Karen Kessner1, Megan Rumble1, Adam Cefai1
1Western Health, St Albans, Australia
With the rising cost of health service provision and mounting demand, occupational therapy services are increasingly required to demonstrate the effectiveness of the services they deliver. The aged care subacute service of a large metropolitan health service identified the need to understand the value and contribution of home assessments on patient outcomes.
A mixed methods approach was undertaken using the ‘Home Assessment Profile’ instrument and consumer feedback. The Home Assessment Profile is a valid and reliable, quantitative performance based instrument used to assess patient performance of representative activities within the home. Hazardous person-environment encounters were rated pre and post home assessment according to the degree of hazard together with the frequency with which the hazard is encountered. Consumer feedback is routinely sought within the Occupational Therapy Department for patient based interventions.
Twelve clinicians completed the ‘Home Assessment Profile’ with 60 patients over a three month period in 2017. Results showed an average risk reduction of 77% between pre and post scores (range between 44-100%), with a reduction in both the frequency and number of risks being observed. Use of the tool was found to be effective as a measure of reduction of hazards. Occupational therapy home assessment recommendations were comprehensive and varied and were able to be themed into six key areas of practice.
Findings from this research support home assessments as an effective intervention for inpatient aged care populations to reduce risk, increase patient feelings of readiness for discharge, and increase patient confidence to participate in meaningful occupations within their homes. The results identified that subacute Occupational Therapists are conducting home assessment in line with Occupational Therapy conceptual practice frameworks.
Karen is a senior occupational therapist for the subacute aged care service at Sunshine Hospital, Western Health. Karen is also the co-convener of the oncology and palliative care interest group for Occupational Therapy Australia- Victorian division. Karen has 24 years experience as a clinician across multiple clinical areas.
Karen has a graduate certificate in business management and palliative care, she is currently undertaking her masters in palliative care in aged care.
Adam is a grade 2 occupational therapist with the subacute aged care service at Sunshine Hospital, Western Health. Adam is a strong advocate for allied health within aged care, holding a ward-based allied health leadership role, as well as sitting on the Western Health Falls Committee. Adam has 4 years of clinical experience as an occupational therapist, which has included work within acute, community and subacute rehabilitation settings.