Emerging OT Practice Areas: Exploring New Opportunities in Healthcare.

"The development and provision of a new type of OT service either in a traditional context or in an environment where services have not traditionally been available or well established".

Growth in health care expenditures: 1. Economic factors: inflation, health insurance 2. Societal demographics: growth in elderly 3. System factors: high cost of health care tech, defensive medicine Philosophical shifts: away from med model to alternative/community based Shifts towards wellness and prevention Medical and technological advances

Mental Health + Productive Aging - Driving and Low Vision interventions -- Screen and evaluate whether someone will be a safe driver - assitance for seniors who wish to continue driving Children and Youth - Psychosocial needs -- how children with autism in school feel about themselves. Behavioral and dealing with stress has been around for a while - autism, stress disorders and violence in school Health and Wellness - Ergonomics and injury prevention, elder wellness, environmental design, accessibility and home modifications, assistive devices, and entrepreneurship Work and Industry - Return to work for individual with disability, Ergonomics Rehabilitation, Disability, and Participation - Technology and assistive devices, consulting, and virtual reality.

Entrepreneurship - Includes exploration of market trends and creation of new products, services, or programs based on SWOT analysis and needs assessment data. - Business/private practice model with therapists are most familiar. Intrapreneurship - Harnessing the "resources within an organization to develop, improve, promote, extend, or enhance a new or existing program" - Ex. adding a driving rehab program/ lymphedema management service to an existing OT department in a rehab hospital creating something new Corporate Infusion - The introduction of new services or programs from outside a business in an effort to make them permanent features of the corporate entity Ex. Ergonomics consultation within manufacturing plants & injury prevention programs in work sites Organizational/Agency Infusion - Same concept as corporate infusion but the services/programs are typically infused into a nonprofit organization / government agency Ex. providing daily living skills services in homeless shelters, adapting leisure in community recreation programs and assessing accessibility for a housing development agency Policy Infusion - A social action strategy to mandate the provision of certain services or programs in sites through legislative or policy actions such as the IDEA and Ticket to Work initiatives

Management - why is this important? structure + strategic planning, the business would not survive if there wasn't good management. Innovators - someone that is doing something new + different Leadership:OT Code of ethics and Ethic Standards: beneficence, non-maleficence, autonomy, confidentiality, social justice, procedural justice, veracity - Model the way: identifies how colleagues should be treated and creates standards of excellence that are established as examples for others to follow - Inspire a shared vision: involves imagining the future and establishing a goal - Challenge the process: may conflict with what's already being done; process seek ways to change the routine and find creative ways to improve the program, services, or facility - Enabling others to act: including others in the process and working in partnerships, involves ensuring that the work environment is characterized by trust/dignity and that others are empowered to act - Encouraging the heart: encouraging others by acknowledging and celebrating their Entrepreneurship - Includes exploration of market trends and creation of new products, services, or programs based on SWOT analysis and needs assessment data.

Identifying opportunities - Brainstorming, needs assessment, SWOT analysis Doing strategic planning - going to go off on drive and motivation may sometime lose that. Poor planning keeps you on tract. - strategic plan includes the priorities of the OT/therapist, measurable goals, & a timeline for completion of activities. Organization type, evaluation Garnering resources Ex. revenue and corporate sponsorships, grants, donations Establishing Partnerships Ex. academic-community partnership

Hard Skills - Competencies that tend to be quantitative and measureable - punctual - Ex. data and spreadsheets to plan for daily staffing issues when OT practitioners are unable to work, coordinate services with other disciplines, monitor practitioners' use of the departments resources, including clinical supplies, equipment, & budget time for documentation; & review data that demonstrates measurable outcomes of the interventions Soft Skills - Competencies that are usually qualitative and not easy to measure. Usually more intuitive and to interpersonal communication. - customer service Ex. S&S of client's dx, their strengths/ weaknesses, their personal characteristics/ physical attributes that influence the tx, or course of recovery Role Delineation - Identification of tasks and duties to be performed by specific individuals on the basis of their credentials, duties, and skills.

Interactive Leaders: - Promote open communication and group consensus when making decisions. Transactional Leadership - Mentorship type leader; enables others to contribute to their own development and professional growth.

Scheduling Inventory Customer Service Departmental/Organizational Issues Departmental Structure Departmental Strategy Professional Development Leadership/Direction Accountability Marketing Policies and Procedures EBP decision making Team building Ethical dilemmas Departmental logistics Self confidence Good communication skills Good people skills Budgeting Staffing and Projections

The Human Factor "Human beings bring complexity to the context of occupational therapy." 1) Achievement- setting appropriate targets/goals - that bring a sense of accomplishment. If the target is set too high, the client/staff may fail to achieve the goal. If too easy, many not feel sense of accomplishment. Ex. grading an activity is similar to managers giving employees a series of targets to challenge them 2) Recognition- Verbal encouragement and constructive feedback when needed. 3) The work itself- challenging, interesting, meaningful. - Challenge provokes the client/employee, which can raise their arousal level 4) Responsibility- It may be empowering to employee. 5) Advancement- Achieving the goals of therapy & obtaining greater independence. Ex. receiving promotions, salary incentives, or new job prospects. Enforces feeling that one is learning & improving oneself/ one's quality of life

1) Planning- Developing a course of action Planning is done in the context of the daily routine, and decisions are made based on experience and available date. 2) Organizing- Mobilizing human resources and materials. 3) Coordinating- Integrating activities toward a common goal. 4) Controlling- Following up to make sure the goals are carried out. Ex. managing expenses and minimizing waste

Contemporary views on management agree that it is anything but systematic and routine Planning is done in the context of the daily routine, and decisions are made based on experience and available date. As a manager you need to: Know your personal strengths and weaknesses Know your employees strengths and weaknesses Develop transparency Instill trust:have to be fair and consistent, make sure you don't lower your standard. You have to train people to get to this standard. You cannot lower your standard. You will be hurting your department in the long run. Others will not work as hard too which is not good! Don't lower your standards to save someone!!! BE FAIR Promote collaboration/cooperation Provide team building experiences Enforce regulations and set policies Manage personal stress Maintain constant attention to detail

The United States continues to lag in its overall health systems performance Our professional well-being as OTs depends on the current status of our healthcare system.

"Requires most U.S. Citizens and legal immigrants to have healthcare coverage and will create a national exchange allowing people to shop for health insurance plans and provides subsides to low-income people" This reform has provisions which are promoting the placement of SNF/Inpatient residents into community settings. "Anytime there are government regulation changes in healthcare, we must be aware of how they will affect our profession in various settings" (AOTA/FOTA) Pay for performance

Emerging Practice Areas A) Board and Specialty Certifications: - Board- Gerontology, Mental Health, Pediatrics, Physical Rehabilitation. - Specialty- Driving and community mobility, environmental modifications, feeding, eating, and swallowing, and low vision. B) Growing Elderly Population C_) Increase in Chronic Population - Heart disease, Cancer, Diabetes, CVA, Cumulative trauma disorders D) Military: Recent prolonged wars; physical and mental health) E) Continuing emphasis on cost containment