tolerance for 3 hours yet*

*typically housed within a SNF*

Outpatient Rehab:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- clients: individuals who are medically stable and living in the community; seen after discharge from the hospital or referred by a provider

- OT focus: restore participation in meaningful occupations, improve strength, endurance, ROM, and functional use, address higher-level ADLs and iADLs, return to work, school driving, leisure, patient and caregiver education

- primary goal: help clients maximize independence and safely return to their desired roles and daily activities

Home Health:

- Who are the clients?

- What is the OT focus?

- What is the primary goal?

- naturalistic environment

- clients: individuals who are medically stable but have difficulty leaving home due to illness, injury, or disability; receiving skilled services in their home environment

- OT focus: ADLs and iADLs in the home, home safety and fall prevention, functional mobility and transfers, adaptive equipment recommendations, caregiver education

- primary goal: promote safe, independent participation in daily occupations while allowing the client to remain in their home

What are some non-traditional and emerging practice settings?

- sometimes insurance will not cover these because they are not as established/evidenced

- Community and Population Health:

--> homeless shelters

--> senior centers

--> community wellness programs

- Work and Industry:

--> industrial rehabilitation

--> ergonomics

--> return-to-work programs

- Justice and Public Safety:

--> correctional facilities

--> community re-entry programs

- Specialty Practice:

--> hospice and palliative care

--> aquatic therapy

--> hippotherapy/equine

--> driver rehabilitation

--> assistive technology

What are some reasons why you should join a professional organization?

- stay current with evidence and best practices

- build your professional network

- advocate for the profession

- access continuing education

- develop leadership opportunities

American Occupational Therapy Association (AOTA):

- primary role?

- what does it provide?

- why should students care?

- optional but encouraged organization in the U.S.

- primary role: advances the occupational therapy profession in the United States

- what it provides: practice resources, continuing education, evidence-based publications, advocacy for the profession, national conference (INSPIRE)

- why students should care: student membership, networking, career resources, NBCOT exam preparation resources

National Board for Certification in Occupational Therapy (NBCOT):

- primary role?

- responsibilities?

OTR/L

- how we get registered as OTs

- primary role: protects the public by certifying entry-level occupational therapy practitioners

- responsibilities: develops and administers the certification exam, maintains the certification requirements, promotes continuing competency

World Federation of Occupational Therapists (WFOT):

- primary role?

- focus?

- primary role: represents occupational therapy WORLDWIDE

- focus: international collaboration, education standards, global advocacy, international conferences

North Carolina Occupational Therapy Association (NCOTA):

- primary role?

- what does it provide?

- why should students care?

- primary role: supports and advances the OT profession in NC

- what it provides: professional networking, continuing education opportunities, annual conference, leadership and volunteer opportunities, state advocacy for the profession

- why students should care: connect with OT practitioners across NC, develop leadership skills, access professional development opportunities

North Carolina Board of Occupational Therapy (NCBOT):

- primary role?

- responsibilities?

OTR/L

- primary role: protects the public by regulating OT practice in NC

- responsibilities: issues and renews licenses, establishes rules for practice, investigates complaints, enforces the NC OT Practice Act

What are some career pathways that can be taken after graduation?

- clinical practice

- academia

- research

- leadership and administration

- program development

- advocacy and policy

- private practice

What are the possible pathways for us after our MSOTs?

- post-professional OTD

- PhD

- EdD

- MBA

What are some areas where you can get speciality certifications?

- Certified Hand Therapist (CHT)

- seating and mobility

- low vision rehabilitation

- lymphedema

- Certified Brain Injury Specialist (CBIS)

- Assistive Technology Professional (ATP)