Ron, 
In my humble opinion and based on my observation........
 
Here are 10 reasons why Occupation-based treatment isn't regularly provided in 
the SNF setting.  When it is not routinely  practiced, it is very difficult to 
explain  it to clients/patients.
 
1) Lack of consistent therapists for patients over treatment course leads to 
disjointed, sporatic interventions including hit and miss use Occupation of PRN 
and contract therapists.
 
3) Therapists who don't have an ongoing relationship or knowledge of the 
patient no offense intended people) doing what treatment they can with the 
patient for that session, that day.
 
4)  An overall lack of appropriate  (ie  short) staffing of a department.
 
3) High Productivity Standards leading to treatment of multiple patients at a 
time and overwhelming paper work.
 
4) Lack of equipment/space/materials needed for Occupation-based treatment
Busy-noisy-crowded clinics distracting environments discourage communication.
 
5) TIme needed to set-up, conduct,and clean up Occupation based interventions 
discourages effeciency.
 
6) Lack of time or enthusiasm for professional development, program building, 
team building, inservicing, energy and enthusiasm within a facility/ 
OTdepartment and culture of  "just seeing the patei getting through the day" 
attitude.
 
7) Inappropriately prolonging intervention sessions, and course of 
treatment with patients without  real skilled srvice or occupational 
interventions or without  progress in order  to satisfy Medicare RUGS 
categories, facility census numbers, and discharge dates. (as pressured by 
facility administrations).
 
8) Lack of creativity in providing occupation based treament and 
programming due to  therapist inexperience, lack of peer support, and 
mentorship, 
 
9) Lack of teamwork with other disciplines (PT, NSG).
 
10) Lack of professional involvement in local forums, state (FLOTA) and 
national organizations (AOTA) that provide support, resources, and professional 
advocacy.
 
By no means are these 10 easy to fix, nor are they excuses for complacency, but 
they do show that the working conditions of some therapists make it challenging 
to practice according to our funadmental philosophy. It takes positive energy, 
enthusiasm, and persistence to get back to Occupation based practices.
 
Thanks for listening
Brent Cheyne OTR/L
 


--- On Sat, 8/30/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:

From: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
Subject: OTlist Digest, Vol 41, Issue 19
To: [email protected]
Date: Saturday, August 30, 2008, 3:00 PM

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Today's Topics:

   1. Difficulty Articulating OT (Ron Carson)


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Message: 1
Date: Fri, 29 Aug 2008 18:06:32 -0400
From: Ron Carson <[EMAIL PROTECTED]>
Subject: [OTlist] Difficulty Articulating OT
To: OTlist <[email protected]>
Message-ID: <[EMAIL PROTECTED]>
Content-Type: text/plain; charset=windows-1252

Has  anyone  noticed that people have difficulty articulating the word
"occupational"?

Just today, a patient's husband had difficulty saying the word. And, I
noticed it with other people as well, even with health care providers.

Anyone else?

Ron
-- 
Ron Carson MHS, OT




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