#OTalk – 25th June 2019 – The Sentinel Stroke National Audit Programme (SSNAP)

This week’s chat will be hosted by Louise Clark on behalf of the Royal College of Occupational Therapists Specialist Section for Neurological Practice @RCOT_NP here is what they had to say.

The Sentinel Stroke National Audit Programme (SSNAP) is the national dataset for stroke, widely used in England, Wales and Northern Ireland. The aim of the audit is to improve stroke care by measuring the structure and processes of stroke care against evidence based standards, such as the RCP guidelines for stroke (2016). For example this includes length of stay on a stroke unit, time to initial assessment by an occupational therapist, number of days OT delivered as a % of patient stay, number of minutes of therapy delivered on average per day, % of mood and cognition screens completed.

Data collection and entry is a significant feature in stroke unit care and Early Supported Discharge and for some is not always a welcome addition to our workload. However, there are positives to having such a huge database of information and comparisons against other services and national averages…..

The aim of this #OTalk is to explore those positives and think how can best use the information we collect and share ideas regarding meeting the 45 minute therapy target. We are joined for our talk by a member of the SSNAP team (………) and will share tools and signpost to resources/help regarding SSNAP.

This #OTalk has been hosted by Louise Clark from the stroke forum of the Royal College of Occupational Therapists specialist section for Neurological practice, in response to member feedback for topics. We hope you enjoy it and carry on the conversations in your workplace.

1. What do you think are the positives about SSNAP?

2. How do you use the data day to day to plan or improve patient care?

3. People have mixed feelings about the 45 minute therapy target. Why is it important (for patients, therapy services)?

4. What can you do to help meet your 45 minute target?

We would ask participants to look out for 3 short feedback questions posted with the transcript in the week following this #OTalk. We’d really appreciate your feedback in helping us evaluate and plan our sessions.

Future sessions from the stroke forum include;
24th September 2019 – Neglect (with Dr Ailie Turton)
26th November 2019 – Driving (with Paul Graham)
25th February 2020 – Vision (with the British and Irish Orthoptic Society- BIOS

Post Chat

Host: Louise Clark @RCOT_NP

Support on Otalk account: @otrach Rachel Booth

Online Transcript

#OTalk Healthcare Social Media Transcript June 25th 2019

The Numbers

1.105M Impressions
371 Tweets
31 Participants
297 Avg Tweets/Hour
12 Avg Tweets/Participant

#OTalk Participants

 

 

 

#OTalk – 21st May 2019 – Why aren’t all occupational therapists using standardised assessments routinely in practice?

This week’s #OTalk is on the topic of using standardised assessments routinely in practice and will be hosted by Dr Alison Laver-Fawcett (@alisonlaverfaw) from York St John University and Professor Diane Cox (@dianecox61) in the UK.

Here’s what Alison and Diane had to say:

In the early 1990s, as part of her PhD studies, Alison undertook a small survey of occupational therapists to explore their use of standardised and unstandardised assessments with people with neurological diagnoses. Results (n = 29 OTs) indicated that 93% of OT respondents were using informal observation of ADL, rather than standardised assessment, to assess for perceptual deficits (Laver, 1994). Back then there were a limited number of assessments developed by occupational therapists to choose from, but nearly 30 years later many occupational therapists have been involved with the development and evaluation of standardised assessments and we have evidence of their reliability, validity, sensitivity and clinical usefulness. A look through Asher’s (2014) annotated index of occupational therapy assessment tools reveals that occupational therapists now have 100s of tests to choose from, many of which have been developed by occupational therapists. Yet standardised assessments do not appear to be routinely used in all areas of occupational therapy practice. Why is that?

But nearly 20 years later, a survey of 109 Irish occupational therapists (Stapleton and McBreaty, 2009) still found that “..the consistency of [standardised assessment’ use tended to be low. The barriers to a more consistent use of standardised assessments and outcome measures included time restraints, the unsuitability of the available measures and a lack of sensitivity of the available measures to capture the effectiveness of occupational therapy’ (p55).

Whilst, a much larger study of 794 occupational therapists in the USA (Piernik-Yoder and Beck, 2012, p97) found that paediatric occupational therapists used standardised assessments more than colleagues working with adult patients. They reported: ‘With regard to administrating of standardized assessments, 393 (49.5%) respondents reported that the most common modification they make is to administer portions of standardized assessments, whereas 221 (27.9%) indicated they modify the instruction when administering standardized measures. However, 106 (13.4%) respondents specified they administer standardized measures out of the age range for which the measure is intended, and 66 (8.3%) reported they modify test materials.’

Often students returning from placement report that OTs are using an assessment that has been developed ‘in house’ in the service to fit the particular needs of the client group and the service. Or students report a standardised assessment was being using but in a modified form. Why do some OTs need to modify standardised assessments to make them useful in practice?

The College of Occupational Therapists’ (2017) in their ‘Position Statement: Occupational therapists’ use of standardized outcome measures’ encourages the use of standardised measures and states that ‘without accruing data from such sources the evidence-base to support the value of occupational therapy will fail to grow and the profession will be challenged to produce the robust information that will be essential to support future commissioning of occupational therapy services’ (p1.). So why aren’t all occupational therapists using standardised assessments routinely in practice?

Whether you are an experienced researcher, a clinician or a student please join us  for this #OTalk twitter chat and share your ideas and experience.

Suggested talking points and discussion questions to focus our chat:

1. What standardised assessments do your use – why do you choose to use this / these assessments?
2. How often do you use standardised assessments in practice?
3. Do you use standardised assessments routinely/regularly in your practice? Why or why not?
4. Did you go on any training to learn to administer any of the standardised assessment
you use – what test was the training for and what did the training comprise?
5. Do you make modifications to standardised assessments? If yes, is this to the
instructions or to the materials or you use a portion of the assessment, or administer it but don’t use the scoring?
6. What are the barriers to implementing standardised assessments in practice?
7. What factors support you to use standardised assessments regularly in your
practice?

References:
Asher, I E. (2014) Asher’s Occupational Therapy Assessment Tools: An Annotated Index 4 th ed. Bethesda: American Occupational Therapy Association.

Laver, A J. (1994) The Development of the Structured Observational Test of Function (SOTOF) PhD Thesis. Guildford, University of Surrey.

Piernik-Yoder, P., Beck A (2012) The Use of Standardized Assessments in Occupational Therapy in the United State. Occupational Therapy in Health Care, 26(2–3):97–108.

Stapleton, T., McBreaty, C. (2009) Use of Standardised Assessments and Outcome Measures among a Sample of Irish Occupational Therapists Working with Adults with Physical Disabilities. British Journal of Occupational Therapists, 72 (2) 55-64. Available from: https://journals.sagepub.com/doi/10.1177/030802260907200203 [accessed
17.2.2019]

POST CHAT

Host: Dr Alison Laver-Fawcett (@alisonlaverfaw) and Professor Diane Cox (@dianecox61)

OTalk Support: Rachel @otrach

Online Transcript

#OTalk Transcript May 21st 2019

The Numbers

1.456M Impressions
515 Tweets
42 Participants
412 Avg Tweets/Hour
12 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

 

#OTalk 30th April 2019 – The Equality Act 2010

equality-act-2010

The OTalk. Team thought it might a good for our CPD to explore and understand UK government, legislation and acts that might impacted on our practise or could inform our knowledge and understanding better,  over the year we will host a number of chat’s looking at these sort of documents,  Please do suggest some for future chats.  

This week Rachel Booth aka @otrach will host a chat, looking at the Equality Act 2010 which cover all areas of the UK however both Scotland and Wales has devotion rights and you can find out more about them at below links.  

I’m not an expert on the equality act but here is a brief over,  and below are the questions that I will be asking during the chat,  followed by a reflect log to fill in after the chat that you can use as some evidence you have engaged in some CDP.

The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society.

It replaced previous anti-discrimination laws with a single Act, making the law easier to understand and strengthening protection in some situations. It sets out the different ways in which it’s unlawful to treat someone.

It is against the law to discriminate against anyone because of:

  • age
  • gender reassignment
  • being married or in a civil partnership
  • being pregnant or on maternity leave
  • disability
  • race including colour, nationality, ethnic or national origin
  • religion or belief
  • sex
  • sexual orientation

These are called ‘protected characteristics’.

You’re protected from discrimination:

  • at work
  • in education
  • as a consumer
  • when using public services
  • when buying or renting property
  • as a member or guest of a private club or association

You’re legally protected from discrimination by the Equality Act 2010.

You’re also protected from discrimination if:

  • you’re associated with someone who has a protected characteristic, for example a family member or friend
  • you’ve complained about discrimination or supported someone else’s case.

You can do something voluntarily to help people with a protected characteristic. This is called ‘positive action’.

Taking positive action is legal if people with a protected characteristic:

  • are at a disadvantage
  • have particular needs
  • are under-represented in an activity or type of work

Disability and the Equity Act

You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.

  • ‘substantial’ is more than minor or trivial, eg it takes much longer than it usually would to complete a daily task like getting dressed
  • ‘long-term’ means 12 months or more, eg a breathing condition that develops as a result of a lung infection

There are special rules that apply to fluctuating conditions. eg arthritis.

Discrimination can come in one of the following forms:

  • direct discrimination – treating someone with a protected characteristic less favourably than others
  • indirect discrimination – putting rules or arrangements in place that apply to everyone, but that put someone with a protected characteristic at an unfair disadvantage
  • harassment – unwanted behaviour linked to a protected characteristic that violates someone’s dignity or creates an offensive environment for them
  • victimisation – treating someone unfairly because they’ve complained about discrimination or harassment

It can be lawful to have specific rules or arrangements in place, as long as they can be justified.

More detail at https://www.gov.uk/discrimination-your-rights/how-you-can-be-discriminated-against 

Questions during the chat 

  1. Before tonights chat what was you knowledge and understanding of the equity act?
  2. Ok over to you now all please ask one question to hopefully further your knowledge and understanding (everyone is welcome to answer)
  3. How if at all do you think this act impacts on or influences you’re clinical practise?
  4. Is there anything not cover by the act that you think should be considered for future updates of the act?
  5. How can we as occupational therapist influence future acts of parliament?
  6. Don’t forget to fill in the reflective log and do you have any suggestions for future chats about government Policy, legislation and or acts.

Link to Scottish act https://www.gov.scot/publications/scottish-governments-equality-duties/

Link to welsh act http://www.legislation.gov.uk/wsi/2011/1064/pdfs/wsi_20111064_mi.pdf

References 

 https://www.gov.uk/guidance/equality-act-2010-guidance#history

https://www.legislation.gov.uk/ukpga/2010/15/pdfs/ukpga_20100015_en.pdf

Equality Act 2010

POST CHAT

Host and OTalk Support: @otrach

Online Transcript

#OTalk Healthcare Social Media Transcript April 30th 2019

The Numbers

1.542M Impressions
227 Tweets
23 Participants
182 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

19th March 2019 #OTalk Gaming a meaningful occupation or a Damaging occupation?

This week our very own Rachel Booth @otrach will be hosting a chat looking at gaming a meaningful occupation or a Damaging occupation?

In 2018 the World Health Organisation added gaming disorder to its list of mental health conditions.

It stated

‘Gaming disorder is characterised by a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline.

Manifested by: 

  1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 
  2. 2) increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; 
  3. Continuation or escalation of gaming despite the occurrence of negative consequences. 

The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. 

The pattern of gaming behaviour may be continuous or episodic and recurrent. 

The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.’

What I thought was interesting about this definition was the use of occupation functioning.

So for this week’s #OTalk I through it might be interesting to explore the use of this occupation, as a treatment tool and how as an occupational therapist we might work with someone who is given this diagnosis.

Question 1 

Do you game? If so what type and why?

Question 2

How much time do you spend gaming in an average week? 

Question 3 

What are you thoughts on the world health organisation adding addiction to gaming as category of mental disorder?  

Question 4

Do you used gaming, as an intervention/treatment? If so how and why?

Question 5

How might an occupational therapist work with someone who’s gaming behaviour pattern is of sufficient severity to result in significant impairment occupational functioning?

Question 6 

On the whole do you feel Gaming is a meaningful or damaging occupation?

Ref 

https://www.who.int/features/qa/gaming-disorder/en/

POST CHAT

Host: Rachel Booth @OT_rach

Support on OTalk account: @Colourful_OT

Online Transcript

#OTalk Healthcare Social Media Transcript March 19th 2019

The Numbers

980.895K Impressions
323 Tweets
29 Participants
162 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

 

#OTalk 26th February 2019 – My Journey thus far towards Advanced Clinical Practice

This weeks chat will be hosted by Carol Rideout @carspring27 and Dr Stephanie Tempest @SetG75 

My Journey thus far towards Advanced Clinical Practice

I am at the top of Band 6 working in an NHS community neuro rehab team, qualified since 1998 and based in the UK.  My career journey thus far has been varied between acute and community settings, in Social Care and NHS.   Despite working part-time and being a parent, I still have an innate drive towards my own personal and professional development.  I have more recently started to question where can I go career wise and what career paths are open to me? 

I became more aware of Advanced Clinical Practitioners (ACPs) last year and began asking colleagues and Managers if this may be a route which I could pursue.  I was baffled to hear that this route was for Nurses and Physiotherapists mainly and not applicable to me working as an Occupational Therapist in community neuro. 

This stimulated me to research and read and I have since discovered that in the UK there is a clear framework and definition for the ACP role and it turns out that this is well within the scope of our profession.  I have since seen there are increasing ACP roles being advertised particularly in the NHS and have learnt that the ACP framework in the UK describes the level of practice required, to be able to prove clinicians are working at this level.

I am now in pursuit of an MSc in Advanced Clinical Practice in the hope that this will enable me to progress in all four areas as described in the Career Development Framework. I appreciate this may not lead me directly into an ACP job role, however, it may equip me to be able to demonstrate in due course, to Health Education England, that I am able to work at an ACP level.  This may lead to me being able to justify to my line managers why I can legitimately be called and recognised as an ACP.  I do not expect that this will be an easy journey and would like to gain support from the OT community to generate ideas how we can push forward this ACP agenda, how we can encourage each other to progress and climb our profession into new heights.

Questions:

  1. Please can you say hello and describe what setting you work in and your location.
  2. Can you describe / detail your interest in the ACP role thus far and your current level of practice?
  3. Can you describe how you have or how you might negotiate your way into an ACP role at work?
  4. Can you give any advice to someone who may want to progress into being an ACP?
  5. Let’s discuss what Occupational Therapists can bring to the ACP role?

Post Chat

Host: Dr Stephanie Tempest @SetG75 

Support on OTalk account: Rachel Booth @otrach

Online Transcript

#OTalk Healthcare Social Media Transcript February 26th 2019

862.184K Impressions
250 Tweets
23 Participants
81 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants


 

 

#OTalk 18th December 2018 – OT and Self Disclosure

This weeks #OTalk is on the topic of “self disclosure” and will be hosted by Solei Naisbett Jones @soleinj_.

Here is what Solei had to say…

Hi I’m Solei! I am a newly qualified occupational therapist currently working in neurology. After qualifying in 2017, I pursued postgraduate studies and completed my master’s degree in Advanced Professional Practice at the University of Plymouth. My research dissertation for my MSc explored therapist self-disclosure by occupational therapists. I am excited to host an #OTalk surrounding this topic area to share the findings of my research and hear about your experiences of self-disclosing to clients in the therapeutic relationship.

Therapist self-disclosure by occupational therapists has not yet been explored in depth within the profession. It can be defined as “non-immediate exposure of personal information regarding the therapist’s life outside the therapeutic encounter, such as emotional struggles, health status, past experiences, personal beliefs, values, or life circumstances” (Audet and Everall, 2010). It has been debated that therapist self-disclosure can impede therapy, creating role confusion, client uncertainty and therapist fear of client judgment (Moore and Jenkins, 2012). Despite this, it is also suggested that self-disclosure can bring therapeutic benefits by facilitating rapport through showing trust, genuineness and honesty on the therapist’s part (Audet and Everall, 2010).

As a person-centred profession which honours the importance of emotional sharing, rapport building, collaboration and partnership (Taylor, 2008), therapists’ interaction and communication with their clients is highly valued within occupational therapy (Boyt-Schell, Scaffa and Cohn, 2014). As occupational therapists, one of our core skills is our therapeutic use of self, a valuable tool in which we make a conscious effort to control our responses to enable client comfort and reassurance (Taylor, 2008). Arguably, therapist self-disclosure is a key component of the therapeutic use of self. As occupational therapists, we have a responsibility to maintain professional boundaries of the therapeutic relationship (Royal College of Occupational Therapists (RCOT, 2015). However, the Health and Care Professions Council (HCPC, 2017) also indicate that as occupational therapists, we are required to work in partnership with clients, adopting an approach which motivates, involves and centres on the client. Ultimately, this #OTalk will explore and discuss the potential enhancing or damaging effect of self-disclosure by occupational therapists on the therapeutic relationship.

Questions:

  1. What do you consider to be “self-disclosure with a patient/client”?
  2. What leads you to share personal experiences with patients/clients? Do you disclose to patients/clients often?
  3. What do you consider the main benefits and potential issues to be when disclosing information to patients/clients?
  4. What conversations/discussions have you had with colleagues about self-disclosing to a patient/client in practice?
  5. Do you think guidance surrounding therapist disclosure of personal information to patients/clients would be helpful for occupational therapists? What should the guidance address/include?

References:

Audet, C, D. and Everall, R, D. (2010). ‘Therapist self-disclosure and the therapeutic relationship: a phenomenological study from the client perspective’. British Journal of Guidance and Counselling.38(3), pp. 327-342.

Boyt-Schell, B, A., Scaffa, M, E., Gillen, G., and Cohn,, E, S. (2014). ‘Contemporary Occupational Therapy Practice’ in Boyt-Schell, B, A., Scaffa, M, E., Gillen, G., and Cohn, E, S. Willard and Spackman’s Occupational Therapy Twelfth Edition. Philadelphia: Lippincott Williams and Wilkins, pp. 47-58.

Health and Care Professions Council (2017). Standards of conduct, performance and Ethics. London: HCPC.

Moore, J. and Jenkins, P. (2012). ”Coming out’ in therapy? Perceived risks and benefits of self-disclosure of sexual orientation by gay and lesbian therapists to straight clients’. Counselling and Psychotherapy Research. 12(4), pp. 308-315.

Royal College of Occupational Therapists. (2015). Code of Ethics and Professional Conduct.London: RCOT.

Post Chat

Host: @soleinj_

Support on the Otalk account: @otrach

Online Transcript #OTalk Healthcare Social Media Transcript December 18th 2018

#OTalk Healthcare Social Media Transcript December 18th 2018

The Numbers

1.469M Impressions
609 Tweets
51 Participants
487 Avg Tweets/Hour
12 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

#OTalk 18th September 2018 – Recognition of OT

This weeks #OTalk is on the topic of “Recognition of OT” and will be hosted by Jen Gash (@OTcoachUK).This chat is one in a series of chats being hosted in collaboration with the OT Show (@TheOTshow).

Here is what Jen has to say…

Ever since I became an occupational therapist around 25 years ago, there has been a constant narrative regarding the lack of recognition of the profession as a whole. Generally, I agree. Forgetting for now the poorly understood name of our profession, we are a small profession compared to other health care professions, rarely mentioned in the press (although this has definitely improved in the last couple of years) but there continues to be poor public awareness about what we do, a lack of acknowledgement regarding the importance of people’s occupational needs and a lack of occupational therapists in positions of leadership and influence.

People kinda just know what a nurse, physio, social worker or doctor is, don’t they and it’s so frustrating.

However, I believe that at this time more than ever before, occupational therapy needs to be recognised in numerous ways:

  • Recognition of what human occupation truly is, how central it is to human wellbeing and also to that of wider communities/societies – health is not merely achieved through a medical approach
  • Recognition that many of societies current difficulties could be alleviated through a grounded occupational approach
  • Recognition of the staggering work that occupational therapists continue to do to support health, social and education systems and that our impact as a profession could be magnified through more consultation opportunities and funding support.
  • Recognition of the trail blazers in our profession and the new frontiers they are exploring

This OTalk will explore the following questions in relation to “recognition” in occupational therapy:

  • What makes us (occupational therapists) feel we lack recognition at work and in broader society?
  • What sort of recognition would society value and make a real difference to our profession?
  • What examples do you all have, that demonstrate that OT is being recognised?
  • What other ways outside of the usual, might give occupational therapy the recognition it needs?

If you want to get some recognition for you, your staff or service, don’t forget to nominate people for this years OT Show Awards! Details here : https://www.theotshow.com/awards

POST CHAT

Chat Host; Jen Gash (@OTcoachUK).This chat is one in a series of chats being hosted in collaboration with the OT Show (@TheOTshow).

Chat Support; @otrach

Online Transcript

#OTalk Healthcare Social Media Transcript September 18th 2018

The Numbers

1.376M Impressions
453 Tweets
50 Participants
362 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants