Occupational Therapy - Essay Example

Occupational Therapy Khaula Al Maamari Institutional Affiliation: University: Abstract For occupational therapy practice to become more evidence based in Australia there is need of having significant change in the behavior of medical officers. The key players in the occupation therapy practice consist of intellectuals and medical administrators in the work-related therapy. The people in charge of supervision need to employ strategies such as coercion so that the process of change brings forth positive results. Case Analyses Strategies used for introduction of evidence-based practice in changing clinician behaviour This paper intends to help the managers in occupation therapy in understanding and preparation of the process of change in to evidence based practice. There are two models of transformation that are pertinent and applied in evidence based practice. They are the readiness for the change process and the responses to change. They help in guiding individuals on how to react when confronted with change. During the alternation process, managers are advised to use strategies that will help them to evaluate the attitudes of the employees towards the job they do because this will help them to identify the reason why they do not fully execute their jobs as required by the management. SWOT analysis is the best tool to help in identifying the strengths, weaknesses, opportunities and threats. There are no instant results to be registered after the SWOT analysis but it is imperative to help the employees to acclimatize to the transformation of attitudes and values which they pick throughout their self directed education which is a life time process. Introduction Clinical practice makes use of evidence based practice which helps in searching, appraising and guiding it in its daily duties (Hammer, 1999). Activities found to be retrogressive in the institution are punished for while the beneficial ones are rewarded so that people can identify with them. The best activities that boost the progress of the company are made a part of the organization’s culture which is to be passed on to new employees (Effective Health Care, 1999). The evidence based process helps practitioners to be able to identify clients who can benefit from the practitioner’s services as well as the best interventions that bring forth positive results after the therapy (Egan, Dubouloz, von Zweck, & Vallerand, 1998). There are benefits of using evidence based practice in occupation therapy that have been documented in the international occupational therapy literature (Alsop, 1997; Eakin, 1997; Law & Baum, 1998). According to Bennett and Bennett (2000), evidence based practice is a recent practice in Australia because it is only in the twenty first century that articles on evidence based practice were published. This is an indication that the people who are supposed to be practicing evidence based practice are not well endowed with it hence making the clients doubt their capability (Hayes, 2000). With time the practitioners will have a wealth of experience on how to go about evidence-based practice when doing occupation therapy. In the process of facilitating the learning of evidence based practice, there were some programs on evidence-based practice that were offered during the 2001 Australian occupational therapy conference. For practitioners to be fully orientated in the practice there were symposiums, pre conference workshops and assorted papers on evidence based practice. The national conference that was held two years earlier had only two papers presented on evidence based practice (Bennet, 1999). The reason as to why evidence based practice was not popular among the occupational therapists is because they never knew what the term evidence based meant. They also had no technical skill on how to go about evidence based practice in relation to occupational therapy. Australian occupational therapists do not have the skills that can necessitate them to carry out evidence based practice with confidence like their Britain colleagues do. This is because the Australian practitioners rely much on the education they learnt during their undergraduate course and practical courses. They boost of their experience in the profession which is nothing compared to refreshers courses that every professional is in the process of acquiring. They need to update their knowledge for the sake of their knowledgeable clients who know how things should be done for them. It is imperative to invest in reading and familiarizing themselves with new technical skill on evidence based practice. This can be done by exploiting the internet because it is the most resourceful innovation in the globalized world. Occupational therapists do not behave any different from the general practitioners and physiotherapists who have common conditions to attend. Occupation therapists need to use evidence based practice because their profession entails confronting new conditions brought about by new approaches in the society. Instead of reading further, they still rely on their old experience rather than using published evidence when making clinical decisions. They rely on the colleagues’ opinions and misguided personal experiences which make them to err when deciding what the best thing is for their clients (Covell, Uman & Manning, 1985). There are health professions who use their experience to come up with clinical decisions. These are experience based rather than evidence based. Experience is theoretical and can mislead someone because one can believe in an error concept but, evidence based practice is empirical and practical. One addresses a problem as it presents itself but not through assumptions (Redmond, 1997). These factors should be acted upon so that the gap in evidence based practice in relation to occupational therapy may be changed. Aims This paper proposes the use of evidence based practice in all health facilities. Heath care managers both in the universities departments and private practice should uphold the use of evidence based practice in their institutions because bit helps to give results that are more accurate than those produced through experience based strategies. The top management of the above institutions should play the role model part in enhancing that evidence based practice is fully supported in their institutions. The mangers need to ensure that the members of staff are developed so that they accept changes that happen within the clinics and apply them with the customers. This is an indication that they appreciate the change within the institutions and work hard to improve the lives of their clients in an easier manner. Application of the recent knowledge in solving occupational therapy helps in achieving positive results that strengthen the relationship between the occupational therapist and the client (Alsop, 1997; Eakin, 1997). Understanding and preparation for change Occupational therapists have been confronted with a series of changes that affect the manner in which they deliver their services. They have experienced the introduction of new technology in the health facilities, closing of wards where they operate from and an increased approach in focusing the manner primary health care and community based health care is delivered. Like all other institutions, health facilities need competent managers who run the facilities as per the current expectations in the economic world. They need to be able to identify opportunities and mobilize the resources in the facility so that they exploit the opportunities. The managers need to be skilled and who frequent refresher courses so that they can combat new challenges in the health facilities. This enhances them to be able to check the manner in which employees run their programs and the hospital programs at large. Nurses affirmed that evidence based practice is critical and needs to be emphasized in the health facilities because it is a success in the health facilities (Johnson et al., 1998). In the same working environment, different people behave different approaches towards the evidence based practice. For example, one can be so interested in learning about it while another will be resisting the change because he or she awns to stagnate bin the old way of doing things. To bring the members of staff at per will depend with their levels of interest, education and encouragement. This is because some staff members are pessimistic while others are optimistic about evidence based practice. When implementing change, there should be four rules to be followed for success to prevail (Lewin, 1951). Change should be implemented for excellence motives, it should be steady, it should be deliberate not impromptu and all persons affected should prepare for change. The managers need to be aware of the change steps and the reactions of the change. The first stage is pre contemplation in which no one is prepared for change. The practitioners are not interested in finding new information. They move on to the contemplation stage where individuals learn new things. They then go to preparation stage where individuals are taught on specific skills which help them adapt when they change. The stage of action is significant because the managers need to encourage and offer support to the employees. When evidence based practice is adopted, there is discontinuation of practices which are known to be the treatment for decades. The final stage is the maintenance stage whereby permanent change of behavior is recorded. There are activities done by the practitioners for instance, library searches or joining journal clubs (Dingle & Hooper, 2000). Individual response to change According to Rodgers (1983), there are five types of individuals in relation to how they changed when a new behavior was introduced into their lives. The five individual representations are innovators, early adopters, early majority, late majority and laggards. The innovators consists of the minority who are unique in the manner they represent their ideas and learning experience. Due to their uptake of new idea such as evidence based practice, they may suffer from negligence portrayed by other staff members. The managers need to offer support and encourage them not to drop the new way of approaching occupational therapy. Early adopters are quite different in that they are the opinion leaders and are the most useful in marketing of ideas such as evidence based practice to others staff members. Hey market it in the staff meetings, workshops and conferences (Effective Health Care, 1999). When designing strategies in the department, the manager should call upon the early adopters to tell their opinion in the evidence based culture. Early majority are the socially rigid people who hold unto the traditional values and views. They change when they find that change is inevitable. The late majority are skeptics in the organization. They are reluctant to accept change or even new ideas in the organization. The laggards are difficult to deal with because they do not accept change. They only do so when it is forced upon them but, they still resist because they do not find any importance in detaching themselves from the past activities like experience to evidence based practice. A SWOT analysis helps to identify all the representations in the health facility hence help you come up with the right approach in doing things. Strengths: The organization has newly employed graduates who are conversant with computer databases. This will make them become a resource in the facility because they are able to access the good library facility. They influence several members of staff to conduct research activities because they take the challenge and enroll in masters programs. The newly employed graduates help in critiquing the contents and analyzing the literature that is researched about evidence based practice. Weaknesses Although there are strengths in the health center, there are a few weaknesses that need to be approached. There is very little time left for literature that is concerned with evidence based research. Despite the fact that there is little time left for studies, there are no enough skills for the people who mostly need to uses evidence based practice in occupational therapy. The computers and the library are not in a convenient location because they are in detached houses from the main health centre. All the time used away from clients is deducted when billing up the amount to be paid. This makes the practitioners not to take a step f trying out their luck in acquiring new knowledge for they feel that they will be deducted during pay time. Opportunities The training that is currently offered by the state health professional association in promoting researching skills in literature is helpful to the employees in that they upgrade their education qualifications. Funding in the future will be because don the ability of the employee to be pro active. The employees who are conversant with evidence based practice have an added advantage because they will benefit. Threats Many employees are busy refining their skill in colleges which results in staff freeze. There is fewer staff attending to a large number of clients which risks efficiency. There is a perception that research is not paramount as patient care. In that aspect, workers do not research but continue to use their experience. Thee rationalize their acts by saying that research is done in the universities while clinical care at the hospitals. They belive that the two are not compatible hence end up failing in delivering f services to customers. Execution of Evidence based practice The execution of evidence based practice is pertinent in any organization. It is done when the management has imparted relevant information about the same. There are steps to be followed which are: formulation clinical questions which have a clarity of content., searching for literature with empirical data that is workable, appraising evidence and integration of findings with practice an detaching of evidence based practice (Bury, 1998a). Evaluation of the introduced program should be given a priority because it helps in identification of weaknesses and strength in the introduced way of doing things. According to Whiteley (1995), most employees share common views so it would be better if the opinion leaders talk about evidence-based practice in meetings so as to evaluate how colleagues take the information. Conclusion For occupational; therapy to remain a valued practice, in Australia, professionals need to shun experience based practice and adopt the evidence based practice. For health facilities to achieve the goals of evidence based practice there is need of major changes in employee attitude, acceptance of new skill through refresher courses through all the levels of profession. Managers need to be the role models because they should exemplify their wish to their juniors. They need to promote use of evidence based practice by encouraging the few who use it. The managers need to identify weakness or barriers to acquisition of evidence based practice and shun them. The managers should use the SWOT analysis as a tool of helping them identify the opportunities and strengths as well as threats and weakness. This helps them in strategy derivation which helps the organization move forward. References Alsop, A. (1997). Evidence-based practice and continuing professional development. British Journal of Occupational Therapy, 60(11), 503- 508. Barnitt, R. & Salmond, R. (2000). Fitness for purpose of occupational therapy graduates: Two different perspectives. British Journal of Occupational Therapy, 63(9), 443- 448. Bennett, S. (1999). The process of evidence-based practice in occupational therapy. Presented at: OT AUSTRALIA 20th National Conference, April, Canberra, ACT, Australia. Bennett, S. & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47, 171-180. Bury, T. (1998a). Evidence-based Healthcare Explained. In: T. Bury & J. Mead (Eds). Evidence- based healthcare: A practical guide for Therapists. (pp. 3-25). Oxford: Butterworth- Heinemann. Bury, T. (1998b). Getting Research into Practice: Changing Behaviour. In: T. Bury & J. Mead (Eds). Evidence-based healthcare: A practical guide for therapists. (pp. 66-84). Oxford: Butterworth- Heinemann. Collison, G. (1999). Ethical Change. In: S. Hamer & G. Collison (Eds). Achieving evidence- based practice: A handbook for practitioners. (pp. 197-212). Edinburgh: Bailliere Tindall. Conroy, M.C. (1997). Why Are You Doing That?: A Project To Look For Evidence of Efficacy within Occupational Therapy. British Journal of Occupational therapy, 60(11), 487-490. Covell, D. G., Uman, G. C. & Manning, P. R. (1985). Information needs in office practice: Are they being met? Annals of Internal Medicine, 103(4), 596-599. Cusick, A. & McCluskey, A. (2000). Becoming an evidence-based practitioner through professional development. Australian Occupational Therapy Journal, 47(4), 159-170. Dingle, J. & Hooper, L. (2000). Establishing a journal club in an occupational therapy service: One services experience. Eakin, P. (1997). The Casson Memorial Lecture 1997: Shifting the balance- Evidence-based practice. British Journal of Occupational Therapy, 60 (7), 290-294. Effective Health Care (1999). Getting evidence into practice, Vol. 5, No. 1. NewYork: The University of York National Health Service Centre for Reviews and Dissemination. Egan, M., Dubouloz, C., von Zweck, C. & Vallerand, J. (1998). The client centered evidence- based practice of occupational therapy. Canadian Journal of Occupational Therapy, 65(6), 136- 143. Faghri, P. D., Rodgers, M. M., Glaser, R. M., Bors, J. G., Ho, C. & Akuthota, P. (1994). The effects of functional electrical stimulation on shoulder subluxation, arm function recovery, and shoulder pain in hemiplegic stroke patients. Archives of Physical Medicine and Rehabilitation, 75(1), 73-79. Hamer, S. (1999). Evidence-based practice. In: S. Hamer & G.Collinson (Eds). Achieving evidence based practice: A handbook for practitioners. Edinburgh: Bailliere Tindall. Hayes, R. L. (2000). Evidence-based occupational therapy needs strategically-targeted quality research now. Australian Occupational Therapy Journal, 47 (4), 186-190. Haynes, R. B., Sackett, D. L., Guyatt, G. H., Cook, G. H. & Muir Gray, J.A. (1997). Transferring evidence from research into practice: 4. Overcoming barriers to application. Evidence-Based Medicine, 2, 68-69. Hunger, J. D. & Wheelen, T. L. (1993). Strategic management. (4th Edn.). Boston: Addison- Wesley. Johnson, M., Morris, J., Agnihotri, S., Elliott, D. & Crookes, P. (1998). Evidence-based nursing: Developing a Clinical Practice Review Network within an area health service. Liverpool: Centre for Applied Nursing Research, South Western Sydney Area Health Service. Read More