The pandemic caused by coronavirus disease 2019 (COVID-19) highlighted the insufficient public health policies and lack of a national pandemic response strategy. Rehabilitation departments faced barriers to providing care in the traditional manner and needed to consider protection of patients and staff, staffing and personal protective equipment shortages, and uncertainty about best practices to address a novel health condition. This article highlights the strategies implemented by acute care occupational therapy leaders to support their staff; facilitate efficient care provision; and pivot with constantly changing policies, procedures, and research during the COVID-19 crisis. Occupational therapy’s distinct value in caring for this population and role in responding to the pandemic are shared to provide a guidepost for future health care crises.

Date Presented 03/28/20 As the population ages, bundled payment initiatives are being used to optimize quality and cost outcomes. Currently, research on these new models does not describe OT’s value. In response, this presentation will describe current evidence on the total joint arthroplasty bundled-payment initiative, articulate OT’s value throughout the care continuum, and generate recommendations for practice and research. Primary Author and Speaker: Ryan Walsh Additional Authors and Speakers: Asari Yahata Contributing Authors: Gail Fisher, Natalie Leland

Importance: Changes in health care policy and payment over the past decade have resulted in a greater emphasis on cost effectiveness, quality outcomes, and the health care consumer’s experience. Payers’ response to the new policies and their expectations have created expanded opportunities for occupational therapy practitioners in health care overall but particularly in acute care hospitals. Objective: The objective of this article is to empower occupational therapy directors, practitioners, educators, and students to be proactive in a rapidly changing acute care setting. Evidence Review: Research on policy and payment changes since the passage of the Patient Protection and Affordable Care Act (Pub. L. 111-148) was synthesized with evidence related to occupational therapy practice and education. Findings: Occupational therapy practitioners in acute care environments are experiencing expanded roles in optimizing patient readiness for safe community discharge, decreasing lengths of stay, and protecting them from hospital-acquired conditions. Conclusions and Relevance: Policy and payment initiatives reward health care organizations for the added value occupational therapy practitioners bring to acute care teams. What This Article Adds: This article details how occupational therapy practitioners can advance consumer satisfaction, outcomes, and efficiency in acute care, which can lead to increased recognition of the vital role that occupational therapy can play, thus leading to expanded opportunities.

The passage of the Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111–148) represents the largest expansion in government funding of health care since Medicare and Medicaid were established in 1965 ( Curfman, Abel, & Landers, 2012 ). Although the health insurance mandate and Medicaid expansion have received the most attention as a result of legal challenges and the July 2012 Supreme Court ruling on the legality of the ACA ( Henry J. Kaiser Family Foundation, 2012 ), other ACA initiatives may have even greater implications for occupational therapy. The ACA includes sections on improving quality and health systems performance for Medicare recipients, with some sections also applying to Medicaid recipients. Insurance companies commonly follow Medicare rules; therefore, the Medicare reforms are likely to spread across all payers, health care settings, and care recipients.

OBJECTIVE. This study describes how occupational therapists who reported using the Model of Human Occupation (MOHO) actually use the concepts and tools of this model in everyday practice as well as identifies supports and barriers to its use. METHOD. A systematic random sample of 1,000 occupational therapists was surveyed as to what theories they used in their practice. Those using MOHO (430) were sent a detailed questionnaire; 259 therapists (60.2%) responded to the survey questionnaire. RESULTS. More than 80% of respondents indicated that they used MOHO in their practice at least some of the time. Therapists reported that MOHO supports holistic, occupation-focused, client-centered, and evidence-based practice. They reported finding MOHO concepts useful for treatment planning and intervention. Most saw the major barrier to using MOHO as their own lack of knowledge. CONCLUSION. Making resources more readily available and accessible to therapists might enhance the extent to which they use conceptual models such as MOHO.