Practicing in an Established Primary Care Setting: Practical Tips and Considerations

Valasek, Samantha; Halle, Ashley

doi:10.7138/otp.2018.2315.f1

Cited by 2 publications

(2 citation statements)

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“…Our findings closely parallel previous literature on occupational therapy in primary care, most notably those of Donnelly et al (2013), who identified three overarching themes that contributed to the success of occupational therapy in primary care: providers developing an understanding of occupational therapy through education and the efforts of a physician champion; developing trust through colocation, shared EMR documentation, and interprofessional gatherings; and working in clinics with a culture of collaboration. Similarly, Valasek and Halle (2018) noted the importance of building relationships with physician champions and maintaining a collaborative approach to working on interprofessional teams. The elements contributing to the success of the LR-OT implementation are similar: Colocation and a shared EMR facilitated trust and collaboration with providers, whereas strong buy-in from clinic leadership and a wellestablished culture of interprofessional collaboration supported integration into the clinic workflow.…”

Section: Discussionmentioning

confidence: 99%

Addressing Diabetes in Primary Care: Hybrid Effectiveness–Implementation Study of Lifestyle Redesign® Occupational Therapy

Pyatak

King

Vigen

et al. 2019

The American Journal of Occupational Therapy

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Importance: Primary health care is rapidly developing as an occupational therapy practice area. Yet, to date, little evidence supports occupational therapy’s feasibility and efficacy in primary care settings. Objective: To report on the implementation and preliminary clinical outcomes of a Lifestyle Redesign® (LR)–occupational therapy (LR–OT) diabetes management intervention in a primary care clinic. Design: Patients were randomized to be offered LR–OT or to a no-contact comparison group (data not reported). We assessed implementation outcomes using mixed methods. Setting: Safety-net primary care clinic. Participants: Clinic providers and staff; English- or Spanish-speaking clinic patients ages 18–75 yr with diabetes and a current hemoglobin A1c (HbA1c) ≥ 9.0%. Intervention: Eight 1-hr individual sessions of LR–OT focused on diabetes management. Outcomes and Measures: Clinical and health behavior outcomes were assessed via electronic medical record (EMR) review and self-report surveys of patients receiving LR–OT at initial evaluation and discharge. We assessed implementation outcomes (acceptability, appropriateness, feasibility, fidelity, efficiency, and timeliness) using patient and staff surveys, interviews, focus groups, and observations. Results: Seventy-three patients were offered LR–OT: 51 completed one or more sessions, and 38 completed the program. Clinical outcomes among program completers indicate beneficial changes in HbA1c, diabetes self-care, and health status. Implementation challenges included a need for patient and staff education, securing adequate workspace, and establishing a referral process. Factors contributing to implementation success included strong buy-in from clinic leadership, colocation, and shared EMR documentation. Conclusions and Relevance: LR–OT is a feasible approach to enhancing service delivery and clinical outcomes in primary care. What This Article Adds: This study provides insight into factors that may create challenges or contribute to the success of implementing occupational therapy services within primary health care settings. In addition, this study provides preliminary evidence of occupational therapy’s effectiveness in improving clinical outcomes among ethnically diverse, low-income patients with diabetes in a safety-net primary care setting.

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Section: Discussionmentioning

confidence: 99%

Addressing Diabetes in Primary Care: Hybrid Effectiveness–Implementation Study of Lifestyle Redesign® Occupational Therapy

Pyatak

King

Vigen

et al. 2019

The American Journal of Occupational Therapy

View full text Add to dashboard Cite

show abstract

“…However, OT has not made significant progress expanding into the PC practice setting in the United States, and statistics to track the number of occupational therapists in the United States currently working in PC settings have not been produced (Trembath, Dahl-Popolizio, VanWinkle, & Milligan, 2019). Recent articles on OT in PC have offered resources to overcome some barriers, such as initiating a relationship with providers, educating providers regarding how occupational therapists can help their patients and their practices, modifying service provision in this setting, identifying funding sources, and providing other general strategies to foster change (Dahl-Popolizio, Muir, Davis, Wade, & Voysey, 2017;Sutherland, Moore, & Serlin, 2018;Valasek & Halle, 2018). The continued lack of understanding of how OT can contribute to the interprofessional team, and the resulting underuse of occupational therapists, is recognized throughout the literature on this topic (Dahl-Popolizio, Manson, Muir, & Rogers, 2016;Donnelly, Brenchley, Crawford, & Letts, 2013;Donnelly, Brenchley, Crawford, & Letts, 2014;Goldberg & Dugan, 2013;Mackenzie & Clemson, 2014).…”

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confidence: 99%