Changing the way Occupational Therapy does business in an acute public hospital

Miss Lauren Matheson1, Ms Debra Phillips1

1The Townsville Hospital, Townsville, Australia

Background: Australian public hospitals are increasing in pace and complexity driven by an aging population and rising incidence of chronic conditions. Therefore, hospitals focus on immediate patient care and discharge. Allied health professions, including occupational therapy, play a major role in the delivery of multidisciplinary care within the acute hospital setting. There is, however, an incongruence between the medical model in acute care and the philosophy underpinning occupational therapy. The Occupational Therapy Department at The Townsville Hospital acknowledge the disparity between our profession’s values and the demand for high patient turnover in acute settings, and have decided to take action. We have identified areas of potential influence: referrals; prioritisation; and workload across teams.

We are in the early implementation phase of redefining the delivery of occupational therapy services on acute wards of The Townsville Hospital by implementing change in areas of potential influence.

Method: Three quality projects were commenced to address 1) referrals, 2) workload allocation and prioritisation and 3) working in teams. Activities undertaken thus far include literature reviews, benchmarking, internal focus groups and surveys.

Results: To date, a specific set of referral flags has been developed and the department priority tool has been modified to include a needs assessment screening process. We are trialling a team-based approach to managing workload on medical wards. Initial feedback from staff indicates more equitable workload distribution, an increase in work satisfaction and staff morale, improved confidence in clinical reasoning for junior staff members and provision of occupational therapy services to patients most in need.

Conclusion: This project demonstrates it is possible to maintain professional identity in the acute hospital setting by undertaking a multifaceted staged project to change the way we do business. Outcomes of this project will have relevance to occupational therapy departments in acute care settings across the country.


Debra and Lauren are senior occupational therapists at The Townsville Hospital, the tertiary referral hospital for North Queensland. They are two of the lead clinicians working on quality improvement projects to redesign occupational therapy delivery within the acute hospital environment

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