Referral and Collaboration

Collaboration:

Previous research indicates that a majority of primary care providers would like additional education regarding the benefits of occupational therapy in primary care (Koverman, Royeen, & Stoykov, 2017), and this was consistent with results of the survey sent to InnovAge primary care providers. When primary care providers receive education about and observe the benefits of occupational therapy services in primary care, they are more receptive and likely to refer for occupational therapy services (Dahl-Popolizio et al., 2016). Thus, it is incumbent on occupational therapists to provide the needed outreach and education to the primary care team.

One question that may come up from different team members is: how is occupational therapy different from other disciplines and who are you trying to replace? The occupational therapist should be prepared to clearly define the unique training and skillset that she or he offers and should be sensitive to the fact that others may not understand the occupational therapy scope of practice or may feel that their expertise is not being respected. Bringing an occupational therapist into the primary care clinic will strengthen the team and what the PACE clinic is able to manage. It will also increase the efficiency of everyone by removing some the burden of care from other team members. The occupational therapist should also be mindful when other team members have more expertise to address a certain topic and should reach out to collaborate in these instances.

To integrate successfully into a primary care clinic, the occupational therapist should consider the following methods of instruction and outreach:

Formal in-services
Informal discussions
The use of examples and case studies
Sharing positive results and feedback from participants regarding occupational therapy services

(Sutherland, Moore, & Serlin, 2018). Flexibility and adaptation have also been cited as beneficial to integrating into primary care (Halle & Valsaek, 2018). Space requirements should also be considered. It is helpful for the occupational therapist to be readily accessible to the primary care team. Private spaces may be needed for individual sessions, while larger spaces may be needed for groups. Whether this is best accomplished within the primary care clinic or in a separate therapy gym will vary based on the availability at each site.

Key Points:

PCPs are more likely to refer to OT when they understand how OT can benefit their patients
OTs should educate the entire team on their role
Flexibility is key

Referral:

Providers who are knowledgeable and who have seen the benefits of occupational therapy are more likely to refer participants, thus it is imperative for the occupational therapist to first establish a good working relationship with the primary care team (Koverman et al., 2017). A separate referral process may be useful to help provide guidance to providers regarding when and why they should be referring participants and to allow the providers to give clarification as to what issues they are seeing in the clinic. After referral and assessment, occupational therapists should create a plan of care in collaboration with the participant and primary care team. Refer to state regulatory guidelines regarding requirements of the referral and plan of care process. These can be accessed here: https://www.aota.org/Advocacy-Policy/State-Policy/Licensure/StateRegs.aspx

Click below for an example referral form: