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OT& OTA Role Delineation

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OT personnel
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four categories: OT: professional level OTA: technical level OT aide: on the job training OT/OTA students
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OT practitioner
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individuals certified to practice as either an OT or an OTA
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ACOTE
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Accreditation Council for Occupational Therapy Education (ACOTE) regulates all OT & OTA programs in the United States They review and revise the standards every 5 years During the accreditation process, ACOTE evaluates each program’s compliance with these standards As of 2010, there were 153 OT programs and 160 OTA programs in the US and Puerto Rico
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OTA
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associate AA/AS degree, 16 weeks of level 2 fieldwork
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OT
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MS/MA/MOT, 24 weeks of level 2 fieldwork
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PhD& EdD
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3- 5 years, disseration completion, is a research based degree
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OTD
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+3 years, clinical research project or practicum required, is a clinical or practice- based doctorate
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OT roles, identified by the profession
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-Practitioner (Direct client care) -Consumer Educator -Fieldwork educator in a practice setting -Consultant -Supervisor -Administrator in a practice setting -Academic fieldwork coordinator -Faculty -Academic program director -Researcher/scholar -Entrepreneur
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Level of Performance
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is based on attaining a higher skill level through work experience, education, and professional socialization.
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Role Delineation in Service Delivery
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Guided by the following entities: 1. AOTA & “Standards of Practice for Occupational Therapy”- defines minimum requirements for OT practitioners working in service delivery 2. State licensure laws- often legally define our practice and may delineate OT & OTA responsibilities related to role delineation, supervision, documentation, and advanced practice 3. Other regulatory agencies ie: Centers for Medicare and Medicaid Services, CMS, has developed regulations which supersede state/AOTA guidelines
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Standards of Practice for OT
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Standards are delineated into four areas: I. Professional standing and responsibility II. Screening, evaluation, and reevaluation III. Intervention IV. Outcomes
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Supervision
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Guided by: – AOTA: “Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services” – State Regulations (supervisory requirements vary considerably from state to state) – Federal Regulations – OT Code of Ethics – Policies of the workplace – Outside Accreditation bodies & Third-party payers
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Supervision more..
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– Collaborative relationship based on communication and trust – Cooperative process to establish, maintain, and/or elevate a level of competence and performance – Process aimed at ensuring safe and effective delivery of OT services – Relationship/process should foster professional development of all parties involved
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Levels of Supervision
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direct/ continuous> close> routine> general
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direct supervision
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supervising OT is on site and available to provide immediate assistance to the cilent or supervisee if needed
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close supervision
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direct and daily contact
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routine supervision
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direct contact at least every 2 weeks
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general supervision
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at least monthly face to face contact
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Supervision even more…
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– Is an ongoing process that changes with the setting and the individuals involved – Must know the regulatory requirements – Must understand each other’s level of competence, experience, and education – Should match the complexity of client needs, diversity of clients, skills of the OT/OTA, and type of practice setting – Supervisory contacts should be documented (ie: frequency of contact, method/type of supervision, content areas addressed, signature/credentials of individuals involved in the process)
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Service competency
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A useful mechanism by which it is determined that two people performing the same or equivalent procedures will obtain the same or equivalent results (Interrater reliability).
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Methods used to establish service competency
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– Independent scoring of standardized results – Observation – Videotaping – Co-treatment – Making sure that practitioners establish service competency for each procedure (is considered established for a procedure when the OT/OTA meet the acceptable standard of performance on three consecutive occasions)
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Supervision of the OT Aide
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– AKA..Restorative aides, service extenders, rehabilitation aides/technicians – OT ultimately responsible for the actions of the aide, even if the state law permits the OTA to supervise the aide – OT aides are not required to have any special training – typically done on-the-job by OT practitioners
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Non-client related tasks
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setup/cleanup of work area, clerical tasks, daily OT schedule
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Client-related tasks
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routine tasks for which the aide has demonstrated competency and is directly/continuously supervised These activities must have predictable outcomes, a stable situation (client and environment); client must have demonstrated prior ability to perform the task, and there must be a clearly established task routine and process
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Multidisciplinary
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multiple disciplines working together in the same setting, but they do not interact
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Transdisciplinary
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members share roles and functions; blurring of traditional practitioner roles
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Interdisciplinary
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common in health care today; team members maintain own professional roles, but interact and work together to solve problems and meet client needs; co-treatment often occurs
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Professional Development
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Organizing and managing one’s work experiences to add to one’s knowledge, motivation, perspectives, skills, and job performance
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How do practitioners meet this need for continuing competence?
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– The Standards for Continuing Competence (2010) established criteria to guide practitioners when examining their own competence – These standards assist practitioners in assessing current level of competence, developing capacity for the future, and documenting continuing competence – Continuing education activities/hours (often required to maintain state license; 36 PDUs are required every 3 years for renewal of certification through NBCOT) – Professional Development Tool (PDT)-developed by the AOTA to assist practitioners in the professional development process
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Specialty certifications
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Provided by AOTA for OTs and OTAs; must document 2000 hours of experience as a practitioner and 600 hours of service delivery in the certification area over 3 calendar years
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Board Certification
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offered by AOTA; specific to areas of practice; based on completion and peer review of a portfolio, professional development plan, and a rigorous self-assessment; must have 5000 hours of experience in the certification area over last 7 years, and 500 hours of service delivery in this area over last 5 years
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Other certifications
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based on passing an exam, evidence of experience, or both; established by organizations outside of our profession
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Continuing competence
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dynamic, multidimensional process in which the professional develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning skills and ethical reasoning skills necessary to perform their professional responsibilities.
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OT practitioners perform at one of the following three levels
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Entry level- responsible for professional activities related to the role Intermediate- increased responsibility; specialization in a particular area of practice) Advanced- expert/resource in the respective role