Final Exam (lectures 6-9)

interprofessional collaboration (IPC)

interprofessional education (IPE)

approach to enable effective collaboration & improve health outcomes where two or more professions learn about/from/with each other

interprofessional practice (IPP)

interprofessional team-based care

integrated care teams

ex: stroke teams, palliative care teams, primary care teams, behavioral health teams

decision making

D/C

discharge planning typically led by RNs, case managers, and SWs

D/C goals

OTs/COTAs

occupational therapists/certified occupational therapy assistants;

SLPs

speech & language pathologists;

PM&R physiatrist

physical medicine & rehab physiatrist;

habilitation

rehabilitation

modes of therapy

individual, concurrent, group, and co-treatment therapy

palliative care

hospice

PT

physical therapist;

PTA

physical therapist assistant; goal

PT Aide

physical therapy aide;

Under Medicare, a PT must ___ PTAs generally or directly.

supervise

general supervision

direct (onsite) supervision

4 important areas that PTs & PTAs need to know

1. state practice acts

2. professional & ethical documents

3. PTA education & scope of practice

4. payer regulations

PTA direction algorithm

The co-sign by the licensed PT demonsrates ___ and ___ supervision of the PTA.

ongoing; continuous

PTAs regulation

therapeutic communication

rapport

acceptance

clinical reasoning

.

ex: diagnostic, procedural, interactive, collaborative, predictive, ethical, reasoning about teaching, & narrative reasoning

interactive model of communication

sender/encode ← message & comms barriers → receiver/decoder

receptive component of communication

expressive component of communication

Mehrabian’s studies imply that communication is ___% body language/non-___.

55%; non-verbal

pt-centered care (LEARN)

L

E

A

R

N

8 principles of pt-centered care

1. respect for pt preferences (shared decision-making!)

2. coordination & integration of care

3. info & education

4. physical comfort

5. emotional support

6. involvement of family & friends

7. continuity & transition

8. access to care

4 principles of person-centered therapy

1. congruence

2. unconditional positive regard

3. genuineness

   1. empathetic understanding

empathy

active listening

10 skills of active listening

1. attending, acknowledging

2. restating, clarification

3. paraphrasing

4. clarifying, probing

5. reflecting

6. supporting

7. silence

8. interpreting

9. checking perceptions

10. summarizing, synthesizing

barriers to active listening

open-ended questions

close-ended questions

graded response questions

multiple choice questions

When asking questions, try to avoid “___?” bc pts can become defensive.

why

4 levels of communication

1. share vision

2. interpret

3. add to

4. convey data

cultural competence

cultural humility

5 R’s of cultural humility

reflection, respect, regard, relevance, resiliency

cultural safety

pt interviewing

IE

initial exam & evaluation;

3 stages of the pt interview

1. initiation/statement of purpose

2. development/exploration & organization of info, data, Hxs

   1. closure/q & a/ summary

types od pt Hx data

current condition, hx of present illness, chief complaint, past medical hx, past surgical hx, family hx, prior level of function, current level of function, prior tests/treatments, social/recreational hx, vocational hx, health habits, general heath status, pt goals

ECHOWs

E

C

H

O

W

chart review

review of medical record prior to clinical interview

general demographics

admitting diagnosis (IP)

primary & secondary diagnoses

current condition/hx of present illness (HxPI/HPI)

mechanism of injury

general health status

pain

symptom

sign

SOCRATES

S

O

C

R

A

T

E

S

red flags

yellow flags

sources to review for pt info prior to clinical interview

intake form, referral, chart review, legal documents (advance directives, informed consent), family members/caretakers, emergency contacts, interprofessional teams/team meetings

respectful communication do’s & don’ts

DO:

• speak directly to the person, not their companion

• use ordinary language

• ask how you can help

• respect privacy needs

DON’T:

• touch/pull/steer a person or their belongings w/o permission

• presume he person has assistance at home

• interrupt or speak over the person

types of documentation

IE, interim notes (reeval, reexam, daily/progress notes), exercise flow sheet, d/c summary, medicare forms, progress letter to referring practitioner, IEP (individualized education program), 1x only visits, copies of pt instructions, videos & photos

reassessment

reevaluation

SOAP notes

Subjective; part of examination hxs

Objective; part of examination T&M & systems review

Assessment; part of evaluation problem list & goals

Plan of Care; part of evaluation

goal writing (ABCDEs)

A

B

C

D

E

plan of care

IDEAL d/c planning

I

D

E

A

L

systemic/institutional racism

structural racism

fear avoidance behavior

assimilation

ethnocentrism

cultural pluralism

6 common microaggressions in healthcare settings

1. mistaken identity

2. mistaken relationships

3. fixed forms

4. entitled examiner

5. pervasice stereotypes

6. intersectionality

metacognition

reflective practice

skills needed for reflection

self awareness, description of events, critical analysis, synthesis/knowledge integration, evaulation/judgments of value

reflection in action

reflection on action

reflection for action

Schon’s model of reflective practice