Occupational Therapists as CCAC Case Managers

Occupational Therapy Promotions Inc.

Tammy Balaban, Angie DeGiacomo, Vivian Ip, Lyndsay McTaggart, Daniella Pratt, and Carolyn Taylor

PRESENTATION OUTLINE

Purpose Job description of a case manager How an OT is qualified to be a case manager Discussion Questions

PURPOSE Most case managers of CCACs are nurses, in fact, in some

CCACs, only nurses can become case managers. Explain to the director of one such CCAC why OT’s are ideal CCAC case managers.

To illustrate to the CCAC why occupational therapists make ideal case managers

http://www.ccacrenfrew.org/Casemanagers.html

SCHEMATIC REPRESENTATION OF CCAC CASE MANAGERS POSITION

taken from a variety of CCAC websites

DUTIES OF A CASE MANAGER Assess client eligibility and needs Provide information and referrals Appropriately manage all resources Able to establish Goals with clients Service Monitoring, reassessment, and

evaluation Discharge Planning

ASSESSMENTWhat is Required: Assess clients’ eligibility

and service needs

Work with clients to coordinate services

Provide direction for those clients not eligible for service

How an OT can do it: Trained to assess client

needs

Use tools such as: Target Complaints

Assessment tool Patient Specific

Functional Scale Occupational Performance

History Interview(Donnelly and Carswell, April 2002, 84-92)

INFORMATION AND REFERRALSWhat is Required: Provide information to

individuals, community groups, families and other social/health service providers about available services in their community

Refer client to the appropriate professionals

How an OT can do it: OT’s work in a

multidisciplinary setting and therefore have an understanding of many health care professions

Information and referrals to other professionals will be provided if the client requires services outside the scope of OT practice

How an OT can do it: “All OT’s participate in

managing materials and equipment for their clients, and in ensuring that they are cost-effective and used safely” (Townsend, 123, 2002)

RESOURCE MANAGEMENT

What is required: To make good (efficient

and effective) use of available resources to support client goals

GOAL SETTINGWhat is Required: Collaborate with clients,

caregivers and families to establish goals of care that support and reflect client centered outcomes.

Established goals are kept within the resources of the CCAC (Hamilton CCAC).

How an OT can do it: Use “client centered

practice” to determine client needs

and goals in the context of the individual and their environments (Law, Polatjko, Baptiste, & Townsend, 2002).

Ultimate goal and focus to enable clients to “do the

things they want, need or are expected to do” H. Polatajko (personal communication Sept 13 2004)

SERVICE MONITORING, REASSESSMENT AND EVALUATION

What is Required: Monitor program

implementation

Evaluate client satisfaction with services

Identify opportunities to improve delivery of services

How an OT can do it: 5 types evaluation process

Process evaluation Evaluating individualized

outcomes Case studies Program implementation Quality improvement(Corcoran, M., 59-60, 2002)

DISCHARGE PLANNINGWhat is Required: Planning for discharge

from services at different times as specific goals are achieved(Thunderbay CCAC, 2004)

To address ethical issues: autonomy non-maleficence beneficence justice

(Atwal & Caldwell, 2003)

How an OT can do it: “underlying client –

centred practice is a recognition of the autonomy of the individual person”

(Law, Polatajko, Baptiste & Townsend, 2002, p. 49)

OTs work along with clients to allow them to set their own goals and help them fulfill each and every one of them

DISCUSSION Why are most case managers nurses in the

CCAC?

WHY NURSES? Clinical Practice Base Regulated much longer

CCAC work must be done by a regulated professional. CCAC Peel Human resources (personal communication September 29 2004)

Number of professionals Administrators within the CCAC may not hire an OT as a case

manager in order to keep them in the pool of available practicing therapists. I. Greenspoon (personal communication Sept. 30 2004)

Rehabilitation is a small part of the services provided by the CCAC. Much more financial resources are directed at nursing, which promotes

the nursing profession as dominant within these organizations. I. Greenspoon (personal communication Sept. 30 2004)

DISCUSSION What are other ways that OTs can advocate

for case manager positions in the CCAC?

QUESTIONS???

REFERENCESAtwal, A., & Caldwell, K. (2003). Ethics, occupational therapy and discharge planning: Four broken principles. Australian

Occupational Therapy Journal, 50(2), 244-251.Christiansen, C. H & Townsend, E. A (2004). Introduction to Occupation: The Art and Science of Living. (p. 123). Upper Saddle

River, N.J.: Prentice Hall.Corcoran, M. (2002).Using Qualitative Measurement Methods to Understand Occupational Performance. In, Measuring

occupational performance: Supporting best practice in occupational therapy (pp. 59-60). Thorofare, NJ: Slack Inc.Gilkeson, G.E. (1997). Occupational Therapists and Teams. In, Occupational therapy leadership: Marketing yourself, your

profession, and your organization (pp. 97-111). Philadelphia, PA: F.A. Davis.Hamilton Community Care Access Centre Case Manager Position Description. Retrieved September 28, 2004 from

http://www.hamilton.ccac-ont.ca/careers.htmlLaw, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The Person-Environment-Occupation Model: A

transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9-23.Law, M., & Baum, C. (2002). Measurement in Occupational Therapy. In, Measuring occupational performance: Supporting best

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occupational therapy perspective Revised Edition (pp. 29-32). Ottawa, ON: CAOT Publications ACE.Stanton, S., Kramer, C., Thompson-Franson, T. (2002). Linking Concepts to a Process for Organizing Occupational Therapy

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Vrkjan, B., & Polgar, J. (2001). Meaning of occupational engagement in life-threatening illness: A qualitative pilot project. Canadian Journal of Occupational Therapy, 68, 237-246.

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