Occupational therapy roles and responsibilities: Evidence from a pilot study of time use in an integrated health and social care trust

Abstract

Introduction: Occupational therapists undertake a broad spectrum of activities, yet no mechanism exists to record how working time is distributed across them. This is a hindrance to research, evaluation and evidence-based practice. Method: A new diary schedule was piloted by 151 qualified and assistant-grade practitioners working in multiple adult health and social care settings in an integrated NHS and social care trust in England. Time use relating to 37 occupational therapy tasks was recorded in 30 minute intervals for one week. Results: Almost 5000 hours of activity were recorded. For the average working week, 39% of time was spent in direct care with clients, 31% involved undertaking indirect casework such as liaison and administration, whilst a further 22% was in team/service activity. Only modest differences were observed between qualified and assistant-grade respondents, whilst occupational therapists in traditional social care roles spent significantly longer in liaison and administrative duties. Individual tasks capturing 'therapeutic activity' accounted for just 10% of practitioner time. Conclusion: The new diary tool is a viable data collection instrument to evaluate practice and the impact of service redesign. However, further work is needed to evaluate its measurement properties in more detail.

What factors influence time‐use of occupational therapists in the workplace? A systematic review

“…This finding was linked to more senior clinicians having more managerial and administrative responsibilities thereby reducing their time available to spend with patients (Evans, ; Hearn, Govier & Semciw, ; Simmons & Kuys, ). In addition, the clinicians’ choice of clinical caseload and its impact on the amount and type of occupational therapy provided was identified as another factor impacting on occupational therapist time‐use (Florian, Sheffer & Sachs, ; Smith, ; Wilberforce et al ., ), which helps to explain differences in time‐use patterns across the range of the included studies.…”

Occupational therapy roles and responsibilities: Development of a standardised measure of time use for staff working with adults in community settings

“…However, in choosing this time frame in this study considerations of the applicability of the diary measure to working lives and the convenience of completion were given priority in the design of the questionnaire to encourage a high response rate. The response rate of 62% in the pilot study suggested that this objective was achieved (Wilberforce et al, 2016). Further sub-division of activities might have increased the possibility of a lower response rate.…”

“…The diary schedule was piloted with a large sample of occupational therapy practitioners in the host trust (Wilberforce et al, 2016). Following this a narrative and pragmatic evaluation of the schedule was undertaken in three parts.…”

“…However, as practitioners noted, an assessment might include more than one of the items listed in the schedule. Therefore, in this study instructions which accompanied the diary schedule advised practitioners that when they undertook more than one activity in any interval they should enter the code relating to the one which took the most time (Wilberforce et al, 2016). The third methodological challenge related to the categorisation of activities in the analysis phase with, for example, activities combined to produce composite measures such as those associated with equipment and adaptations or multidisciplinary working.…”

“…Review of completed schedules. Overall, these were completed to a high standard by 151 respondents (Wilberforce et al, 2016). Particular attention was paid to activities recorded by a small number of respondents.…”