Assembling the Pieces

Transcription

1 A NEW FRONTIER FOR OCCUPATIONAL THERAPY: PRIMARY HEALTH CARE Assembling the Pieces Mary Ann McColl, PhD Centre for Health Services & Policy Research at Queen s University October 2008

2 Objectives 1. To discuss the challenges encountered by people with disabilities in attempting to obtain primary care 2. To offer guidelines for proposing an occupational therapy role in primary care

3 Definition PRIMARY HEALTH CARE health services provided at the first point of contact with the health care system. Primary care is the element within primary health care that focuses on health promotion, illness and injury prevention and the diagnosis and treatment of illness and injury (Health Canada, 2006) Primary health care refers to an approach to health and a spectrum of services beyond the traditional health care system. It includes all services that play a part in health such as income, housing, education and environment.

4 Spotlight on primary health care Recent developments Primary Health Care Transition Fund (2000-6): supported provinces to reform the primary health care system and introduce new approaches to primary health care Enhancing Interdisciplinary Collaboration in Primary health care (EICP): national initiative brought together leaders in primary health care to facilitate interdisciplinary collaboration. Canadian Collaborative Mental Health Initiative (CCMHI): (CCMHI): to improve the mental health of Canadians by increasing collaboration among health care providers, consumers, families and caregivers.

5 ACCESS Four points of access to primary health care Getting a doctor Getting an appointment Getting into the office, diagnostics and treatment space Receiving a reasonable standard of care

6 ACCESS Four types of barriers encountered when attempting to access primary health care 1. Physical barriers 2. Attitudes 3. Expertise 4. Systemic barriers

7 Approach to defining a business plan for occupational therapy in Needs Assessment primary health care Model Selection Role Definition Business Plan

8 Steps in Needs Steps in Needs Assessment Step 6 Identifying the Stakeholders Step 5 Approaching the Practice Step 4 Identifying Target Populations Step 3 Identifying a Contact Step 2 Learning about the Practice Step 1 Learning about the Community

9 what is the demographic makeup of the community? are there any particular health issues in the community? how are health services organized in the region? 1. Learning about the community

10 2. Learning about the practice What kind of a primary care site is it? What are the service priorities? service ethic? mission? How many physicians and other professionals work there? What is the size of the caseload? Is the practice associated with a network or other group for call coverage, research, teaching, continuing education, administrative and physical plant services? An educational institution?

11 3. Identifying a contact someone within the practice; an ally to help you to understand the practice and to begin to see where occupational therapy might make a contribution.

12 4. Identifying target population(s) identify specific populations or groups where occupational therapy might make an important contribution to the practice.

13 5. Approaching the practice With a clear idea in mind of how you can help the practice, it is time to ask for a formal meeting with decision- makers within the practice to discuss the possibilities.

14 6. Identifying stakeholders link with a network of health, social service, occupational therapy and disability organizations in the community who can provide support and continuity.

15 ROLE DEFINITION providing psycho-social social and rehabilitation services that are required by complex patients with multiple chronic conditions or disabilities.

16 Model selection Models for providing occupational therapy in primary care 1. Traditional clinic 2. Outreach 3. Self-management 4. Case management 5. Community-based rehabilitation

17 BUSINESS PLAN 1. What do you see? Needs assessment Region Community Practice

18 BUSINESS PLAN What do you offer? Role definition Services offered Rationale for practice

19 BUSINESS PLAN What do you need? Model selection Model of collaboration Referral system Relationship to practice

20 BUSINESS PLAN What do you need? Business plan Method of payment Space and equipment Accountability & governance