© Prostock-Studio via Getty Images
Risk and quality of care
The responsibility for all multidisciplinary team aspects of the assessment is an entirely new way of practice for clinicians . There is also a new level of clinical risk that needs to be managed , given that a clinician is now responsible for aspects of care that they were not usually responsible for .
The falls clinic used several ‘ safety nets ’ that were essential in both establishing clinicians ’ confidence and ensuring quality of care .
The multidisciplinary team is given information about all elements of the assessment . There is a low threshold for recommending a face-to-face appointment . Following the telephone consultation , decisions and plans can be discussed with any multidisciplinary team member as required .
Each week , telephone consultations are presented to the team using the clinical letter compiled following the assessment and the decision making is overseen by the consultant geriatrician .
The final safety net is collaborative planning with the patient . In the instance that a face-toface appointment is recommended , an explanation regarding specific measures in place in clinic to reduce the risk of infection is provided and consent is obtained for attendance , while an alternative plan is devised if the patient is not agreeable to attend clinic .
in patients ’ homes , which in my opinion provides a solid foundation for the creation of a positive relationship .
Yet with time I grew confident in my ability to build rapport during these contacts . I learned to develop my communication skills , so as to ensure expectations are managed before , during and after the consultation , while engaging the individual in meaningful discussion , despite not being with them in person , while ensuring all the required information is obtained for optimal clinical decision making .
I now possess an enhanced knowledge of all aspects of specialised falls assessment , including those carried out by other professions ( medicine , nursing and physiotherapy ).
Other professions now have an increased knowledge of occupational therapy . Accordingly , multidisciplinary team working has improved .
The transferrable nature of the knowledge gained has impacted on the quality of the falls risk assessments I complete during home visits . I now have a greater understanding of the implementation of comprehensive geriatric assessment in practice , while I am more confident in my clinical decision-making and letter-writing ability .
Admittedly , change is not easy . However , the flexible and adaptable nature of the occupational therapy profession means that occupational therapists are well equipped at embracing the most rapid transformations in healthcare , even during the most unprecedented of times .
The occupational therapy perspective
RCOT ( 2020 ) produced figures that indicated 60 % of occupational therapists were providing an alternative method of service delivery due to COVID .
The challenges the pandemic has placed on services also provides an opportunity to embrace novel approaches , but as an occupational therapist working in a multidisciplinary team falls clinic , what was my experience of a novel approach to practice ?
Just over half ( 51 %) of occupational therapists reported learning new skills as a result of the pandemic ( RCOT 2020 ). On reflection , despite my initial apprehension about the use of telephone assessments , I undoubtedly gained skills too .
As an occupational therapist , building rapport is at the forefront of my clinical interactions and I had never used any other mode of practice other than face to face . My role comprises of a combination of falls clinic and home visits , so I am used to being
As an occupational therapist , building rapport is at the forefront of my clinical interactions and I had never used any other mode of practice other than face to face .”
Patient perspective
During a three-month period from May to July 2021 , we sought feedback from six patients , to begin to gain some insight into their perspectives of these telephone consultations .
22 OTnews April 2022