Management vs. leadership: moving the relationship between managers and clinicians from transactional to transformational

     Holding a managerial position in a professional setting comes with a multitude of responsibilities. The skills required to successfully manage a group of professionals, large or small, are not skills that everyone possesses. With that being said, what constitutes a successful manager? What qualities make a manager the one who sticks out in your mind as someone who you looked to for guidance, or for whom you felt truly had your back? If you’re one who struggles to bring someone to mind, you’re not alone. This concept of a disconnect between management and staff has been a topic of discussion for decades. Research suggests that managers and practitioners have differing opinions about the performance of management, with management rating themselves significantly higher than their staff even though the only notable difference between the two groups is title (Brollier, 1985; Arroliga et al., 2014; Heard, 2014; Heard et al., 2018). The question to be posed then would be how can that gap be closed? Or at least lessened.

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Health management as an IADL

        The updated Florida Occupational Therapy Practice Act defines health management as “therapeutic services designed to develop, manage, and maintain health and wellness routines” (The Florida Legislature, 2022). The American Occupational Therapy Association also de- fines it as an instrumental activity of daily living (IADL) in the Occupational Therapy Practice Framework (American Occupational Therapy Association [AOTA], 2020). The goal of health management is to improve or maintain health to support participation in occupations. The categories of health and wellness can be broken down into the following categories (AOTA, 2022):

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Three important pathways towards telehealth integration: a closer look

Integration of telehealth services occurs within several notable pathways. These pathways include academia, clinical practice, and mHealth, which included Connected Health Devices (CHDs) or Wearable Digital Devices (WDDs). Virtual pathways interconnect and add value to the healthcare industry in diverse and useful ways. Conversely, they do not work well when intentional integration is not taken seriously. The academic environment is a good place for telehealth instruction, as this exposes future providers to value-based virtual care and expands access to their beneficiaries (Dy Aungst & Patel, 2020; Muntz et al., 2021). There are many health care professions that are purposefully incorporating telehealth instruction within their curricula (Dy Aungst & Patel, 2020; Muntz et al., 2021). This mindful integration was spurred from the need to embed instruction on telehealth within traditional practice models (Muntz et al., 2021). Similarly, occupational therapy (OT) programs were offered to instruct students on telehealth through ACOTE standard B.4.15 which was authorized in the summer of 2020 (Patterson et al., 2021). However, this educational standard does not explicitly outline how telehealth may be leveraged by academicians to enhance greater adoption. (Hui et al., 2021; Patterson et al., 2021). Telehealth’s integration within the academic setting is essential as it exposes occupational therapy students to didactic instruction, hands-on learning, and virtual simulation experiences that foster greater interoperability within the clinical arena (Posey et al., 2020).

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OT Pelvic Health CE offered by Region 9

Call to Action: Share Your Feedback with CMS

Call to Action: Share Your Feedback with CMS

OT practitioners, it’s not too late to make your voices heard by CMS!
 
As you may already be aware, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on its Medicare Physician Fee Schedule (MPFS) Proposed Rule for Calendar Year 2023. AOTA is in the process of finalizing a comment letter that will be submitted on behalf of organizational members, highlighting key areas of concern noted in the proposed rule and advocating for better access and reimbursement for occupational therapy services under Medicare Part B.
 
In this rule, CMS proposes a 4.4% decrease to the conversion factor and confirms continuation of the 15% payment cut for services delivered in whole or in part by an OTA. CMS proposes additional codes that may be delivered via telehealth after the COVID-19 public health emergency ends, but occupational therapy practitioners will only be able to access those codes for 151 days beyond the PHE since we are not considered permanent telehealth providers.
 
AOTA has been continually advocating on these issues and AOTA’s voice is strong, but we are stronger when the voices of our members are raised in support of the needed changes to keep our profession alive. 
 
We encourage members to share your personal story with CMS on how these cuts and policies are impacting your practice. This doesn’t have to be a formal comment letter—it can be a few sentences, a case example, or a paragraph on the struggles you face every day in delivering quality occupational therapy services. 
 
CMS needs to hear from you that continued cuts and lack of access to telehealth services after the public health emergency will have a direct impact on Medicare beneficiary access to timely, medically necessary occupational therapy services. 
 
Comments are due to CMS by September 6, 2022 at 11:59pm. We hope you’ll take a few moments to share your real-world experience with CMS.
 
Your advocacy efforts will make a difference!!!
Thank you for your membership!
FOTA
 

An evidence-based guide to combining interventions with sensory integration in pediatric practice: A book review

An evidence-based guide to combining interventions with sensory integration in pediatric practice: A book review

by: Gustavo Reinoso, Ph.D., OTR/L and Thomas J. Decker, Ed.D. OTD, OTR/L

Because of the complexity of the clients we assess and treat utilizing sensory integration, we often wonder about how we can best address a family’s needs by incorporating other approaches during our busy practices. The concept of combining and blending approaches is not new. In 1995, Blanche, Botticelli and Hallway published a textbook “Combining Neuro-Developmental Treatment and Sensory Integration principles: An Approach to Pediatric Practice.” The textbook was well-received among clinicians

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Wake up to the occupation of sleep: Its importance in the older adult

Wake up to the occupation of sleep: Its importance in the older adult

by: Anette Bullard, MEd, COTA/L and Anjali Parti, OTD, OTR/L 

WAKE UP TO THE OCCUPATION OF SLEEPEveryone has experienced having to power through the day after a night of not sleeping well with every aspect of the day feeling more challenging due to your lack of sleep. The National Institute of Health (2017) identifies sleep as one of the most important occupations for maintaining all aspects of health. In fact, the Centers for Disease Control and Prevention (2018) has recognized sleep deprivation as a public health problem with broad, negative effects on safe occupational performance. For the older adults the challenges brought on by age compounded with a lack of sleep can further decrease successful occupational performance. Many age-related changes tend to disturb patterns of sleep and the myth that older adults need less sleep is actually incorrect (Suni, 2022b). The older adult is confronted with additional sleep obstacles such as, chronic conditions, medications, diminished physical activity, and decreased cognitive exercise, all of which have all been associated with decreases in sleep satisfaction. The resulting downward spiral of poor sleep results in less successful occupational engagement. The Occupational Therapy Practice Framework includes ‘rest and sleep’ as an area of occupation and defining occupational therapy practitioners as qualified professionals to assist clients with the occupation of rest and sleep (American Occupational Therapy Association, 2020). This brief article seeks to assist practitioners with identifying resources and awareness for more consistently addressing the occupation of sleep in the older adults. 

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Lymphedema Basics: Increasing Client Occupations

Lymphedema BasicsLymphedema Basics: Increasing Client Occupations

by: Candice D. Young E.d.S., COTA/L, CLT

Increasing independence in occupations is what occupational practitioners are known for. For many experienced clinicians, it is a daily routine recognized through experience through evidence-based practices. However, many clients suffer from diseases uncontrolled by either primary or secondary causes resulting in delayed healing or ongoing therapy services. The growing anxieties of past medical history, congenital conditions, or surgeries are not always straightforward nor understandable, and the complications may be unknown. Lymphedema could be lurking in the foreseeable future for many with no current cure and awaiting breakthrough treatments (Schaverien and Aldrich (2018).  

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The pelvic floor: The muscle group we all should know more about

The pelvic floor: The muscle group we all should know more about

by: Sujata Martins, MS, OTR/L, CD

Out of sight, out of mind is a common saying for most and unfortunately tends to be applied to the pelvic floor. By learning to take care of our pelvic floor, most of us can avoid embarrassing accidents, as well as spending money on incontinence products, medications, and even surgery. It is also extremely valuable for pregnant women in order to prepare for delivery and postpartum healing, and plays an important role in intimacy. 

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Integrating research into fieldwork experiences: Benefits for practitioners, students, and faculty

Integrating research into fieldwork experiences: Benefits for practitioners, students, and faculty

by: Annemarie Connor, PhD, OTR/L, Sarah Fabrizi PhD, OTR/L, and Adrienne Yaryan, OT-S, and Kevin Ortiz, OT-S

As new occupational therapy programs continue to develop, it has become more difficult to find fieldwork (FW) sites for students since practitioners are less willing to supervise students due to the lack of resources, limited time, and questions of student preparedness (Varland et al., 2017). Unfortunately, this predicament is now exacerbated in the era of COVID-19. Emerging practice fieldwork sites, largely focused on prevention and health promotion in community-based practice, have been one mechanism for creating meaningful and productive fieldwork sites during this increasingly challenging landscape (Clarke et al., 2015; Dancza et al., 2013). 

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Telehealth value and future considerations in pediatric occupational therapy practice to support innovation and healthcare equity

Telehealth value and future considerations in pediatric occupational therapy practice to support innovation and healthcare equity

by: Elizabeth Morejon, OTD, OTR/L, CSIPT,  and Evelyn Terrell, OTD, MS/HAS, OT/L

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(DOH) issued a press release last week containing guidelines related to the Treatment of Gender Dysphoria for Children and Adolescents.

As you may know, the Florida Department of Health (DOH) issued a press release last week containing guidelines related to the Treatment of Gender Dysphoria for Children and Adolescents
 
As stated, the press release is guidance and does not create a requirement for health care practitioners.
 
According to our practice framework, and regardless of condition or diagnosis, occupational therapy practitioners support clients by offering evidence-based treatments which affirm the lived experience, encourage exploration of identity, provide a safe and supportive environment, maximize strengths and resources, reflect on consequences of treatment approaches, facilitate participation in preferred roles, and prevent loss of engagement in meaningful occupations. 
 
Clinicians with specific questions regarding the guidance should contact the DOH directly. 
 
Clinicians should also feel free to reach out to [email protected] with comments, concerns or to speak with practitioners familiar with these topics. 
 
FOTA will continue to share information as it becomes available.
 
Sincerely,
 
Your Government Affairs Team"

OT Scope of Practice Legislation Stalls in Senate

OT Scope of Practice Legislation Stalls in Senate [Government Affairs]

The 2020-2021 Legislative Session was the first of its kind for the State of Florida. In response to the global pandemic, the State Capitol closed its doors to the public around March 2020 and only reopened to the public in May of 2021. During this time legislators and relevant stakeholders met virtually for committee meetings, to provide testimonies, and execute the legislative process that, by Florida law, usually requires physical presence. Despite these challenges, the Florida Occupational Therapy Association (FOTA) was still able to continue service throughout to its constituents by advocating for an updated OT Scope of Practice (Scope).

The Occupational Therapy Practice Act had not been updated in over two decades. For the past two years, FOTA has been working with the American Occupational Therapy Association (AOTA), the Florida Board of Occupational Therapy, and our sister professions to thoughtfully modernize language that reflects current & future practices. Prior to the start of the 2021 legislative session, FOTA enlisted the sponsorship of Representative Traci Koster and Senator Jennifer Bradley. These Bill sponsors were chosen because of their known track record for service to Florida’s citizens and involvement in committees that administer bills of this nature. The Governmental Affairs committee for FOTA and legislative representatives, Johnston & Stewart, vetted language with House and Senate staff while reviewing the language with key personnel from the Department of Health and Board of Occupational Therapy. FOTA’s Scope Bill was filed early to allow ample time for movement through committees. The House Bill 543 passed its two committees of reference and the entire House chamber unanimously. The Senate Bill 990 passed 2 of its 3 committees unanimously. When it was time for the final Senate Appropriations Committee vote, the Bill was surprisingly left off the agenda. Communication with the Appropriations Chair and the President’s office revealed no concerns other than they simply ran out of room on the agenda. It was sometime later FOTA learned the primary limiting factor was technical language included within the Bill referencing the Gardiner Scholarship Program (GSP). Because the GSP was repealed and merged into a different program during the same session, certain language in the OT Scope was rendered obsolete which ultimately prevented inclusion into law this session.

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Occupational therapy leadership perspectives used to facilitate faculty retention

 

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The new normal: Supporting post-pandemic independence within the home and community health setting

The New normal: Supporting post-pandemic independence within the home and community health setting

Since March 2020 the world has continued to evolve and change to meet the restrictions and demands of what is known as COVID-19. Twenty-one months later we continue to track outbreaks and attempt to prevent the spread through handwashing, masking, and social distancing, as well as develop treatments that are scientific and alternative. Both healthcare workers, including occupational therapists, and clients are experiencing difficulties in the areas of occupations of work, self-care, and leisure due to COVID-19 and the associated restrictions (Sithong, 2021). However, with states lifting restrictions, clients and practitioners are hoping to return to their pre-pandemic lives despite the occupational imbalances and hardships they have undergone.

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Medicare OTA payment differential

The Medicare OTA payment differential went into effect on January 1, 2022 and many occupational therapy practitioners still have questions regarding what the policy means for OTAs. 
 
Additionally, AOTA has resources that are immediately available. Please feel free to share this recording of the Special OTA Confab: Legislative and Regulatory Changes with your membership. The recording provides both the legislative background of the policy and a detailed discussion of when the modifier should be applied. An article and video can also be found on the AOTA website on how to apply the modifier and an easy to read handout is linked here.

Contemplating the Capstone

Contemplating the Capstone

by Pamela Kasyan-Howe, OTD FOTA SIS Fieldwork

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Motivation: An important factor in adherence to home programs for patients with chronic conditions

Motivation: An important factor in adherence to home programs for patients with chronic conditions

By Kristin Domville, DrOT, OTR/L and  Kaye Rubio, Ph.D., MHS, OTR/L, CLT-LANA,

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Virtual Reality in Occupational Therapy

Virtual Reality in Occupational Therapy

By Jonathan E. Urrely, OT-S and Carlos Martoral

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ASSESSING STUDENTS’ CLINICAL REASONING ON FIELDWORK

ASSESSING STUDENTS’ CLINICAL REASONING ON FIELDWORK

By Maria A. Colmer, OTD, OTR/L, Associate Professor, Academic Fieldwork Coordinator, Florida Gulf Coast University, OT Program, FLOTEC

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