...if we learn most from our mistakes. 

I am a very new OT out in the field, to be exact 496 days (aka 1 yr and 18.85 wks). I still go into treatment sessions with a mixture of nervousness and excitement. Nervous that I won't find the "just right" activity for my patient and create a session where I feel guilty as if I wasted their time and I did not benefit the patient to the best of my ability. Excited that I WILL “hit the nail of the head” and have an awesome session that continues to build a rapport with my patient. We all make mistakes, have difficult sessions, or misinterpret what we think will be best, but hopefully we learn from them and they help us grew into a better therapist. I often think about the first big whoops I made as an OT, one that happened only a few hours into my first job; in fact, one that happened with the first patient I treated on my own as an OTR/L. 

Let me begin by telling you a bit about the facility I work in. It is a sub-acute facility; sometimes we see patients typical for a SNF (skilled nursing facility) however we are fortunately enough to have LTAC (long-term acute care) the floor above us, so occasionally those individuals will transfer down to our floor making us sub-acute. In any case, our facility is made of two large buildings, the building attached to our rehab housing LTC (long-term care) residents as well as the facilities' gift shop, synagogue/chapel, laundry machines, our beloved ramp. :) The distance from the rehab to the gift shop, etc. would be "community mobility" ie- 150' x4. I feel that we are VERY LUCKY in how creative we can get with activities, especially those for "higher-level" patients, however we always can be motivated by new ideas. 

Our huddle a couple weeks ago discussed a variety of standing activities to use that are more "grown up" - rather than putting a brightly colored ring arch in front of them. (don't get me wrong I do love my ring arch). Here is what we discussed...

First and foremost, as you can see in the picture, MRSA and C-Diff (the stuffed animals of course) joined us for our first huddle. I'm sure they will pop in and out occasionally! Our initial HUDDLE was taken over by the fact that Medicare has yet again changed guidelines for billing. Surprised? On our unit we maybe get a Med B patient once everyone couples months, but we felt it necessary to review what these new guidelines were and possible assessment tools that they be beneficial to add to our OT department. 

According to AOTA, as of July 1st CMS is requiring functional report for all OT reimbursement. Therefore, a therapist must choose a patient's primary functional limitation to report a G-code and modifier on. The functional areas in which OTs work on are the following: mobility, changing and maintaining body position, attention, memory, carrying/moving/handling objects, etc. Once a primary G-Code has been chosen for a particular limitation, a modifier that reflects a patient's score/severity on a particular functional assessment tool should be identified. AOTA provides a link to a great website that provides conversions for G-Codes and a search engine for assessment tools.

HELLO  to fellow OTs!

I have been wanting to create a group for the OTs of my sub-acute rehab unit to further our knowledge and experiences between each other. After much deliberation (and a couple of Dark & Stormies), a friend and I brainstormed the group name to be HUDDLE …

• H elping
  
• U s
  
• D etermine
  
• D ifferent
  
• L earning
  
• E xperiences

Most therapists typically participate in journal club groups, but how many people have time/energy to read journals after going to yoga, or putting the kids down, or taking the pup for a walk?! I thought our unit would benefit from having a group where we can all bring some of the following to the group to discuss, brainstorm, and possibly learn from. Here I am to share it with you as well. Here is what we discuss:

1. A problem we are having with a patient, whether it be "I have a patient with a subluxed shoulder and I have no idea where to start "... or "I have a patient that has met all his goals, but I just cant seem to get him to be able to perform his own pericare after a BM"
2. A success story! We've tried something new, or read an article and tried out the suggested treatment, and it worked... this is something we bring to the group and share so we can all learn from the experience
3. Suggestions for us to add to our tool box (bag 'o trix)...For example, standing activities you really love and found great ways to modify/adapt as the patient progresses. OR  search for new standing activities because sometimes we just run out because our patient has been on our case load for 7 weeks.
4. Lastly, case studies! Some of us have had the opportunity to work/treat TBI patient however, some of us have not. I think we can all really benefit from learning from each other's past and present experiences. Typically when we get a "great stroke" or a "great/interesting" case on our unit, not everyone gets the opportunity to treat or learn about the patient or diagnosis. Let's share! 

I hope this group be a great way to share the experiences we have in our field so we can all benefit and learn for our future patients we may have the opportunity to treat hands on. I also hope whomever may come across this in their google searches will learn and enjoy as well. I would love to hear about every OT's experiences and maybe I can share them here as well. ENJOY this leisure activity! 

Functionally yours,
m