Leadership Final 2

SWOT analysis

strategic planning framework to evaluate a business

strengths

weakness

opportunity

threats

Strengths

internal and helpful

loyal customers, connections, etc

weakness

internal and harmful

limited budget

opportunity

external and helpful

emerging trends, growing need / demographics

threats

external and harmful

competition

environmental assessment for marketing

leaders v managers

styles of leadership

who are customers/stakeholders who determine quality

Patients/clients, family, caregivers, payers/insurance, administration/supervisors, referrals, regulators

quality management

Method for ensuring that all activities necessary to design, develop and implement a product or service are effective and efficient with respect to the system and its performance

components of quality management

quality control

quality assurance

quality improvement

quality control

ongoing effort to maintain the integrity of a process to MAINTAIN the reliability of achieving an outcome

quality assurance

planned or systematic actions necessary to provide enough confidence that a product or service will satisfy the given requirements for quality

detecting defects through testing and inspection / standardized procedures

quality improvement

purposeful change of a process to improve the reliability of achieving an outcome

plan do act check cycle

Plan: identify what needs improvement

Do: implement the change

Check: analyze results

Act: adopt or adjust the improvement

relationship of QI, EBP, and outcome studies

Outcome studies are "reality-based" with the purpose of improving client care

1. Match outcome studies with objectives

2. see if you are meeting objectives

3. if not look at QI strategies

4. update objectives

5. start over

joint commission

Oldest accrediting agency for ....

General, psychiatric, children, and rehab hospitalsHealthcare networks'Home care organizationsNursing homes and other long term care facilitiesAssisted livingBehavioral health care organizationsAmbulatory care providersClinical laboratories

joint commission accreditation is based on

1. Compliance with consensus based national standards

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

3. Performance measurement and improvement activities

process of joint commission

surveys the workplace, reviews docs and talks to leaders

survery info sent to joint commission

within 45 days they send recs

joint commission survey happens every ____ years

3 (with annual visits)

CARF

commission on accreditation of rehabilitation facilities

international, private, not-for-profit organization

CARF accredits

Adult day services

Assisted living

Behavioral health

Employment and community services

Medical rehabilitation

CARF process

Survey process

standards applied

if outcome of service is not achieved they must have a plan to address the deficit

CARF accreditation outcomes

3 year accreditation, 1 year, provisional, or no accreditation

ACOTE

accreditation for OT education

is affiliated with AOTA but it is its own independent body recognized by the US department of education and council for higher education

Assures programs value external evaluation and that program meets standards of professional field

ACOTE standards are reviewed formally every ___ years

5

ACOTE process

programs engage in self-study process

make review

receive report and make improvements

on site visit

ACOTE outcome

accreditation, probationary accreditation, accreditation withheld

first visits grants accreditation for 5 years and then subsequent visits can be 7-10 years

council on quality and leadership

Own organization from the joint commission in 1969

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

types of documentation

evaluation, re-evaluation, treatment, progress notes, discharge note

documentation must follow ....

both state and medicare guidelines

if they differ, follow the stricter one

skilled services

require professional training, clinical judgement, and expertise of a qualified OT

evaluation codes

1 code for any eval, no matter how long it is

3 codes based on level of complexity

there is ___ code for re-eval

one

treatment codes

billed on 15 min increments

0-7 mins

0 units

8-22 mins

1 unit

23-37 mins

2 units

38-52 mins

3 units

54-67 mins

4 units

jimmo settlement

law used to require progress to be made for services to be covered

but JIMMO eliminated the "improvement standard"

Therapy can now be provided to maintain function, to prevent or slow decline

MPPR

multiple procedure payment reduction

If you bill 2 units of the same code, then the second one will only be covered 50%

Paid more if you do lots of short sessions on different days

Therapists paid more if OT/PT/SLP are on different days

MIPS

merit-based incentive payments

Promotion or cuts based on "best practice"

Impacts solo practitioners, small practice, rural most

purpose of job description

Clarifies the role, anchors evaluation (pinpoints growth areas and focuses training), sets the agreement (on expected results)

job description must communicate

basic requirements, key qualifications, desired performance attributes

performance appraisals

Structured formal assessment over set period of time, measures clear and realistic standards, is collaborative and recurring at predetermined intervals

performance appraisals purpose for employees

Clarifies strengths, supports development and skill building, can influence promotion, pay and advancement

performance appraisals purpose for supervisors

Highlights where coaching or support is needed

Confirms performance expectations are being met

SBI model

situation, behavior, impact

FMLA

family medical leave act

covers 12 weeks of unpaid, job-protected leave per year

FMLA qualifying reasons

birth of child, care or newborn, placement of child through foster care / adoption, care for spouse/child/parent with serious health condition, own serious health condition

what you cannot ask about when hiring someone (bc of ADA)

disabilities, medical disgnosis, workers comp history, pregnancy, mental health history

what you can ask about when hiring

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

For medical exam and drug screening on conditional offer but only for ALL employees

reasonable accommodations when hiring

When appropriate, unless doing so creates an undue hardship for the organization

Ex: modified schedule, ergonomic workstation, adaptive equipment, flexible break schedule, temporary light duty

continuous supervision

Aide/paraprofessional

For development of skills

close supervision

Daily, direct contact at site of work

For entry level OT or OTA

routine supervision

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

Intermediate-level OT or OTA

general supervision

At least monthly direct contact and available as needed

Intermediate-high level OT ot high-proficiency OTA

minimal supervision

Only on an as needed basis, may be less than monthly

High-proficiency level OT

OT responsibilities

Responsible for all aspects of OT service delivery

Must be directly involved in services during initial evaluation and regularly throughout treatment

Does intervention planning, implementation and review

Can determine responsibility of OTA in outcome evaluation but must be directly involved / responsible for selecting, measuring, and interpreting outcomes that are related to the client's ability to engage in occupations

OTA responsibilities

Can administer OT services under the supervision of/in partnership with the OT

OTA contributes to the evaluation process by implementing delegated assessments and providing verbal and written reports of observations and client capacities to the OT

Must be knowledgeable about interventions and outcomes

role of OT or rehab aide

they handle non-client tasks like sanitizing equipment, managing supply inventory, escorting patients, and taking care of scheduling or clerical duties to ensure smooth clinic operations

creating a safe, functional environment so therapists can focus on skilled, hands-on care

supervision of students

Both OT and OTA students MUST be supervised by OT practitioners with at least one year of experience (beyond passing the NBCOT exam)

OT students can ONLY be supervised by an OT

OTA can be supervised by OT or OTA

state regulation

Protect consumers from unscrupulous practitioners

Setting standards, coverage and reimbursement, funding for higher education, awarding research grants

Scope of OT and OTA under supervision

supervises license

Liscensure

Ensures patient protection, particularly in the investigation and resolution of consumer complaints involving fraudulent or negligent delivery of OT services

requires passing NBCOT and continuing education

monitored by the state

practice act

What you can and cannot do per state (scope)

Laws passed by the state legislators that establish regulations for healthcare professionals

components of practice act

Requirements for licensure or other forms of regulation

License renewal requirements

Supervision of OTAs, Aides and Limited permit holders

Disciplinary Action

what does AOTA regulate

nothing

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 should be reported to NBCOT

broader ethical issues

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

NBCOT controls

certification from NBCOT and who can sit for the exam

what should be reported to AOTA

infractions made by members of AOTA

professional misconduct

harm and neglect

billing and legal violations

documentations failure

what should be reported to the state

violations to state laws or professional regulations

failure to renew license, practice act violations

renewing NBCOT and license are ....

not the same

NBCOT does not need to be renewed but license does

continuing competency

academic coursework

continuing ed

presentations

publications

research peer review

work experience

advanced certification