What is occupational therapy's role in transitions to prevent hospital readmissions?
One of them is definitely making sure that medications are reconciled. Typically, nursing would do this when someone is leaving an institution. However, when you are looking at medications being reconciled, you also have to think about whether they can open the container, do they know what times to take it, do they know if they need to take the medication before or after eating? When they are in the hospital their routine, habits, and roles have been changed. This is a great opportunity for occupational therapists to take a leadership role in helping people lay out a plan for their first week home. Do not forget to incorporate different things like a change in medication or diet. For example, if someone has CHF and has to weigh themselves, this needs to be incorporated into their daily routine.
Other things are home exercise programs or home activity programs. We need to help them incorporate this into a daily routine. We can also work with the patient before they leave the acute care hospital or whatever setting to identify risk factors and also incorporate this into caregiver training. Do you have the key information in a personal health record? There are many of these that are available online that could be used. Are you educating in a manner in which the patients and families understand? What happens if there is going to be a change in caregivers? Have you created a backup plan for caregivers and caregiver education so there is continuity and no break in care.