Background
Rebecca is an occupational therapist working in home and community care. She receives a referral to assess a client’s ability to transfer using a mechanical lift and provide training to the personal support worker. The personal support worker (PSW) is from a different community agency and will be assisting the client to transfer daily.
Rebecca wonders whether this situation is the same as assigning a task to an occupational therapist assistant and reviews the Standards for the Supervision of Occupational Therapist Assistants, 2018.
Discussion
Rebecca contacts the College’s Practice Resource Service for clarification, and they discuss the following:
- When assigning a component of the occupational therapy service to be delivered by an occupational therapist assistant (OTA) or person acting in the role of an OTA, the occupational therapist is accountable for all the activities assigned and is responsible for monitoring and re-evaluating the services provided by the OTA.
- OTAs are only involved in the care of the client for the duration of the occupational therapy service outlined by the occupational therapist.
- When the occupational therapist is acting as a consultant, they are identifying problems, providing recommendations, education and/or training regarding a specific issue with a client.
- In a consultation role:
- the occupational therapist is only providing recommendations and training.
- the occupational therapist does not assign occupational therapy service components.
- The occupational therapist is accountable for the recommendations they make, but they are not accountable for the individual carrying out the recommended activities.
- The individual carrying out the recommendations may be involved with the client even after the occupational therapist service has ended, and accountable to their employers.
- The occupational therapist must take into consideration the skills and competencies of the individual when providing the recommendations and training to mitigate any potential risks to the client.
Outcome
- Rebecca reasons that she is not assigning mechanical lift transfers to the personal support worker (PSW) as a part of the occupational therapy service.
- Rebecca determines that she is providing recommendations and education to the PSW regarding the transfer needs of the client. These recommendations will continue to be carried out by the PSW after the occupational therapy service has ended.
- She considers the skills and competencies demonstrated by the PSW and problem-solves any concerns to meet the needs of the client to avoid any potential risks.
- She understands that she is accountable for the quality of the occupational therapy consultation and training provided but is not accountable for the individual carrying out the recommendations or the outcome of their service.
- She clearly explains her role to the client and others involved (such as the family, PSW and PSW supervisor) and obtains informed consent before proceeding.
Summary
- Occupational therapists must determine if they are assigning a component of the occupational therapy service, or if they are providing recommendations as a consultant.
- Occupational therapists must take into consideration the skills and competencies of the individual they are teaching or training.
Other examples of occupational therapists in a consulting role
- Teaching care providers a home exercise program for a client.
- Teaching an Educational Assistant (EA) strategies to help a student dress at school.
- Providing recommendations to a building contractor about home modifications for a client.
References
Contact
If you have questions about the application of College Standards and resources, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or [email protected].
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