1. Module 2: Program Development in Community-based Practice
Barry University
MSOT Program
OTR 675: models of service delivery
Fall semester

2. Overview
1. Health is impacted when social participation is limited due to disruption of occupation, occupational habits, and occupational routines
2. Social & cultural trends create opportunities for occupational therapy
3. The program development process – how will you relate conceptual models or frameworks to support the need in your community?

3. 1.
Health is impacted when social participation is limited due to disruption of occupation, occupational habits, and occupational routines

4. What is your Program Development Idea?
From current practice area
From request of employer, individuals
Observed need in community or population
From personal interest
May come from request of community members that have identified a need and have ideas.

5. Look to the barriers or areas of disruption to identify the focus of your program

6. 2.
Social & cultural trends create opportunities for occupational therapy

7. Historical Overview
Consider some of the health care trends in response to events of past decades (slides follow)
Think about: What are some of the events today that may lead to a response from the health care industry?
OTs can help impact policy, access, and reimbursement through program development that will support consumers’ in having their health care needs met.

8. 1960s Events Health Care Responses Vietnam war Poverty
Space Technology
Payor models
Health Care Responses
Hospice care
Nutrition
Social Medicine
Mental Health

9. 1970s Events Health Care responses Diplomatic Relations HMOs
Community health care centers
Access for economically deprived
Child abuse programs
MRDD programs

10. 1980s Events Health Care Responses AIDS DRGs Geriatrics
Palliative Pain Management
Sport Injury and Recovery
Mental Health in Secondary Schools
Obesity Management

11. 1990s Events Health Care Responses Internet Technology War
Aging Society
School Violence
Medically un-insured grow in number
Health Care Responses
Program evaluation & outcomes
Teleconferencing
Under-nutrition programs
ADA
International Year of Older Persons

12. 2000s Events Health care responses Natural disasters Global conflicts
Increased world wide access and advanced technology
Continued obesity rates
Aging population
Health care responses
Increased focus on mental health
Aging in Place

13. 3.
The program development process – how will you relate conceptual models or frameworks to support the need in your community?

14. Activity/Participation
Program Development
Treatment Plan
Impact on Individual
Physical
Socio-emotional
Environmental
Activity/Participation
Program
Evaluation
Measures:
Outcomes
Satisfaction
Financial
Evaluation
Program Concept
Needs assessment

15. Element: Needs Assessment
Describe the community
Describe the target population
Identify needs
Identify Resources

16. Clarify the Purpose of the Needs Assessment
What do you know? Think you know? Want to know?
Why are you doing a needs assessment?
What will you do with this information?
What are you trying to measure?
How will you report this information?
Are all groups included in the planning and conducting of the needs assessment?
Who is responsible for various steps?

17. Analyze the Data from the Needs Assessment
What are strengths and weaknesses?
What are the barriers?
Can this information help you develop reasonable and appropriate program goals?

18. Element: Program Planning and Implementation
Define Focus
Adopt frame of reference
Establish goals and objectives
Identify expected volume
Allocate resources ( develop a budget for evaluation, treatment and support)
Identify equipment that is needed
Identify level of staff that is required (OT, COTA, etc.)
Establish methods to integrate into existing systems
Develop Referral system

19. Assessment of Impact on Performance
How does the disability, injury, illness, situation affect the persons ability to participate in their occupations?

20. Element: Program Evaluation
Goals and objectives
Patient Specific Outcomes
Functional
Skill attainment
Financial
Client/Customer satisfaction

21. Data from Evaluation Process
Enables process improvement
Provides guidance to enhance program
Able to demonstrate impact of program for clients, community leaders, and payor sources

22. An Example of the Program Development Process
Clinical Need Area: Low Vision

23. Program Concept
Environmental Scan #1: Aging Population

24. Demographics of Older Population
United States: 35 million: increase 11% from – 65 + (AOA, 2002)

25. United States
Number of people 80+ yrs: 11 million in 2000; 33 million in 2050

26. Environmental Scan #2
Vision Rehabilitation: covered service May 2002 by CMS
Created reimbursement source

27. Market Segment Two chronic health conditions occurring in elderly:
Cataracts
Diabetes
Both can result in visual impairment
Visual impairment: Loss in independence

28. Process- Key Informant
Completion of a Focus Group made up of Interdisciplinary professionals serving clients with low vision at community clinic
Asked the group three questions
1. What are the needs of the older adults with low vision?
a. Identify services already available.
2. What are the ideal services for older adults with low vision?
What is missing from current low vision service?

29. 1. What are the needs? Optical device training
Safety assessment and intervention
Technology access
Work/leisure Volunteer opportunities
Case Management:
Caregiver issues
Access to services
Transportation

30. a. Services already available
Low vision exams
Large print materials and training
Radio reading services

31. 2. What are the ideal services?
Coordinated services in various service delivery environments involving multiple disciplines:
Centralized
Satellite
Client’s home
Community based

32. 3. What is missing?
Coordinated services with Occupational Therapists

33. Result: OT Program implemented in the following areas
Activities of Daily Living
Functional communication
Functional mobility safety

34. Vision Services for Older Adults with Low Vision
Goals and objectives
Provide OT services to improve
Satisfaction with engagement in activities in the home
Improve independence in ADL’s, including reading, & writing, using prescribed optical aids and compensatory strategies

35. Program Services- OT Optical Aid training: ADL compensation strategies
Static
Dynamic
ADL compensation strategies
Environmental assessment for safety

36. Program Evaluation Constructs: Reading Writing Use of Aids
Quality of Life
ADL’s

37. Tools Functional Vision Performance Test (FVPT)
The Functional Assessment Questionnaire (FAQ)
Daily Living Tasks Dependent on Vision Questionnaire (DLTV)
Patient Specific Functional Scale (PSFS)

38. The End