April is Occupational Therapy Month, a time to recognize and reflect on the significant role that occupational therapists play in supporting residents as they experience physical and cognitive changes. Occupational therapists are valued members of the interdisciplinary team (IDT). They lead team efforts in identifying and evaluating activities of daily living (ADLs). Occupational therapists complete care area assessments (CAAs) that drive care plan development for ADLs. They provide interventions to maintain, improve, or prevent avoidable decline in residents’ ADLs.  

Does your facility leverage the expertise of occupational therapists to develop and implement facility programs, with the goals of promoting the health and well-being of residents, rehabilitating deficits, and addressing the impact of disabilities?  Establishing formal programs such as contracture management and positioning management can help improve residents care and outcomes while decreasing facility risk.

Lead your IDT in reviewing your current processes for contracture management. Identify gaps and develop an action plan. Evaluate the following:

• Does your facility have a formal contracture management program?
• Do you empower your occupational therapists to drive the program?
• Are residents routinely assessed for risk of contracture? 
• Does the CAA, care plan, and daily medical record documentation reflect interventions and treatments for contracture management?
• Are staff trained in contracture management and can they describe their roles and responsibilities?
  
  

Next, support your IDT in assessing your current processes for positioning management. Identify gaps and develop an action plan. Evaluate the following:

• Does your facility have a formal positioning management program which includes wheelchair safety?
• Do you support your occupational therapists in facilitating the program?
• Are your residents routinely assessed to determine their assistance level that is required to maintain adequate posture and positioning?
• Does the CAA, care plan, and daily medical record documentation include interventions and treatments that support and individualized plan for proper positioning?
• Are staff trained and can they describe their roles and responsibilities in positioning techniques and wheelchair safety?
  
  

Processes surrounding contracture and positioning management often raise concerns for facilities in terms of survey and legal risk.  Taking time now to review and improve your facility’s current processes can help you to improve residents’ outcomes, develop and maintain survey readiness, and mitigate your risk.