Improving the standardisation, timeliness and efficiency of the occupational therapy admission process in an older adult inpatient service

BMJ Open Qual. 2023 Dec 14;12(4):e002514. doi: 10.1136/bmjoq-2023-002514.

Abstract

Occupational therapists (OTs) are at the forefront of providing recovery-oriented care for older people through timely assessments of patient's engagement in daily living activities among many other interventions. This aids a timely, safe and successful discharge from hospital.This project built on the foundations of previous work while considering the context and requirements of two older adult wards, the rates of admission and staff retention. The specific aim agreed was for 90% of patients admitted to the older adults' inpatient units to be assessed by the occupational therapy (OTY) team within days of admission by December 2022.The OTs worked in collaboration to initiate two tests of change with a total of five PDSA cycles.Our tests of change resulted in an increase of patients engaging in OTY initial assessments within seven days of admission from 47.65% (May to November 2021) to 78% (December 2021 to December 2022).Our team embarked on a quality improvement project to improve standardisation, efficiency and timeliness of the OTY process in an older adult inpatient service by using a pragmatic measure and tests of change evidenced in a previous study. This evidenced the generalisability of the findings of this study. While we were able to improve the timeliness of OTY initial assessments, we concluded that the overall impact on outcomes such as timely discharge was also dependent on other clinical and social factors.

Keywords: audit; clinical; improvement; occupational therapy; older adults; quality; sustainable development.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Hospitalization
  • Humans
  • Inpatients
  • Occupational Therapy* / methods
  • Patient Discharge