OLD - 20th century teams
collated, professionally-streamed -- everyone stays in their lane
administratively-organized
problem-oriented
specialist-focused
somethings things fall through the cracks (someone on the team things someone else did it)
Current, 21st century teams
integrated, shared responsibility
seamless, client-centered
collaboratively developed health outcomes with all team members, including the client
everyone must work together
must have good OT identity (what do you bring to the table?)
must understand the scope of practice for the state you are working in
interprofessional education - must learn about the roles & scopes of other professionals on the team
focus on collaboration between professionals & clients
work together on the team to develop & achieve shared goals with the client
FOCUS: Cooperation, coordination, collaboration between disciplines delivering client-centered care
encourage interprofessional education, collegial communication, goal-directed engagement, & mutual respect amongst disciplines
senior & peer-support groups (interprofessional)
used "shared language" & terminology
promote the use of EBP to encourage all disciplines to use appropriate techniques
starts the process
addresses the issues & determines the needs for evaluation
selects & administers the assessment methods & tools
interprets findings from numerous sources of data
writes the evaluation report
determines the need for OT services
develops goals & intervention plans
contributes written or verbal data regarding the client to the OTR
can do standardized & non-standardized screening & assessments if has additional training, oversight & demonstrates competency
During the intervention process:
follows an intervention plan designed by the OTR
provides individual & group interventions
documents data on progress towards goals
brings forth data to the OTR when the intervention plan needs to be modified, continued, or discontinued - cannot change the intervention plan
must advocate for support when delegated tasks are beyond their knowledge base or competencies
must follow state guidelines for practice
COTAs cannot work fully independently when providing client care
If they are working in another capacity, such as rehab manager, fully administrative, etc., they would not require OTR supervision as they would not be dictating the course of client care, but rather overseeing a dept
amount & type of supervision may be dictated by the state or the facility/organization you work for
must ensure that at least "minimum supervision" is provided that allows for safe & effective service delivery -- more can be given depending on the client's needs, practice setting, & diversity of services
supervision should not be based on the COTA's years of experience, but instead, on the complexity of the clients' needs
Frequency intervals of supervision are dictated by the state licensure regulations
direct
COTA is delivering services in the immediate area/building that the OTR is working in
close
daily, direct contact at the work site
routine
regular, face-to-face contact
can determine weekly, biweekly, or monthly
minimal
occasional face-to-face contact
meet to discuss changes or to modify plan
general
OTR is available by phone, email, or Zoom
meet with COTAs to determine type, frequency, & plan for supervision
decide who will be doing the supervision documentation, where it will be stored, and for how long
documentation should include a log of:
type
frequency
areas covered, clients covered
evidence of competencies (as necessary)
collaborative, mutual respect, open communication
develop an understanding of each person's experience, competencies, communication preferences, & learning style
if supervising a discipline outside of the OT profession, get ot know the state's scope of practice for each of the disciplines you oversee
set regular meeting times to discuss clients & other ethical, procedural, administrative, and/or practice concerns