Occupational Therapy's Value in Provision of Quality Care to Prevent Readmissions.

Health care systems are prioritizing the quality of outcomes over the quantity of services provided, and health care payers and other stakeholders are focusing on preventing hospital readmissions. This priority supports the effort to reduce the cost of health care by avoiding the most expensive care type and improving the quality of health care by promoting sustained return to the community and remaining in the community. Occupational therapy practitioners have expertise that is critically important in this effort. Occupational therapy places a unique and immediate focus on patients' functional and social needs, which can be important drivers of readmissions if they are not addressed. By addressing activities of daily living, instrumental activities of daily living, functional cognition, psychosocial needs, vision, fear of falling, and safety, occupational therapy practitioners can be a valuable addition to the effort to keep people out of the hospital and participating in their lives. This article reviews the literature supporting the role of occupational therapy in each of these key areas.

Opportunities for Occupational Therapy to Serve as a Catalyst for Culture Change in Nursing Facilities.

Ensuring that older adults are receiving quality and effective rehabilitation and skilled nursing services must be a priority to society and to the health care system, but health care policies and systems driving reimbursement continue to challenge the delivery of services. A review of the literature indicates significant problems among residents of skilled nursing facilities (SNFs) that could be alleviated by meaningful occupational therapy. Research and practice in the occupational therapy community should focus on this large area of practice. Advocacy by individual practitioners-challenging themselves and others to provide more patient-centered care-can lead to changes that benefit clients, facilities, and payment systems as well as contribute to career satisfaction of occupational therapy practitioners. Occupational therapy can and should serve as catalyst for culture change in SNFs by providing meaningful interventions and opportunities that support engagement and health.

Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy.

As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy's distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection.

Healthy Habits for Children: Leveraging Existing Evidence to Demonstrate Value.

Healthy habits is a psychoeducational construct that refers to the preventive practice of analyzing and then adapting the sleep, physical, and eating routines of children in ways that enhance health and well-being. This approach is based on evidence that demonstrates the positive therapeutic value of engaging in proactive, healthful behaviors. In addressing healthy habits, occupational therapy practitioners have an opportunity to contribute to the Triple Aim of health care reform while demonstrating the value of occupational therapy in educational, medical, community, and other settings.

P4 medicine and pediatric occupational therapy.

Pediatric occupational therapy practitioners face a complex and ever-changing health care environment, creating many challenges and opportunities. P4 medicine is a systems approach to health care that emphasizes proactive wellness over reactive acute care disease management. The four Ps of P4 medicine stand for predictive, personalized, preventive, and participatory, concepts that align well with the practice of pediatric occupational therapy. P4 medicine offers a model for pediatric occupational therapy practitioners to demonstrate the value of occupational therapy services.