Abstract
Two OT students initiated services in a geriatric primary-care clinic, where they worked with an interprofessional team. To assess the team’s perceptions of OT services, three surveys were modified to include quantitative and qualitative questions. Results indicate that OT services were well-received and add to overall patient care and service delivery. This research supports OT in geriatric primary care.
Primary Author and Speaker: Pari Kumar
Additional Authors and Speakers: Hannah Sclarsky, Tracey Earland
The aging population is expected to increase the primary care workload by 29%, outnumbering the projected growth of practitioners working in primary care by approximately 22% (Bodenheimer & Pham, 2010). As the aging population expands, the prevalence of individuals living with one or more chronic health conditions is also expected to increase (Centers for Disease Control, 2018). Over the past several years, primary care practices have been transitioning towards a multispecialty approach, including health professionals such as nurse practitioners and physician assistants to meet the increase in patients scheduled each day (Bodenheimer & Pham, 2010). There is growing evidence that occupational therapy practitioners, with their distinct knowledge and skills in addressing physical, behavioral, and mental health issues across the lifespan, can optimize successful and cost-effective health outcomes within the primary care system (Dahl-Poplizio, et al., 2017). At this time, it is imperative for occupational therapists to identify their added-value and determine how services can best be utilized within primary care (Goldberg & Dugan, 2013).
In response to this need, two occupational therapy Doctoral students were placed in a geriatric primary care clinic working with health professionals such as physicians, medical assistants, nurse practitioners, pharmacists, and students of various disciplines. The goal of this placement was to conduct a cultural needs assessment and initiate evidence-based occupational therapy services. Over the course of eight months, occupational therapy services were provided to appropriate patients based on physician referral and chart review. Areas addressed included functional cognition, chronic disease management, and caregiver support through methods of in-person and telehealth sessions.
The Doctoral students sought out to understand the perceptions of the primary care team on the roles and services of occupational therapy in this geriatric clinic. A mixed-methods study design was implemented using three modified surveys: Modified Index of Interdisciplinary Collaboration, Attitudes Toward Health Care Teams, and A Phenomenological Study on the Perception of Occupational Therapist Practicing in the Emergency Department. Surveys were distributed to a convenience sample of health professionals in the geriatric clinic, yielding both quantitative and qualitative responses. The modified survey inquired about the experience of working on an interprofessional team, in addition to beliefs about occupational therapy services provided in this primary care clinic.
A total of six anonymous surveys were collected. Quantitative items were analyzed for frequencies. Majority (83.33%) of participants strongly agreed that the team approach enabled health professionals to meet the needs of patients and their caregivers. Nearly all (83.33%) respondents felt that the addition of occupational therapy services lead to outcomes that they could not have achieved alone. Qualitative survey items were analyzed for themes. Responses indicate that occupational therapists understand healthy behaviors, enhance the interprofessional team, increase ease of care coordination, and support patients, caregivers, and physicians.
This research demonstrates that occupational therapy services are well-received by the interprofessional team and are able to provide added-value to patient care. These findings add the unique perspective of an interprofessional team in support of the inclusion of occupational therapy in geriatric primary care.
Bodenheimer, T. & Pham, H. H. (2010). Primary care: current problems and proposed solutions. Health Affairs, 29(5). doi:10.1377/hlthaff.2010.0026
Centers for Disease Control and Prevention. (2018). Chronic diseases in America. Retrieved from https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
Dahl-Popolizio, S., Rogers, O., Muir, S. L., Carroll, J., & Manson, L. (2017). Interprofessional primary care: the value of occupational therapy. The Open Journal of Occupational Therapy, 5(3). doi:10.15453/2168-6408.1363
Goldberg, D. G., & Dugan, D. P. (2013). Review of the new models of primary care delivery. Retrieved from https://www.aota.org/∼/media/Corporate/Files/Secure/Advocacy/Health-Care-Reform/commissioned-report.PDF