#OTalk Research – Tuesday 5th September – Engaging occupational therapists in and with research

September’s #OTalk will feed into the Research and Development Review being undertaken by the Royal College of Occupational Therapists with the particular aim of considering how we encourage qualified occupational therapists to engage in and with research to boost the professions’ capacity for research.

The chat will be co-hosted by @TheRCOT and @JoWatson22. It will be supported by @preston_jenny from the #OTalk Research team.

The Royal College of Occupational Therapists has launched a substantial review of its research and development activity. This is no small task and will involve undertaking a bit of a ‘journey’ over the next 12-18 months, the outcome of which will be a revised RCOT Vision, Strategy and Action Plan for Research and Development. As you can imagine, there is a great deal to consider, and this is where we need your help.

We know that there is a lot of great research going on that is both undertaken by occupational therapists and informs occupational therapy practice, so there is a lot to celebrate as the image below suggests.
5.9.17
However, we also know that we still have a long way to go to develop a really strong evidence base to underpin the broad spread of our practice and robustly demonstrate the effectiveness of our interventions and the value that occupational therapy brings to the lives of individuals, groups and communities. One way to try to speed up the rate of progress is to increase the professions’ capacity for research, or the number of occupational therapists who are engaged in or with research. That’s what we’d like to chat with you about during tonight’s #OTalk.

The questions forming the basis of our discussion are:

  1. What does engaging in or with research mean to you?
  2. To what extent do you think engaging with research is, could or should be core to the practice of all occupational therapists?
  3. Research engagement takes many forms. What tangible things can you do to demonstrate involvement on a spectrum or range of levels?
  4. How receptive is the culture of your workplace to engagement with research?
  5. What would make the biggest difference to supporting and enabling more occupational therapists to engage with research at some level?

We are really looking to hearing all of your thoughts and ideas, which will be a very welcome contribution to the RCOT Research and Development Review. If you get a chance ahead of the #OTalk session, it would be really helpful if you could give some particular thought to the types of practical activities that you could do to engage in or with research. We’d really love to hear all of the creative ideas that you can come up with so that we can use as examples them to inspire others.

Thank you.

Post chat

Online Transcript

The Numbers
3.717M Impressions
961 Tweets
72 Participants
769 Avg Tweets/Hour
13 Avg Tweets/Participant

 

#OTalk Participants

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#OTalk 29th August 2017 – Assessing Toileting.

This weeks #Otalk is on the topic of “Assessing toileting” and will be hosted by Kate Sheehan (@TheOTService).

Here is what Kate had to say…

I have long been fascinated with toilets, how they are designed, manufactured and how we use them. Going to the toilet has been the butt of many a joke but no one person completes this activity the same way; we are influenced by our culture, our faith and from those who teach us to use them. So the key question this week is how do we assess this complex task?

Are we confident as therapists to really break down the task and work with our clients to make this a task that they can become independent at, or do we just skim over it as it can be an embracing problem to address?

I am hoping that this will be an opportunity to share in 140 characters or less, your thoughts and ideas. This topic is for everyone, regardless of area of practice, because we all need to empty our bowels and our physical and mental health depends on it.  

The objective of this chat is for participants to share their thoughts on how to assess toileting as a complex occupation and give consideration to:

  1. How do you assess toileting?
  2. Do we need to physically observe?
  3. How can we modify the technique?
  4. How can we influence designers to design toilets that work?

Post Chat

On line transcript

The Numbers
918.946K Impressions
238 Tweets
27 Participants
190 Avg Tweets/Hour
9 Avg Tweets/Participant

#OTalk Participants

#OTalk 22nd August 2017 – Occupational Therapy and Digital Care Records

This weeks #Otalk is on the topic of “Occupational Therapy and Digital Care Records – Help or Hinderance?” and will be hosted by Paul Sugarhood (@PaulSugarhood).

 Here is what Paul had to say…

I am an occupational therapist currently working in education and research at London South Bank University, having spent many years in clinical practice in the NHS in east London. One topic that colleagues often talked (perhaps complained?) about was clinical documentation: the amount of time it takes, various mixes of paper and digital records, and wondering whether much of what was documented was ever used for anything.

Digital care records (DCRs) have been positioned as essential in promoting quality, safety, standardization and integration of care, and reducing duplication, inefficiency and fragmentation (Department of Health, 2008, 2012). The National Information Board (NIB) is the senior advisory group charged with developing strategy and priorities for data and technology across the health and social care system. It has set the specific target that “all patient and care records will be digital, real-time and interoperable by 2020” (NIB, 2014).

This target is repeated in the Sustainability and Transformation Plans that aim to deliver the Five Year Forward View (NHS England, 2016). According to the quick guide for digital, success in 2020 will be demonstrated when:

Patient information is recorded once, digitally, at or close to the point of care…Information is digital (paper-free) and flows between primary, secondary and social care providers seamlessly…Patient information at the point of care is available digitally (irrespective of where it was recorded), on a secure, timely and accessible basis…[and] Transfers, referrals, bookings, orders, results, alerts, notices and clinical communications are passed digitally between organisations” (NHS England, 2016).

This ambitious vision is matched in occupational therapy in the publication Managing information: a 10-year strategic vision for occupational therapy informatics (COT, 2014). The vision emphasises the fundamental importance of DCRs as the underpinning of most information flows for service users. Recommendations are made for development of DCRs so they facilitate integrated and seamless recording of referrals, assessments, care planning, interventions, outcomes and discharges (COT, 2014).

However, there are indications of a significant gap between vision/policy and the real world of occupational therapy practice. A UK-wide survey identified that nearly half of occupational therapists do not have access to DCRs, and nearly one third have no regular access to computers at work (National Allied Health Professionals Informatics Strategy Taskforce 2014, cited in COT, 2015). Occupational therapists complain of duplication of effort and inaccessible data within and across organisations: “The…example given, in which a member of staff was rushing around recording information in multiple systems, is no doubt something which will resonate with many occupational therapists” (COTIM, 2016).

A systematic review by Greenhalgh et al. (2009) concluded “that even though secondary work (audit, research, billing) may be made more efficient [by DCRs], primary clinical work may be made less efficient.” I have attended multidisciplinary team meetings where we needed to log onto three different systems to access client records: the GP with the primary care system, the community health staff with a (different) community system, and the social worker with the Local Authority system. Even then, we did not have access to what happened at the local hospital, which used yet another system. The same client’s information recorded in 4 different DCRs!

Suggested discussion questions and talking points for this tweet chat are:

  • How do you use digital care records, and to what purposes?
  • Do digital care records reduce duplication and inefficiency? How?
  • What are the impacts of digital care records on communication and collaboration between health and social care professionals?
  • Do digital care records promote safety and standardization? How?
  • Are your work practices shaped by digital care records, or are you able to shape the records to match your practices?
  • How do you work around digital care records if/when they do not support your practice?

 

References

COT (2014) Managing information: a 10-year strategic vision for occupational therapy informatics. London: COT.

COT (2015) Managing information: implementation plan 2015-2025. London: COT.

COTIM (2016) Newsletter. Issue 205, 22 November 2016. Available at: https://www.cot.co.uk/ehealth-information-management/cotim-newsletter [Accessed 6 January 2017].

Department of Health (2008) The NHS informatics review report. London: Stationery Office.

Department of Health (2012) Digital strategy: leading the culture change in health and care. London: Stationery Office.

Greenhalgh, T., Potts, H., Wong, G., Bark, P., Swinglehurst, D. (2009) Tensions and paradoxes in electronic patient record research: a systematic review using the meta-narrative method. The Milbank Quarterly 87 (4), pp. 729-88.

National Information Board (2014) Personalised health and care 2020: using data and technology to transform outcomes for patients and citizens. London: Stationery Office.

NHS England (2016) Sustainability and transformation plans. Available at: https://www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/stp/ [Accessed 6 January 2017].

Post Chat

Online Transcript

The Numbers

775.690K Impressions
245 Tweets
27 Participants
196 Avg Tweets/Hour
9 Avg Tweets/Participant

#OTalk Participants

#OTalk 15th August 2017 – Stroke and Executive Dysfunction

This weeks #Otalk is on the topic of “Stroke and Executive Dysfunction” and will be hosted by Charlie Chung and members of the Stroke Forum committee, RCOT Neurological Specialist Section (@chungsongyau and @OTstrokeSSNP).

 Here is what they had to say…

 We are the Stroke Forum committee of the Specialist Section Neurological Practice and for our session, we wondered how case study work would look on OTalk.

The questions this week relate to Jane, a lady with stroke and executive dysfunction. We hope that this will be an opportunity to share ideas freely, but in 140 characters or less, of course! Even if your practice does not include working with people with stroke, executive dysfunction is experienced by many people with a range of conditions and we would love to hear from you, too.

Executive function (EF) is a series of inter-related cognitive processes that we need for responding to novel, difficult, complex or dangerous situations. Impairment of executive function (executive dysfunction (ED)) is a frequent consequence of stroke and often limits people’s ability to adapt to their new situation, reducing their participation in occupation.

 The Case Study

‘Jane is 72 years old and she was discharged home from the acute stroke unit following a 10 day admission with a left hemisphere partial anterior circulatory syndrome stroke. She experienced a right sided weakness and word finding difficulties. Both improved daily and at the time of her return home, she was walking distances of 50 metres with a stick and was able to participate in conversations with only occasional difficulties finding words. 

During the first two weeks at home, Jane received visits from the early supported discharge team who worked with her to establish a daily regimen of exercises and ensured that she was participating in her necessary activities of daily living (ADL). The service was discontinued when it was clear that Jane was independent with ADL.

All seemed okay over the next two months until a referral was received by the community rehabilitation team from Jane’s GP. Her husband had made an appointment which he had accompanied her to. He explained that although Jane had the ability, she was not completing ADL when he was not at home. She was leaving dishes unwashed and was often not washing and dressing. When out together, she avoided paying for items in shops and remained dependent on her husband to do this. Supermarket shopping was a particular challenge as Jane would put items in the trolley which were unrelated to their meal plan or on their list’

 The objective of this session is for participants to share their thoughts on how to work with Jane, and more information will be provided with each question.

  1. What do you understand about executive function?
  2. How has Jane’s executive function been affected by the stroke?
  3. What Occupational Therapy interventions would you suggest?
  4. What further knowledge about executive function do you feel you need?

Post Chat

online transcript

The Numbers

1.602M Impressions
643 Tweets
61 Participants
514 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants

#OTalk 8th August – Media Club: Preparing to Age In Place: TEDxYouthAlamitosBay

This weeks #Otalk is on the topic of “Aging in place” and will be hosted by Bill Wong (@BillWongOT).

Here is what Bill had to say…

Normally for media club sessions, we typically review media content produced by other people. However, this time it will be one produced by me! I am fine with whatever comments you might have for me (positive or negative) on this presentation.

When I did my first TEDx Talk in early 2015, I viewed it as an early career highlight at the time. Although I became aware that there have been people on that stage multiple times, I truly never thought I would be the first person in the occupational therapy profession to achieve this feat because I knew there would be many deserving occupational therapy students and practitioners who wish to go on there even once during their careers. After all, I humbly admit that I am neither the most accomplished nor the most competent occupational therapist out there.

My Ted Talk is on Aging in Place. When I was practicing this presentation initially, I realized I had not as much passion as my past autism presentations because I lacked self efficacy during my practices. I had to ask Mandy Chamberlin (@SeniorsFlourish) for fact checks before I submitted my draft reviews. Then, I told myself, “In order to make a great speech, I must own the presentation. The stories I have are great stories. But they won’t come alive if I don’t have the confidence to share”.

Fortunately, I was able to remember the process of making a TEDx speech from my first time. So, I was able to come up with 6 to 8 patient stories depending on the tone that the curator wanted me to portray about the nursing home environment. Initially, I went with a somber tone because I wanted the audience to understand the reality of what I am working with. However, when the curator wanted me to bring some positive spins to the reality, I was ready to accommodate what she wanted. Because of that, I only went through 2 minor revisions instead of 5 major ones from my first time.

To tell the truth, working in the nursing home setting in the US has taught me many life lessons. It also made me realize how great a forward thinker my late grandpa was when he chose the place my family and I now live in Los Angeles. After all, although my dad has developed some mobility issues since then, he still was able to participate in community occupations because of how close certain types of places in the community are (a mile or less away) relative to our home. Moreover, my parents have the flexibility to live downstairs if needed. To this day, I still don’t consider geriatrics and physical disabilities as my specialties in OT. However, I hope as you watch this presentation that we have to go beyond our comfort zones at times when we advocate for OT.

Post Chat

Online transcript

The Numbers

1.218 M Impressions
254 Tweets
23 Participants
203Avg Tweets/Hour
11Avg Tweets/Participant

#OTalk Participants