Connections Summer 2022

Bringing OTA’s Premier Event to Far North Queensland

ABOUT CONNECTIONS

Connections is a publication of Occupational Therapy Australia (OTA), the peak body representing occupational therapy in Australia.

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DISCLAIMER

This newsletter is published as an information service and without assuming a duty of care. It contains general information only and, as such, it is recommended that detailed advice be sought before acting in any particular matter. The materials included in this newsletter by third parties are not attributable to Occupational Therapy Australia, and are not an expression of Occupational Therapy Australia’s views. Occupational Therapy Australia is not responsible for any printed expressions or views in any third parties’ inclusions. Any enquiries regarding inserts, advertisements or articles placed by these third parties should be directed to them.

Occupational Therapy Australia respectfully acknowledge the Traditional Custodians of the country on which we live, learn and work.

OT Week wrap-up

Assistive technology enabling goal achievement and safe discharge home: A complex NDIS case study

Assistive technology in palliative care

Taking focus: OT, assistive technology and vision impairment

Long COVID: Developing an OT service for a novel disease

Bridging the assistive technology divide through online training in Australia

Assistive technology to develop skills needed for driving: The DriveFocusTM app

Exploring the experiences, perceptions and attitudes of therapists delivering physical rehabilitation in a group format

Social media risks when running a small business

Managing risk: The importance of documentation in AT assessment and prescription

An HR view of digital tech in your practice

Student Careers Forum wrap-up

OT has given me the ability to support people in a meaningful way and add value to their lives.

REBECCA WATSON-BROWN

President’s Report

Associate Professor Carol McKinstry

In my third year in the privileged role of OTA president, I am immensely proud of what OTA staff and the Board have achieved in yet another challenging year. We are emerging from the global pandemic in good financial health, with more member benefits and better prepared to lobby and advocate for Australian occupational therapists. As a Board, we have made important decisions to position OTA for current and future needs, investing wisely to improve the organisation so members will see positive change now and in the future. We are working to ensure OTA is fit for purpose in an ever-changing world.

As occupational therapists, we have seen increased recognition and valuing of what we do. With ongoing COVID cases and the impact of the pandemic continuing to stretch systems, demand for occupational therapy across all sectors has never been higher. With more people experiencing mental health issues, the need for services for those with chronic diseases increasing, and the positive impacts of occupational therapy evident for those with disabilities and ageing populations, demand is outstripping supply and workforce shortages are present in all practice areas.

Australia’s occupational therapy workforce has also changed. We are one of the fastest growing professions with an increasing number of graduates. There are more occupational therapists working in the private sector, providing services in schools, in mental health settings and to those with NDIS packages. Increasing use of technology, such as telehealth and online access to information and continuing professional education, has highlighted the need for digital literacy in the profession. Hybrid working arrangements have changed the way we work, and the type of services offered.

This year, the Board invested in several

strategic projects that have now been delivered, including the Private Practice Toolkit and the Supervision Program. We increased the number of occupational therapists working with OTA in strategic positions to an all-time high. Our Government & Stakeholder Relations team was bolstered so we can respond both in the short- and long-term, building valued relationships with other organisations and government departments.

In a world first, we published the book “Doing our Best”, available in digital and hard copy, which highlights how people used occupation to overcome the challenges of natural disasters and the global pandemic. Emphasising its value, other countries are looking to replicate similar versions of the book. We have also continued our meaningful journey to reconciliation with First Nations people as part of our Reflect RAP, enlisting the support of Bundyi Girri to guide and educate OTA staff and the Board. I thank all OTA staff and members for their extensive work on these projects.

Other highlights in 2022 have included a return to face-to-face events, while continuing virtual meetings and CPD. Annual divisional meetings, the second OT Exchange Conference and the World Federation of Occupational Therapy (WFOT) Congress provided networking opportunities for many occupational therapists both nationally and internationally. I would like to congratulate Marilyn Pattison on her WFOT Merit Award in recognition of the outstanding

and sustained contribution she has made to WFOT. Congratulations also to Professor Lynette Mackenzie on her election to the WFOT executive team in the research portfolio and to Professor Elspeth Froude as Congress Scientific Convenor. We are very proud and fortunate to have such wonderful Australian occupational therapists volunteering for WFOT.

OTA had a very popular booth at the WFOT Congress promoting our association, our 2023 National Conference, and the current work opportunities in Australia. In talking to occupational therapy leaders across the globe, the challenges of workforce shortages are evident everywhere. It was fantastic to see the high-quality research being showcased at the WFOT Congress, indicating that Australian occupational therapists are leaders in many practice areas.

Next year is shaping up to be another exciting and challenging year for both OTA and the Australian occupational therapy profession. OTA is very prepared to maximise opportunities and increase our reach and influence, both within the profession and to external stakeholders. We are constantly looking to the future and have already commenced work on our next strategic plan. I hope you have the opportunity to take a breath and reflect on 2022 over the summer and look forward to 2023 with optimism and great pride in being part of the best profession there is!

As occupational therapists, we have seen increased recognition and valuing of what we do. With the impact of the pandemic continuing to stretch systems, demand for occupational therapy has never been higher.

CEO’s Report

Samantha Hunter

It has been another year of challenge, change and growth for Occupational Therapy Australia, and it is timely to stop and look back on all we have achieved. After two years of pandemic living, of adapting to a new way of working and being, we emerged both locally and nationally from our much smaller, sometimes more intense localised lives.

Many of us emerged exuberantly, picking up where we were previously cut off – back to the workplace, back to sport, back to friends and family gatherings – making up for what we might have considered lost time. Others were more tentative in their approach – a gradual opening and a reluctance to let go of the smaller space and sometimes slower pace that we had become accustomed to. No matter where you sit on the spectrum of re-immersion, we all emerged somewhat changed.

We do things differently now. We had rapid change and uncertainty thrust upon us, and we had to adapt. All of us. At OTA, that has meant that we have changed – we hope for the better – and we hope that our members and the profession will see and benefit from the difference.

During these times of crisis, we heard the uncertainty of occupational therapists and their clients, and we mobilised our professional standards and government relations staff to seek out necessary information, keep members informed and advocate for better access and outcomes for the profession. We answered thousands of questions posed by our membership.

How did this change us? We listened more deeply, we learned to better reach out and into government and to build deeper relationships with our allied health partners, and we displayed the power of a unified voice – both as a profession and as a sector. These alliances and strong bonds will continue to hold the association in good stead as we continue to navigate the complex operating environment of the health landscape.

Our staff have adapted remarkably well and as we continued to grow, we fully realised the ability to draw talent from right across the nation. Occupational Therapy Australia is now able to attract the best of the best with our hybrid or fully remote work options, as well as our ability to flex our work to meet the needs of families, members and our wider community of stakeholders and connections.

During 2022, the structure of our Senior Leadership team changed – take a look at pages 8 and 9 for an introduction to the team. The composition and skillset of our new team positions OTA to continue meeting our strategic objectives and supporting our members. Don’t hesitate to reach out to any members of the team if they can provide support or if you have any feedback.

While we have grown significantly to continue meeting the demands of our growing membership and the increased need for representation, we have also championed inclusion and diversity in our own OTA workforce allowing us to draw from a large range of experiences, ideas and perspectives. I am incredibly proud of our people and the commitment they

show to each other and our membership, and I am incredibly proud that our people are increasingly more representative of our broader community. Our diversity is our strength, and our shared values are our glue. We share a vision, a purpose and a passion for our mission at OTA.

Another COVID-induced change was to have a razor-sharp focus on what really matters. For many of us, that meant deep reflection on our own personal “why”. For many businesses, OTA included, the time demanded a focus on what was mission critical – a time to perhaps to let go of legacy, to refine our scope, to prepare for a new future. Our future requires us to be more nimble than ever before and to be prepared to act quickly in the face of change. We have learned, and are still learning, when to be iterative and when to be exact.

As an association, we are listening more deeply, looking for the opportunities amongst the issues and determining with clarity the things that matter most to our members and our profession. A critical step in ensuring our continued growth and responsiveness to the challenges ahead is to revisit and revise our strategic direction. The association has commenced this important piece of work that will guide our future while acknowledging the uncertainty of our environment. Of course, we will be seeking the views and insights of our members, our key stakeholders and our wider sector. I encourage all of you to be part of the conversation that carves out our place in the future, enhancing the outcomes for our community and our pride in the profession.

Vale Ruth Read

Ruth Marit Read was born on 4 March 1930 in Inverell, NSW. In early 1948, Ruth moved with her family to Brisbane and enrolled at the Central Technical College Art School. Deciding she was too strait-laced and not sufficiently creative to fit into the art world, she sought alternatives including the Australian Red Cross handcraft service. Ruth was employed from June 1951 to June 1953 as a handcraft instructor at the Red Cross Handcraft Service at Brisbane General Hospital.

Ruth moved away from home and worked as an occupational therapy assistant (or light trades instructress) at the Commonwealth Department of Social Services Rehabilitation Centre, “Maryport”, in Mt Martha, Victoria. She got on well with the occupational therapists and they invited her to Melbourne to join their meetings.

In 1955, a diploma course in occupational therapy started at the University of Queensland (UQ). Having already matriculated, Ruth obtained a Commonwealth scholarship for the course and was awarded her Diploma in Occupational Therapy in February 1958.

Shortly after, Ruth was employed as a part-time demonstrator for the occupational therapy diploma course at UQ. In October 1959, she became a full-time university demonstrator – a position she held until December 1962.

An occupational therapy degree course was in the planning stages, so Ruth enrolled in an arts degree, undertaking three years of psychology studies.

In February 1963, Ruth became senior occupational therapist at Princess Alexandra Hospital, Brisbane – a role she held until 1972.

The occupational therapy degree course commenced in 1968, and Ruth took the additional physiology, anthropology and

sociology subjects required. She was awarded her Bachelor of Occupational Therapy in December 1970 – the first recipient of that degree in the country.

In 1972, Ruth obtained an occupational therapy position in the Division of Geriatrics, which was later reclassified as adviser in occupational therapy. Ruth remained in that position until her retirement on 4 March 1989.

Ruth’s involvement in the Queensland Association of Occupational Therapists (QAOT) commenced in her student days. Following her graduation, she had a 20-year involvement as an executive member, holding positions of treasurer, secretary and vice-president. She was federal delegate to the Australian Association of Occupational Therapists and active on national committees. QAOT awarded Ruth honorary life membership in December 1989 when she retired.

The state Health Minister appointed Ruth as the inaugural chair of the Occupational Therapists Board of Queensland when the Occupational Therapists Act (1979) came into effect in April 1980 and registration of occupational therapists finally commenced. Ruth held that position until April 1992.

Ruth’s interests also included the National Parks Association of Queensland, of which she was a member since 1962, including vice-president from 1991 to 2005. She was awarded honorary life membership in 2007.

Ruth also travelled extensively and had an interest in photography, winning many prizes for it. She was a member of the Australian Photographic Society and the Queensland Camera Group.

From Jacqueline McConnell, Ruth’s friend and colleague:

Ruth didn’t suffer fools gladly and was a straight talker. She had many stories from her overseas and Australian travels.

She excitedly told me about her “boyfriend” at an Independent Living Centre function when she first started going out with Rob. When travelling together to our Occupational Therapy Oldies breakfasts and lunches, she would talk about Rob and his family and the places she and Rob went. Rob went to her occupational therapy functions, and she to his family get-togethers and engineering reunion.

She enjoyed the outdoors and seemed to enjoy the walks we had in the later years in the gardens at Regis. The following are some of the memories I received from occupational therapy colleagues when hearing of Ruth’s passing:

• Several mentioned their memories of Ruth during their student placements at Princess Alexandra Hospital, Brisbane

• A couple of people recalled Ruth interviewing them for occupational therapy positions way back in the 1970s

• One commented on Ruth’s photographic prowess, and another on her exotic cats

• Ruth was a great advocate for occupational therapy, a pioneer in occupational therapy, dedicated to the profession, stalwart of the profession, and did so much for the profession

Ruth’s passing marks the end of an era.

Profile adapted from the Occupational Therapists Board of Queensland: a history 1980 – 2012

2022 award winners

2022 Elspeth Pearson Award winners

Rana Morgan

Rana will advance his learning in culture, ethnicity and health to further develop his skills in supporting culturally and linguistically diverse (CALD) families and children to experience equal and equitable access to health literacy in his practice. “It is a privilege to be a recipient of this award as it provides an opportunity to continue to develop my skills to support and empower culturally diverse families,” said Rana.

Megan Simon

Megan will further her understanding of working with children with developmental delays and to guide her in developing a bespoke self-care and social skills program specifically for these children. “It’s a privilege to be a part of a profession that values developing early career clinicians and delivering best practice. I’m really looking forward to undertaking these courses so that I can be the best OT that I can, positively impact the children and families that I work with, and give back to the profession in future,” said Megan.

Elspeth Pearson (1926-2015) was a member of the first cohort of occupational therapists to be trained in Australia and was well known for her pioneering work in mental health. She was an inspirational leader who had a clear vision for occupational therapy in Australia and a strong commitment to developing and nurturing occupational therapists throughout their career. Her commitment to the profession lives on through the Elspeth Pearson Award by supporting and inspiring early career occupational therapists. Applications for the 2023 Elspeth Pearson Award will open in January 2023.

Occupational Therapy School of Victoria Clinical Award winner

Laura Jolliffe

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videos for therapists to support skilled-delivery of complex upper limb interventions”. Laura is currently employed at Peninsula Health as the Allied Health Research and Knowledge Translation Lead and Monash University as a lecturer in the Department of Occupational Therapy.

NEEDED

Put your skills to good use and support positive change in developing countries with the Australian Volunteers Program.

received

award for her project

“Equitable education: educational

Meet the Senior Leadership team

Samantha Hunter –Chief Executive Officer

Sam was appointed to the role of CEO by the Board of Directors in September 2018 and given the mandate to drive transformation and growth in the association to ensure longevity, ongoing contemporary relevance and increased influence through representation and advocacy.

Over the past four years Sam has led, developed and grown a highly skilled team who have successfully achieved solid growth and increased awareness and representation of the profession with key stakeholders, agencies and government agencies and ministerial portfolios.

Sam has over 25 years of experience as both a senior leader and board director working across corporate, professional services and not-for-profit organisations. She has a breadth of experience collaborating with multi-disciplinary teams across sectors and understands the nuances of complex and competing political environments. Sam strives to work with members, government and stakeholders to create collaborative solutions for an engaged and resilient profession.

Sam is a natural communicator with high level business development skills demonstrating consistently strong growth, with a strong focus and belief in continual learning and development and looks for opportunities to develop her team to be inspired leaders and to be at the forefront of innovation in their sectors.

In her spare time Sam is an enthusiastic but inconsistent golfer, sings in a choir, collects art and has her hands full wrangling office dog Rosie, the wild dog Poppy, and the real boss Kitty. She is the very proud mum of Tom.

Brooke Carter – General Manager, Divisions

Brooke joined OTA in February 2020 as Queensland Divisional Manager and spent her first two years navigating the complexities of a global pandemic and contributing to policy initiatives and activities to support occupational therapists in Queensland.

Now, as General Manager Divisions, Brooke leads a team responsible for driving the association’s work at the state/territory level. This includes developing strategic stakeholder relationships, monitoring industry trends and topical issues and delivering Hot Topic events. She works closely with Divisional Councils and OTA members to provide advice and recommendations to support occupational therapists across the country.

Brooke has worked across a range of industries in Australia and the UK. Following a Bachelor of Exercise & Nutrition Science, she worked in nutrition. She then completed postgraduate studies in Business/PR and refocused her energy on contributing to initiatives which improve health and wellbeing for people and organisations. Brooke has worked in a variety of roles in training & development, stakeholder engagement, people & culture, governance, and membership associations.

Originally from New Zealand, Brooke now lives on the Sunshine Coast and spends her spare time at the beach, tinkering with the veggie garden, on creative pursuits such as pottery and painting, and exploring local places.

Erin Garner – General Manager, Occupational Therapy

Erin is an experienced occupational therapist who has worked across a range of health areas including public health, community practice and private practice.

Erin’s clinical experience is predominately in the area of spinal cord injury, in both adult and paediatric settings. Erin has been involved in several research activities and publications, and holds a Master of Advanced Occupational Therapy, as well as a Master of Business Administration.

Erin is the lead clinical expert at Occupational Therapy Australia, leading a team responsible for the provision of clinical oversight of professional practice for occupational therapists including practice scope and standards, and learning and development.

Erin is an experienced leader, having held a number of senior management positions at major public hospitals, following a solid grounding in various clinical roles.

Outside of work, Erin loves trail running, food and family. Erin has lived overseas and speaks two languages.

Lea Rawlings – Chief of Staff, Executive Advisor

Commencing with OTA in 2016, Lea Rawlings is experienced across the association with roles as WA Divisional Manager, Special Project Manager, and General Manager, Divisions. Currently as Chief of Staff in the Office of the CEO, Lea works closely with CEO Samantha Hunter, the Office of the CEO team members and Senior Leadership team to represent and collaborate with the portfolios to ensure delivery of the current Strategic Plan and supporting the development of our next strategy. Lea plays a key role in embedding organisational strategies into the day-to-day operations of OTA, including the Reconciliation Action Plan and the OTs in Action social justice groups.

With a bachelor’s degree in Health Science and qualifications in Workplace Training and Assessment combined with Lea’s 20 years of experience, particularly in public

health settings, high level stakeholder management, membership and project management, she ensures that OTA is always performing optimally and serving our members, stakeholders and profession with utmost care and professionalism.

When Lea is not juggling kids sport and dog walks, she likes to get on the tools and enjoys a hands-on approach to home renovating.

Rebecca Meyer – General Manager, Membership and Engagement

Rebecca joined OTA in 2014 as National Manager, Conference Events and Business Development, setting up the inaugural team that brought management of OTA’s national conference, sponsorship and advertising in-house.

Her role developed in 2019 to Head of Events and Business Development and again in 2021 to General Manager of Events and Business Development.

In July 2022, Rebecca’s role was further expanded to General Manager of Membership, Marketing/Communications, Events and Business Development. Leading a team of 15, Rebecca has accountability for strategy, structure, communications, budget, stakeholders and ensuring the teams operational plans are aligned to the OTA Strategic Plan, while working closely with the CEO and Senior Leadership team.

Rebecca is a strong business professional with a Bachelor of Business Management from La Trobe University. Prior to joining OTA, Rebecca had over 15 years of experience working in Australia and overseas in event and conference management, including national conference meetings and large, complex projects.

Rebecca has developed a thorough and detailed understanding of the association and her passion, enthusiasm and attention to detail drive her to bring innovative growth to OTA.

Outside of work, Rebecca enjoys running, baking sweet treats, solving Sudoku puzzles and beach time with family.

Erin Eades – General Manager, Corporate Services

As a qualified Company Secretary, Fellow of the Governance Institute of Australia and a member of the Australian Institute of Company Directors, Erin brings to OTA a wealth of knowledge in connecting governance processes and improving procedures.

In her previous role at the Ovarian Cancer Research Foundation, Erin led the HR function supporting the CEO to ensure impact and outcomes for the organisation. She also led a digital transformation of data management, marketing and fundraising capability. At the CFA, Erin gained expertise in identifying potential conflict situations, connecting executives on cross directorate issues and developing solutions to progress key outcomes.

Erin is a member of the AICD Not-for-Profit Committee and a Director of Flemington Financial Services Ltd and has held roles as Company Secretary for the Melbourne Women in Film Festival and Flemington Association. She also provides her services to smaller charities and consults for larger organisations.

Erin has a keen interest in supporting culturally and linguistically diverse (CALD) communities. She has volunteered for organisations such as Foundation House and completed an honours thesis in communicating risk to CALD communities. As a bit of an Italophile, Erin enjoys returning to Italy to brush up on her language skills.

General Managers, Government and Stakeholder Relations

As General Managers of Government and Stakeholder Relations, job share partners Alex Eather and Alissa Fotiades work in collaboration with the CEO and the Senior Leadership team to lead OTA’s engagement with its key stakeholders and advocating for its members. Alex and Alissa’s goal is to make sure that OTA is talking to the right people at the right level on the right issues to get the greatest impact for OTA members and the profession. They enjoy working with members and stakeholders to understand the complex

challenges the sector faces and leading their team to develop policy and advocacy solutions.

Alexandra Eather

Alex worked in Victorian state government for nearly 20 years and brings a wealth of experience in government relations and communications. Alex holds a Bachelor of Arts/ Commerce (Hons) and a Postgraduate Diploma in Communications and Media Studies. Before working at OTA, Alex worked with Alissa to manage the government relations team at the Environment Protection Authority. Before that, Alex worked in government relations at WorkSafe Victoria for several years, where she worked on many complex and controversial policy and stakeholder issues.

Alex enjoys baking cakes and reading cake recipe books, sewing and drawing. She is learning French in hopes of visiting Paris soon. She is usually reading a hardcopy novel and a couple of audiobooks at any one time.

Alissa Fotiades

Alissa holds a Bachelor of Laws (Hons) degree and a Bachelor of Physiotherapy (Hons) degree and has extensive experience as a senior lawyer and policy advisor across a range of government, health and insurance settings. She has over 20 years’ experience across the health portfolio gained through working in a diverse range of clinical and government sectors. Prior to joining OTA, Alissa worked with Alex to lead the government relations team at the Environment Protection Authority and was an advisor in external affairs and health policy at WorkSafe Victoria.

Alissa enjoys going on family holidays and lunching with friends. On the weekend, she enjoys watching junior sport and in the summer, she can be often found on a beach ignoring everything but her book.

Quarterly update – Member news

OTA engagement with MPs

On 26 August 2022 OTA was delighted to meet with the federal Assistant Minister for Mental Health and Suicide Prevention, and Rural and Regional Health, the Hon. Emma McBride.

OTA discussed the importance of mental health occupational therapists, and how to support and promote their work. The minister said she appreciated and understood the value of occupational therapists across diverse settings and was determined to raise their prominence and the profile of all allied health professionals to ensure they could work at their full scope of practice and contribute to the wellbeing of all Australians.

On 6 September 2022 OTA was pleased to meet with the Victorian Shadow Minister for Health and Ambulance Services, Georgie Crozier. OTA discussed the current issues facing occupational therapists across the health sector, and OTA’s work to support the profession, particularly in mental health, public health, disability and aged care. Ms Crozier spoke about the important contribution of allied health professions, including occupational therapists, in the health sector.

OTA has also recently written to the Minister for the National Disability Insurance Scheme, the Hon. Bill Shorten, to restate its interest in being involved in the coming NDIS review. More specifically, OTA highlighted to Mr Shorten the critical role that occupational therapists play in the NDIS, and the need for the NDIS fee structure to offer fair and appropriate

remuneration for the high quality and wide scope of services that occupational therapists provide to NDIS clients.

OTA mental health strategy

As many of us know, the practical, recoveryfocused approach of mental health occupational therapists is under-recognised. OTA recently commissioned a research report “Thinking ahead: Mental health” that was the culmination of substantial engagement with occupational therapists, consumers and the mental health sector. This report forms the key input into OTA’s mental health strategy.

In addition to the lack of awareness of occupational therapy mental health practitioners, the nature of mental health

work means occupational therapists working in this area may become burnt out. There is a need for ongoing career support, including training and education, and a defined career pathway to enable full recognition of this work as a specialist skill.

As a peak body, OTA can use its influence by engaging more fully with all stakeholders in this area, including consumers, to ensure the value of mental health occupational therapy practice is communicated, new opportunities are uncovered, and consumer needs are understood and supported.

To support the occupational therapy profession, and specifically mental health practitioners, OTA will deliver

OT full membership of Employee Assistance Professional Association of Australia

At a member request, OTA recently lobbied the Employee Assistance Professional Association Australia (EAPAA) for eligibility of occupational therapists in its clinical membership.

Following discussions with EAPAA, the association will now allow appropriately experienced mental health occupational therapists to apply for full membership. Those wishing to apply will need to be Better Access to Mental Health-endorsed through OTA and have an individual statement of ongoing supervision in relation to mental health work and counselling.

EAPAA has also invited our General Manager of Occupational Therapy, Erin Garner, to present at the EAPAA conference in November to raise awareness of mental health occupational therapists.

We hope this will lead to further opportunities to give EAPAA and the wider mental health community new insights, broader experiences and deeper collegiality.

greater workforce support and career pathways, increased awareness of occupational therapy mental health capability, and improved stakeholder and consumer relationships and advocacy.

We will provide further information about the mental health strategy (including expanded learning and development opportunities for mental health occupational therapists) at the OTA Mental Health Forum on 25 November 2022.

Aged care

OTA continues to represent members by participating in reform engagement opportunities with the Federal Government and Department of Health and Aged Care and attending various webinars and workshops to stay updated on changes.

Following a recent roundtable meeting (ahead of the recent national Jobs and Skills Summit) with the federal Minister for Aged Care, the Hon. Anika Wells, OTA, as a member of AHPA, assisted in identifying actions for Ms Wells to consider during the summit.

OTA strongly emphasised the need for dedicated funding and mandated care minutes for allied health professionals to address the lack of job security, particularly in residential aged care. OTA also emphasised that without a strong allied health workforce in aged care, it was unable to support the training of the future aged care workforce through student placements. AHPA has released a statement outlining its key recommendations and a media release, both of which can be found at the AHPA website at ahpa.com.au/advocacy.

This quarter, OTA has also prepared joint submissions with AHPA on the pricing framework for aged care and inputting into an aged care data strategy. It has independently submitted to the Department of Health and Aged Care in response to a consultation paper about the new approach to regulation across aged care.

Disability

OTA is looking forward to working with the new leadership team at the NDIA following the appointment of Chair Kurt Fearnley AO and CEO Rebecca Falkingham PSM in late September.

Mr Fearnley was a serving member of the NDIS Independent Advisory Council during the trial phase of NDIS from 2013 to 2015. Ms Falkingham joins the NDIS after spending several years as the Secretary of the Victorian Department of Justice and Community Safety.

OTA has prepared submissions to the Parliamentary Joint Standing Committee on the NDIS and the Australian National Audit Office on aspects of the NDIA’s operation, particularly highlighting the lack of consistency and transparency in a number of NDIA operational and decision-making processes. OTA members provided valuable input into these submissions, which highlight challenges for occupational therapists working with NDIA, and drive change in the agency and improved outcomes for participants. They are available on the OTA website.

Workforce

OTA has been in communications with the Department of Home Affairs and the National Skills Commission (NSC) to highlight the shortage of occupational therapists nationally. The NSC has updated the recent 2022 Skills Priority List to reflect

this shortage, including a change to the Queensland status where no shortage was previously listed. OTA will continue to engage with NSC to ensure the future demand of occupational therapists is reflected as “strong” rather than “moderate”.

Veterans

OTA has recently engaged with the Department of Veterans Affairs (DVA) in its review of the occupational therapy fee schedule. OTA has lodged a submission outlining current issues and potential solutions. Additionally, OTA representatives attended a virtual and in-person workshop in Canberra to further discuss and fine-tune these ideas. The review has stated that it aims to be budget neutral; however, OTA is hopeful that current administrative burdens may be eased by improving internal DVA processes.

OTA also attended a deep-dive workshop in September to contribute to the DVA Mental Health and Wellbeing Service Review and Transformation Program.

OTA has lodged a submission to the Royal Commission into Defence and Veteran Suicide. The submission focused on the role of mental health occupational therapy in addressing veteran suicide and poor mental health outcomes and hopes to raise awareness of the valuable work of mental health occupational therapists in this space. The submission also addressed

Continued next page

The past few months have been exciting at federal and state levels, and the next six months promise to follow suit.

Quarterly update – Member news

administrative issues similar to those discussed in the fee schedule review, as well as how more traditional occupational therapy services can directly link to mental health outcomes. This submission will be available on the OTA website.

OTA has also been busy at a state level

In the ACT and NSW …

OTA met with the ACT Shadow Minister for Mental Health, Ed Cocks, in August. OTA also lodged a submission as part of the ACT Disability Strategy Consultation and provided feedback to the ACT Government on the proposed legislative change to mandatory reporting of drivers of heavy vehicles in certain circumstances.

In South Australia ...

OTA had ongoing correspondence with the office of the SA Minister for Health and Wellbeing, Chris Picton, about the implementation of mental health specialists and supports in schools. The SA Divisional Manager continues to liaise with the office regarding OTA’s involvement in the planning and implementation of the new initiative, advocating for

occupational therapists as the primary mental health professionals working within state primary and secondary schools.

OTA met with ReturnToWorkSA again regarding the introduction of specific mental health occupational therapy services with the RTWSA fee schedule.

OTA lodged a submission in August to the Social Development Committee inquiry into, and report on, the impact of the NDIS on South Australians living with disability who have complex needs and are, or are at risk of, residing for long periods in inappropriate accommodation (such as hospitals or residential aged care). Additionally, OTA provided feedback through the recent consultation process for the review of the SA Mental Health Act 2009.

In September, the SA Divisional Manager attended and represented OTA at the Caring Futures National Forum to co-produce a road map to deliver better care for Australia’s future.

In the Northern Territory … The NT Divisional Manager met with the NT Chief Allied Health Officer in August to

Over the next four months, OTA will be developing a stakeholder engagement strategy.

The development of the strategy will consider how OTA engages with stakeholders, its established relationships with groups and individuals, and opportunities to grow connections to build OTA’s reach and influence to result in better outcomes for members, the occupational therapy profession and occupational therapy clients.

The strategy will build OTA’s capacity to engage effectively with stakeholders and enable it to meet its strategic goal to enhance awareness of, access to, and the impact of the occupational therapy profession.

OTA will keep you updated with the development of the strategy. If you have any questions, please reach out to the Government and Stakeholder Relations team via policy@otaus.com.au

advocate for greater opportunities and support for local occupational therapists to engage in and drive occupational therapy-specific research in the territory.

In Queensland ...

OTA met with Workcover Queensland (WCQ) to further specify mental health occupational therapists in WCQ, their role and recognition. Additionally, OTA achieved a 4.4 per cent increase in occupational therapy services fees under WCQ, and the inclusion of mental health occupational therapy through BAHMs in their table of costs.

In Victoria ...

OTA made submissions on the Victorian Suicide Prevention and Response Strategy and engaged in consultation workshops and made a submission to inform the Victorian Health Workforce Strategy.

In Tasmania ...

OTA made a supplementary submission to WorkCover Tasmania advocating for the role of occupational therapy in the assessment and treatment of psychological injuries.

Recent Hot Topic events

Over the past few months, OTA ran several successful Hot Topic events, including the following:

• Managing risk: Confidentiality, privacy and record storage – a national event presented by representatives from Maurice Blackburn Lawyers and attended by more than 165 occupational therapists

• Long COVID: What every occupational therapist needs to know – a national event attended by more than 150 occupational therapists

A summary of these events and copies of presentations and resources can be accessed in the Hot Topic event section of the OTA website.

Considerations in assistive technology: research advancements

Dr Jacki Liddle and Dr Tammy Aplin Editorial Board Members, Australian Occupational Therapy Journal

Globally, there is increasing awareness of the benefits, barriers to access and impact of assistive technology (AT). Earlier this year, the World Health Organization (WHO) and UNICEF “Global report on assistive technology” was released, highlighting global unmet need and recommendations for change1. In Australia, advocacy groups and the media have highlighted issues of unmet need, with the new funding systems creating complexity and challenges to accessing required AT and supports2. There has also been attention on the importance of considering the risks and access of new and emerging technologies, such as Artificial Intelligence. In particular, there has been focus on the human rights implications of these new technologies, with emphasis on technology as an enabling right including accessible mainstream technologies3.

Reflecting the need to explore the complex and diverse range of AT-related supports, recent publications in the Australian Occupational Therapy Journal (AOTJ) have highlighted a range of technologies and areas of recommendations and action consistent with the WHO global report. Publications in recent years have focused on lower-tech AT, assessment and support processes, economic impact, and broader sociotechnical and cultural considerations.

While perhaps not an obvious example of AT, assistance dogs have received heightened research and practice attention in recent years, with the NDIS supporting assistance dogs as reasonable and necessary support for some participants. While assistance dogs

can support participation and promote psychological wellbeing, gaps in therapist knowledge and skills have been identified. A recent survey of occupational therapists reported in the AOTJ indicated expanding occupational therapists’ knowledge, and increasing access to reporting templates, supports and education-improved clinical reasoning and practice in this area4.

While assistance dogs represent a relatively new technology for therapists, home modifications and the recommendation of AT and task modification during home visits is a common aspect of occupational therapy in supporting safe discharge from hospital and community participation. While a routine part of practice, high-level research such as randomised controlled trials are uncommon. The Lockwood (et al., 2020) study was an important step in evidencing this routine practice5. Their process evaluation within a randomised controlled trial of multidisciplinary rehabilitation after hip fracture explored the impact of home visits to inform and support AT recommendations including home modification. The impact of a home visit included more recommendations and higher adherence to the recommendations (including those for AT). The authors suggest home visits support collaborative decision-making, therefore supporting improved clinical outcomes.

Like home-visiting practice, the recommendation of wheelchairs is a common role for occupational therapists. Access to wheelchair assessment; however, can be inequitable. Telehealth therefore offers the potential of increased access when

collaboratively designed. In New Zealand, the design of a telehealth wheelchair assessment service was explored from a range of stakeholders, including Indigenous (Maori) therapists and wheelchair users6. The work indicated the importance of considering risk, uncertainty, and access and equity within service delivery and design. Culturally safe communication practices were emphasised, as were user goal-focused approaches.

Given the strain on the health system, there is growing need to provide evidence for the value of AT and related occupational therapy services, in particular the economic impact. A recent publication in the AOTJ provides an excellent example of how research can provide high-level evidence of the value of AT. The study indicated the social return on investment of modified vehicles for people with disability7. Vehicle modifications can be an important AT in enabling access to the driving or passenger role. Costs can vary widely; however, this analysis indicated that even with higher-cost modifications, and in scenarios where costs were shared between the consumer and funders, there is a clear return on investment. The authors indicated that with the highest-cost scenarios, payback periods were less than four years. This approach helps providers determine, monitor and advocate for the impact of this type of intervention.

References can be viewed by scanning the QR code

WFOT update

1st Alternate Delegate

The 35th WFOT Council Meeting was held in Paris, France, in August. Delegates from 57 countries and six regional groups joined executive management to review and discuss WFOT aims and strategic planning for the future. OTA delegates Adam Lo, Emma George and Lynette Mackenzie participated in focus groups on justice equity, diversity and inclusion, education, human resources and governance. We welcomed four new full members to the WFOT (Peru, Lebanon, Ethiopia and Costa Rica) and one new

associate member (Kyrgyzstan), bringing the total membership to 107 organisations. Elections were held for executive positions, and we are thrilled to report that OTA’s longserving WFOT delegate Lynette Mackenzie (2nd Alternate Delegate) was elected as WFOT Programme Coordinator Research. Lynette brings a decade of service to WFOT, and we are excited about her leadership at the executive level. In addition, Margarita Gonzalez (Colombia) was re-elected as WFOT Vice President and Tecla Mlambo (Zimbabwe) as WFOT Programme Education.

A tradition of WFOT Council Meetings is that delegates exchange cultural gifts. Adam prepared cotton bags (more environmentally friendly) with Vegemite, Australian honey drops, mini koalas and boomerangs/ flags, handmade cards from a local school, beautiful Indigenous art stones that Emma organised with her friend and First Nations artist Mickey Barlow, and pens and lip balms from OTA. They were a big hit with delegates, and a hard act to follow as we start to consider what to include at our next WFOT Council Meeting in Bermuda in 2024

Adam Lo, WFOT Delegate, and Dr Emma George, WFOT

Welcome to WFOT Council Meeting 2022

WFOT Council Group Photo

(decided after a vote by all members, with the other contenders being Hong Kong, Morocco and Rwanda). Please send us any ideas, including anything else WFOTrelated – whether requests for information or support, or ideas on collaboration or how to link up with international colleagues.

Adam’s reflection

With fond memories of the WFOT Council Meeting in South Africa still fresh in my mind as the 1st Alternate Delegate in 2018, it was an absolute pleasure to represent Australia in Paris as the OTA delegate. The previous council meeting scheduled for 2020 in Hong Kong was cancelled due to the COVID-19 pandemic and rescheduled as a virtual meeting in 2021. The Paris meeting was the first time I met others face-to-face since becoming the delegate. I was excited about the opportunity to catch up with many of the delegates from other countries in the flesh – and meet new ones – with a hug here and there (something that I almost fell out of practice with in social settings due to the pandemic!).

At the meeting, I was also acting proxy for the President of the Asia Pacific Occupational Therapy Regional Group, Associate Professor Ling-Hui Chang, of Taiwan, in her absence. This gave me the opportunity to network, plan and work with the presidents of the other WFOT regional groups over the course of the week. This included the Association of Caribbean Occupational Therapists, the Arab Occupational Therapists Regional Group, the Confederación LatinoAmericana De Terapeutas Ocupacionales, the Council of Occupational Therapists for the European Countries and the Occupational Therapy Africa Regional Group. We all agreed we are keen to further enhance our collaboration and communication through several identified strategies and actions.

Additionally, WFOT invited me to be a mentor for two other delegates attending the council meeting for the first time. I gladly accepted, and really enjoyed hosting and mentoring the Acting Delegate of Japan, Professor Jumpie Oba, and the Acting Delegate of

South Korea, Professor Byoungjin Jeon. I believe it is very important in international occupational therapy diplomacy to not only develop a good relationship with colleagues across the world, but also pay close attention to collaborative ties with near neighbours within the Asia-Pacific region.

In my observations, our 1st Alternate Delegate, Dr Emma George, was a shining star during the council meeting, with cross-cultural networking seemingly a natural habitat for her. Emma will no doubt successfully carry the baton forward when she becomes the delegate in 2024. The election of our 2nd Alternate Delegate and my predecessor, Professor Lynette MacKenzie, into the WFOT executive team is testament to our intent to serve as long-term (possibly lifelong) volunteers to

the cause, and ensures a continuous chain of contributions and representations from Australia in WFOT. Marilyn Pattison, the previous WFOT president and honorary fellow – the highest international honour an occupational therapist can receive – was a previous WFOT delegate for Australia and continues to contribute significantly for our profession. In Paris, she received the WFOT Merit Award with a standing ovation from the audience. Marilyn is not only an inspiration to many Australian occupational therapists, but also to colleagues across the globe.

Ten occupational therapy associations inaugurated WFOT in 1952. Australia was one of the pioneering nations with Canada,

Continued next page

Adam Lo and Carol McKinstry (OTA President) at the OTA booth at WFOT Congress

Asia Pacific Occupational Therapy Regional Group

Adam with delegates from Japan

WFOT update

Denmark, India, Israel, New Zealand, South Africa, Sweden, the United Kingdom and the USA. Today, the overall footprint, output and reputation of Australian occupational therapists continues to be positive and strong within the international community – something we will strive to maintain. This positive perception is no doubt a collective achievement of Australian occupational therapists across various fields, whether in traditional practice settings or emerging areas, in clinical care or education, or research and policy development. Well done, to all involved. Keep up the great work together, as it is not all done domestically or internationally.

Emma’s reflection

It was an honour and thrill to attend my first WFOT Council Meeting. As the 1st Alternate Delegate, this was an opportunity to listen, learn and observe how delegates from different countries communicated, advocated and worked together. The meeting is formal and well-structured, and the discussions rich and focused on the needs, growth and priorities of the profession. Throughout the meeting, we sat with colleagues from Japan and South Korea as Adam mentored all of us on council processes and strategic decision-making. During breaks, we met delegates from all regions, and it was interesting to hear how occupational therapy is in demand around the world in so many areas of practice. There is a shared commitment to supporting the development of the profession locally and globally.

A highlight was meeting Ukrainian WFOT delegate Olya Mangusheva, who shared how she left Ukraine with her young family at the start of the war. She delivered a passionate call for support for occupational therapists, survivors and the broader community: Dear colleagues, on behalf of the Ukrainian Society of Ergotherapists, we would like to thank WFOT for its continued support of the Ukrainian ergotherapy community, especially at this tragic time of the Russian invasion of Ukraine. We thank WFOT as well as numerous member organizations for their public

statements of condemnation of this war that infringes on the rights of the Ukrainian people to live purposeful and engaged lives in safety and peace. Forty million people in the heart of Europe are experiencing severe occupational injustice and deprivation in the worst war and humanitarian crisis since World War II.

The Ukrainian Society of Ergotherapists has been working hard to support our therapists across the country, who are working with wounded soldiers returning from the war front with online learning and mentorship projects, but we are such a young profession, and due to our limited capacity, we cannot meet the increasingly growing needs of our colleagues, not to mention our clients.

So, allow me to focus on the ways WFOT member organizations can assist us in enabling access to the human right to participate in chosen occupations.

Firstly, I address European colleagues, as the majority of refugees have entered your countries and are putting a strain on your healthcare systems (and we are aware of that). We ask that, in solidarity, you extend your services to Ukrainian refugees AND when you carry out outreach programs for our citizens, please let the Ukrainian Society of Ergotherapists know about them.

Secondly, we are planning the fourth annual occupational therapy conference in Ukraine to be held online on 3 December 2022, and we are seeking skilled occupational therapists with

experience treating war veterans, refugees and working in under-resourced contexts. Please inquire within your national associations and help us find such expert speakers.

And thirdly, we invite WFOT member organizations to be paired with rehabilitation departments in hospitals or rehabilitation centers across Ukraine in an extended mentorship project. However, we ask that you carefully consider your resources, availability of professionals qualified to address unique needs of clients in war crises or experienced in developing OT services in under-resourced environments, or creative and culturally sensitive thinkers, as well as possibilities for fundraising. If this sounds feasible to your organization, we welcome your help. Please contact us and we will further discuss this. We have got some very tangible ideas in mind. Our email is ergo.ukraine@gmail. com. It is also on the WFOT website.

Lastly, we would like to remind you that WFOT encourages contacting the national organization prior to initiation of projects to be carried out in the foreign country.

Once again, I would also like to thank WFOT and all member organizations at this council for expressing their solidarity with the people of Ukraine. We will need your ongoing support.

- Olya Mangusheva, Ukrainian delegate to WFOT

Australian delegates Lynette Mackenzie, Emma George and Adam Lo

WFOT Congress

The 18th WFOT Congress “Occupational R-Evolution” was successfully held in Paris from 28-31 August 2022. The WFOT delegates attended with OTA President Professor Carol McKinstry and CEO Samantha Hunter. The hybrid congress was attended by more than 2,500 delegates from more than 100 countries.

The congress provided a range of content – starting from the Education Day to the Closing Ceremony – as a valuable learning experience for all (in English and French).

WFOT awards were officially presented during the congress. The Thelma Cardwell Foundation Award for Research was presented to María Agostina Ciampa, Natalia

Soledad Fiorella Martínez and Gonzalo Aranés. WFOT Merit Awards were presented to past WFOT Executive Management team members Marilyn Pattison, Sandra Bressler and Liliana Alvarez. The highly prestigious WFOT Honorary Fellow Award was presented to Sue Baptiste, Margarita Gonzalez and Ritchard Ledgerd.

An OTA information/exhibition stall at the congress was well attended by delegates, volunteers and other Australian occupational therapists. Consultation and promotion of OTA conferences and opportunities to work in Australia were delivered by the OTA CEO, President, WFOT delegates and a handful of member volunteers.

The location of the next congress in 2026 is yet to be decided. Due to the uncertainty of the global situation, the WFOT executive team will announce the decision after careful planning and consideration.

Emma George and Adam Lo at the WFOT Congress

OT Week 2022 wrap-up

OT Week 2022 ran from 24-30 October, coinciding with World Occupational Therapy Day on 27 October. OT Week is our annual national week when we celebrate and talk about all things occupational therapy. It enables OTA to shine a light on the amazing work OTs do across the community.

This year’s theme was What OT means to me and provided OTs, their clients, and industry partners with the opportunity to reflect on occupational therapy from their personal perspective.

OT teams across the country celebrated the week by holding events, displaying our OT Week social tiles and posters, and sharing with us what OT means to them.

Check some of the messages that OTs shared with us about what OT means to them, and visit otaus.com.au/otweek to see more!

“WHAT OT MEANS TO ME”

Natalie Harbour, Apricus Health

For me, occupational therapy means doing ordinary things and achieving extraordinary results for the clients that access our service. There is nothing more satisfying than receiving thanks and a smile from a client because they’re able to achieve a goal that they previously couldn’t.

We have a chance to make a real difference for our clients in many areas of their lives, including improving access to the community, engaging in leisure activities, preventing falls –right down to simple tasks such as being able to independently put on socks. We are part of a fantastic profession that continues to adapt to the needs of our valued clients.

Zach Isaac, Apricus Health

I love the people that I work with and the gratitude they demonstrate. You can see it in their faces and the way they treat you – people are genuinely grateful and thankful to have you in their home.

I love the challenges that you face in trying to overcome different obstacles. Thinking outside the box can be difficult at times but is more rewarding when a unique or alternate way can be done to achieve a desired outcome.

I love working as a team, including with other health professionals, family members, stakeholders and more. When a team is dynamic and receptive, it is amazing to see the results that can come. Some of the best outcomes I’ve seen have come from great teams where everybody contributes and works towards the same goals.

Patrick Dodds, NeuroRehab Allied Health Network

Whether the goal is greater choice, inclusion, or new possibilities, being an occupational therapist affords us the privilege of joining people for a few hours along one small stage of their lifelong journey. The breadth of scope of practice for OT can be challenging but gives us an incredible opportunity to empower people in all aspects of life.

de la Perrelle, Encourage OT

Occupational therapy means being part of a creative and caring profession that makes a difference in people’s lives. It’s such a meaningful and valuable profession but one that also comes with its challenges too. Personally, I am passionate about helping other OTs be the best OT they can be for their clients and to achieve the best outcomes, confidently and without burning out.

Nicole

On World Occupational Therapy Day, Adam Lo (Occupational Therapist and WFOT Delegate), Shimona Win Law (Occupational Therapist) and Smitha Bollur (Shimona’s student) joined the Member for Stretton, James Martin MP at Queensland Parliament. The visit recognised what occupational therapists do in the community across many different settings.

Thank you to everyone who participated in OT Week this year. A special thanks to Rachel Knight, Chris Pearce, Adam Lo and Rebecca WatsonBrown for allowing OTA to profile them as the faces of the 2022 campaign.

OT Week feature in the Bendigo Advertiser

OTA celebrated OT Week across our social media with quotes, stories and a giveaway OTA’s merchandise designed to celebrate the amazing work of OTs

Adjustable beds are a widely used tool in occupational therapy (OT) and other allied healthdisciplines. As therapeutic devices, they have a range of applications for patients with chronic conditions and physical disabilities.

Importantly, though, a distinction needs to be made between basic adjustable beds, which deliver benefits purely through adjustments in height and positioning, and enhanced adjustable beds(EABs), which complement their intrinsic mechanical benefits with other therapeutic

An enhanced adjustable bed can be defined by two key traits:

1. It is a full sleep system that comprises a mattress and a base.

2. It features therapeutic technologies other than just height and positioning adjustment.

For example, many EABs use whole-body vibration therapy (WBVT), a technology that may improve chronic back pain, muscular strength, circulation, and bone density.

Less commonly, frontier technologies like CELLIANT® are also used in EABs. CELLIANT is a bio-responsive textile that converts body heat into full-spectrum infrared energy, promoting local circulation and cell oxygen ation.

In the following sections, we’ll examine how EABs can be used to manage three common conditions.

LOWER EXTREMITY OEDEMA

One clear use case for EABs is to ease lower extremity oedema (swelling in the lower legs). The aetiology of oedema is complicated, but it’s often correlated with diabetes.1 Left unmanaged, oedema can cause pain, weakness, self-consciousness, and limited mobility.2

Leg elevation is a commonly recommended treatment for oedema; raising the swollen body parts above the heart decreases hydrostatic and venous pressure, which reduces swell ing.2,3 As such, EABs with independent leg elevation can be ideal as a management tool –they can be used to regulate oedema at night or during sedentary periods, such as when patients are watching television or using laptops.

Just as importantly, therapeutic technologies like CELLIANT and WBVT may increase local circulation, promoting local cellular oxygenation.4,5 A side effect of leg elevation can be that tissue oxygenation is decreased – CELLIANT and WBVT can help counter this, making an EAB generally preferable compared to a basic adjustable bed.

CONDITIONS

One of the biggest benefits of EABs is their transformative impact on patient mobility. Age-related conditions like sarco penia and arthritis, as well as mobility-limit ing physical disabilities, can make sitting up and getting in and out of bed difficult.

In many cases, patients may need assistance from clinical staff and allied health practitioners. This reduces indepen dence and poses health risks to staff and practitioners, who may not have the equip ment or physical capabilities to easily manoeuvre patients.6,7

A height-adjustable EAB obviates these risks through two mechanisms: a back tilt function that helps patients sit up, and a vertical adjustment function that elevates the bed from a normal height to a standing height, which acts as a lift to help the patient to their feet. Having both these features may reduce occupational stress in staff and carers, especially in relation to lower back strain.6,7,8

Importantly, EABs also eliminate the need for bed railings (for the majority of patients). Despite their prevalence, bed rails have been strongly linked to problems like bed-rail entrapment, which can result in adverse patient outcomes, and have not

PRESSURE ULCERS

Pressure ulcers are a serious condition common in older people and people with disabilities. The majority of ulcer prevention strategies aim to reduce either the magni tude or the duration of pressure between a patient and a support surface. The tilt func tions of EABs can, to a point, alleviate pressure on certain parts of the body (such as the occiput and heels) – this may provide limited, temporary relief.

Allied health practitioners, though, should focus on mattress choice. Selecting an EAB with a pressure-relieving support surface is essential for evenly distrib uting pressure throughout the patient’s body.10 Although high-specification options like air-fluidised beds exist, more widely available mattresses feature technologies like memory foam and micro-coils.10

Mattress enhancements like CELLIANT may also be beneficial. CELLIANT has been strongly linked to better local tissue oxygenation in five peer-reviewed studies; separate research indicates that tissue oxygenation may help prevent ischemia and hypoxia.8,11,12,13

SUMMARY

Restful sleep is critical for occupational performance. When patients live with chronic conditions, their ability to get the sleep they need is compromised, which can affect everything from mental health to independence.

Enhanced adjustable beds combine the benefits of better sleep with therapeutic technologies, making them a useful addition to the allied health toolkit. No single device is a panacea, but EABs, with their clear use cases for oedema, mobility conditions, and pressure sores, certainly merit consideration for many interventions.

About Seniors Plus

Seniors Plus by SleepHive is a leading Australian manufacturer of therapeutic sleep systems. Founded in 2012, Seniors Plus promotes better health for older Australians by making good sleep accessible for everyone, including people with chronic health conditions.

For more information: healthysleep@seniorsplus.com.au | 1300 375 337 | seniorsplus.com.au

Assistive technology enabling goal achievement and safe discharge home: A complex NDIS case study

Hayley Scott, Senior Occupational Therapist, Western Health, Victoria Sharon Neale, Grade Four Subacute Occupational Therapist, Western Health, Victoria

The introduction of the NDIS has enabled individuals to leave hospital and live full lives in the community. Occupational therapists play a pivotal role in assessing and advocating for NDIS participants to ensure their goals and disability needs are met. This often includes assessing and prescribing assistive technology (AT). Within inpatient hospital settings, occupational therapists are increasingly treating individuals with complex functional care needs and supporting hospital discharges into the community at lower levels of occupational performance than before. To support these participants, there is a need for increased AT innovation and development.

This case study highlights two key pieces of equipment that enabled NDIS participant “Amber” (pseudonym) to achieve her occupational goals.

Who is Amber?

Amber is a 24-year-old who presented to an inpatient rehabilitation ward in Victoria with a diagnosis of functional neurological disorder. Amber has a large body habitus and an extensive medical history, including lower limb fractures and mental health conditions. Amber made small gains while receiving inpatient rehabilitation; however, she remained unable to walk and required a hoist for all her transfers. She required assistance from two people for her personal care occupations and utilised a wheelie commode.

What were Amber’s goals?

“To get home so I can see Cara (her horse).”

“To have a shower – as I feel disgusting.”

What assistive technology did Amber require and what impact did this have?

To enable Amber to achieve her goal of getting home to see Cara, Amber needed to be able to sit out of bed and transfer safely to her wheelchair, wheelie commode/ bed within her home environment.

Amber had a range of physical impairments that impacted her ability to achieve this goal, including reduced sitting tolerance, lower limb dystonia, chronic pain, increased body mass index (BMI) and non-epileptic seizures. A 20inch, tilt-in-space wheelchair with elevating leg rests was prescribed to enable her to sit out of bed, and a portable ramp was installed within the garage to enable safe access to her home.

A hoist was also required; however, during assessment it was determined that a standard floor hoist would pose significant manual handling issues. Following a home assessment, a gantry hoist was deemed suitable to enable Amber to get out of bed without putting her carers at risk. This portable AT simulates a ceiling track hoist, can be quickly installed and eliminates the need for home modifications. A gantry hoist enables non-ambulant patients with increased BMI to return home as it reduces significant manual handling risks. After

four months in hospital, Amber reported that “getting home was the best feeling”.

Amber desperately wanted to achieve her goal of showering daily – being clean and feeling fresh was important to her as an occupational being. To achieve this goal, Amber needed to access a standard shower recess with a wheelie commode. A Showerbuddy was trialled and prescribed. This equipment allows non-ambulant patients to access a standard shower recess with minimal modifications. This is a game changer for timely discharge planning. Without this AT,

Pressure fit ceiling track gantry hoist from Rehab Assist

Occupational therapists play a pivotal role in assessing and advocating for NDIS participants to ensure their goals and disability needs are met.

Amber would have had to wait months for home modifications. Amber reported: “I use this daily. Showers are the best part of my day, as I have fresh hair and I smell good.”

Where is Amber now?

Amber was safely discharged home with her NDIS package and all AT was funded for an initial hire period. Achieving these initial goals provided Amber with the stepping stones to achieve further goals, including attending her best friend’s wedding and using a power wheelchair to look after and train her horse. Amber continues to participate in outpatient rehabilitation, working on long-term goals of exploring alternative AT to return to work/ study, drive and, one day, ride her horse.

Innovations in AT and the unique skills occupational therapists possess to match individuals and their environments with the right AT have enabled not only Amber to return home, but many other individuals who would have otherwise required specialist disability accommodation.

For more information about the AT described, please visit the following websites:

Showerbuddy SB1 from Rehab Hire

Showerbuddy

bathcheck.com

shower-buddy.com/wp-content/ uploads/2021/06/Custom_Bridge_ How_To_Measure.pdf

Gantry Hoist

rehabassist.com.au/free-standing-gantries/ rehabhire.com.au/shop/patienthandling/gantry-systems/

About the Authors Hayley Scott

Hayley Scott is a senior occupational therapist on the inpatient rehabilitation ward at Western Health. She has nearly 10 years of experience working across inpatient and outpatient areas within a public health setting. She is passionate about providing evidence-based, high-quality care to patients, which involves prescribing various AT to support complex discharge planning.

Sharon Neale

Sharon Neale is a grade four subacute occupational therapist at Western Health. She has more than 20 years of clinical experience working in subacute inpatient and community settings of the public health system. Sharon is a strong advocate for the essential and valuable role occupational therapists play in supporting individuals to achieve their occupational goals sustainably with the right AT.

Assistive technology in palliative care

Renae Kelly, Bridget Manning and Dr Kieran Broome, Medical Aids Subsidy Scheme clinical team members, Queensland

The Medical Aids Subsidy Scheme (MASS), a statewide funding body for assistive equipment in Queensland, historically did not subsidise aids and equipment for people receiving palliative care. This changed on 1 April 2020, when MASS launched the Palliative Care Equipment Program (PCEP). The program provides assistive devices to children and adults in their final six months of life (with a possible extension up to 12 months) with no co-payment. The assistive equipment comprises basic, off-the-shelf mobility aids, daily living aids, home oxygen equipment and continence aids. In most cases, equipment is provided to clients within one to two business days. Clinical eligibility utilises the Australia-modified Karnofsky Performance Status (AKPS) and Resource Utilisation Group – Activities Daily Living (RUG-ADL) scores, as recommended by the Palliative Aged Care Outcomes Program. These tools measure functional status and can be useful for prognostication.

Prior to the PCEP, provision of assistive equipment to people with life-limiting conditions was fragmented and inequitable across the state. To our knowledge, MASS PCEP is one of the first government funded programs of its kind.

MASS Palliative Care Equipment Program: initial outcomes

Two years on, data analysis and feedback indicate that MASS PCEP has achieved its central aim – the equitable and coordinated provision of assistive equipment to people with life-limiting illnesses across the entire state. It appears to have a high potential to translate to other jurisdictions.

The program has funded equipment for more than 3,000 people. Most applicants

Program participant story

Mr K. had not been able to sit out on his deck for twelve months until he received help through Brisbane community therapists and the MASS Palliative Care Equipment Program. Back on his deck after a long hiatus, Mr K. was able to feel the sunshine on his face and arms, watch and listen to the birds and soak in his bush surroundings.

Living with motor neurone disease, Mr K. had very limited movement of his limbs and was dependent on a ventilator. His occupational therapist, physiotherapist and registered nurse made applications to the program for Mr K. to receive an electric/ adjustable bed, pressure redistribution mattress, wonder sheet, hoist, mobile pressure care chair and continence aids.

The equipment greatly helped family provide care for Mr K. and maintained his wellbeing. For example, prior to receiving the pressure redistribution mattress through the MASS PCEP, Mr K. was suffering with pressure injuries on his heels and the base of his spine. The new mattress helped these pressure injuries

heal and he did not experience any more.

Once Mr. K. had been hoisted into his mobile pressure care chair, he could be easily manoeuvred through the house. With access to the family room, Mr K could enjoy listening to 1950s music on a highquality sound system – a nice contrast to using a portable CD player in his bedroom. He was also able to celebrate his eldest son’s birthday in their family room. Mr K. experienced immense pleasure having his whole family together at home.

When asked if they could have sourced the equipment without the MASS PCEP, Mrs K. replied, ‘I wouldn’t have known where to start!’

(99.1%) have been adults, with a small number being children (0.9%). The most common medical condition has been cancer, at around 75%. Saliant findings include most program participants having more hospitalfree days, increased independence (where applicable) and reduced carer burden.

Delivery of equipment to remote areas has been a challenge, so storage facilities were established in regional areas to

reduce transportation time. Referrals to occupational therapists and palliative care specialists reportedly increased in some regions in relation to the program.

About the authors

Renae Kelly (OT), Bridget Manning (SP), and Dr Kieran Broome (OT), form part of the clinical team at the Medical Aids Subsidy Scheme in Queensland.

View from Mr K’s deck

Taking focus: OT, assistive technology and vision impairment

David Vosnacos Program Manager Assistive Technology and Low Vision Services, VisAbility

Introduction

In Australia, almost half a million people have a vision impairment. Aboriginal and Torres Strait Islander peoples are three times more likely to be blind or vision-impaired than other Australians (Vision 2020 Australia, 2022). As we live longer, the prevalence of vision impairment also increases.

Occupational therapists specialise in supporting people who are blind or vision-impaired through a range of interventions, including education on strategies and techniques to adapt to changes in vision; adaptations to the home, school or workplace to promote independence and use of remaining vision; and providing advice and training in a range of specialist assistive technology (AT).

Assistive technology and vision impairment

AT related to vision impairment can encompass the following:

• Portable or desktop electronic video magnifiers

• Smartphone and computer builtin accessibility features

• Specialised screen magnification, screen reading or text-to-speech software

• Stand-alone devices with Braille input/output

• Wearable smart devices

The focus of these technologies depends on individual needs and functional vision. Often one item may have more than one purpose. For example, a desktop video magnifier that magnifies hard copy text could also come with text-to-speech functionality. Occupational therapists determine which

combination will best meet individual needs within their available budget.

Impact of universal design

Over the past 20 years, specialist AT in the area of vision impairment has changed dramatically, as has the role of occupational therapists. This has been in part through the integration of universal design principles in many mainstream devices such as mobile phones.

The introduction of the Apple iPhone 3GS in 2009 provided the first smartphone with builtin accessibility features such as voice control, VoiceOver (screen reading) and Zoom (screen magnification) (Everything Apple, 2022). Before that, getting the same functionality required a high-end mobile phone, the purchase of specialist software such as Nuance Talks and Zooms (Nattiq Technologies, 2022) and technical assistance for the installation.

While this has broadened the range of solutions available, it has also presented other challenges. For example, funding would previously cover a specific mobile phone and specialised software, whereas now the same functionality is available in a mainstream device, making funding harder to source.

The rise of artificial intelligence

The rapid development of artificial intelligence (AI) has had a profound effect on the AT now available for occupational therapists to consider. For example, the Seeing AI (Microsoft, 2022) and Envision (Envision, 2022) apps allow people to read hard copy text, describe a scene, detect colours, scan a barcode for product information, and find people and objects via their smartphone.

Wearable devices now offer the same functionality without the complexity of a smartphone. Devices like the OrCam Read (OrCam, 2022) can be integrated into a broader solution when paired with mainstream devices. VisAbility occupational therapist Kate Thompson recently assisted Sinead – a young mother with a vision impairment who has two children under three years of age – with independently reading to her children without the use of a screen device that would be a distraction to her children. The OrCam Read, paired with a pair of bone conduction headphones, meant Sinead could independently access printed material to read to her children while still being able to hear her surroundings.

Future trends

We are faced with an ageing population, and with that an increased prevalence of vision impairment. How we interact with fast-evolving technology continues to present different challenges. Occupational therapists in this field need to be abreast of mainstream and specialist technologies as they evolve and consider how they can meet the needs of individuals with a vision impairment.

References can be viewed by scanning the QR code

Long COVID: Developing an OT service for a novel disease

Skye Deutschbein, Occupational Therapist, Nepean Hospital, NSW

Nepean Hospital had up to 500 people admitted with COVID-19 over just a few months from June 2021 when the Delta outbreak occurred in NSW. During this time, its occupational therapists became curious about how these patients were recovering after discharge. Internationally, reports were emerging about a condition known as long COVID, in which individuals were continuing to experience a variety of unresolving, multisystemic COVID-19 symptoms after recovering from an acute COVID-19 infection. We started asking questions and researching whether there was an emerging and unmet need for this cohort to receive occupational therapy intervention.

What we found

Post-acute sequelae of COVID-19 (PASC) –known colloquially as long COVID – is defined by the World Health Organization (WHO) as “the condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually three months from the onset of COVID-19, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis” (WHO, 2021).

Evidence suggests more than half of COVID-19 survivors can experience long COVID six months after recovering from the acute infection (Groff et al., 2021). The most common symptoms reported are fatigue, breathlessness, cough, depression, anxiety, cognitive impairment (brain fog), joint and muscle pain, mobility impairment, palpitations and chest pain, altered sense of taste/smell and post-traumatic stress disorder (WHO, 2021).

It became clear that this cohort could benefit from occupational therapy intervention. Unfortunately, due to the novel nature of this emerging disease, services did not exist in the Nepean Blue Mountains Local Health District to assess and assist the growing

number of patients who needed access to support as a result of long COVID.

A new service emerges

In December 2021, Nepean Hospital used temporary funding to establish the first post-COVID clinic in NSW in response to this need. This clinic is a multidisciplinary clinic staffed by medical specialists (rehabilitation, infectious diseases, cardiac and respiratory), physiotherapists and occupational therapists. At the time of establishing this service, very little literature existed locally or internationally detailing an effective occupational therapy service delivery model for this cohort of patients. We were aware that any service delivery model needed to include telehealth options as a result of COVID-19 restrictions during the pandemic. A post-COVID occupational therapy service at Nepean Hospital was developed to address the needs of long COVID.

Current OT service delivery model for post-COVID clinic

1. Referral received and triaged: Referrals can be accepted from the medical specialists in the clinic, general practitioners and other allied health professionals. Referrals should include the date of COVID-19 diagnosis and severity of disease, including hospital/ICU admission.

2. Initial assessment: Telehealth assessment completed over the phone, including the following:

• An occupational therapy initial assessment to ascertain the patient’s occupational roles;

• Completion of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), a patientreported outcome measure that provides comprehensive information about the patient’s specific long COVID symptoms;

• Determine which symptoms are impacting on occupational performance as per patient report and significance to patient;

• Refer on to other disciplines as required; and

• Provide verbal education as required.

3. Provision of written resources: posted to patient as needed, including sleep hygiene, and cognition and fatigue post-COVID-19.

4. Follow-up phone call: approximately two weeks later to discuss resources, specific strategies implemented and patient progress or barriers. For many patients this more generalised education and follow-up has been adequate to empower patients to manage postCOVID symptoms independently in conjunction with natural recovery. If this is the case, the patient can be discharged at this stage.

5. Home visits: A home visit is offered to a small number of patients who are more significantly impacted by long COVID symptoms. These patients benefit from a home visit to discuss the individual impact of long COVID on their occupational performance in greater detail –most often for symptoms such as fatigue, brain fog, depression and anxiety. Assessments on the initial home visit include the following:

• Completion of the PROMIS-29 (qualityof-life patient self-reported scale)

• Completion of the Fatigue Severity Scale (patient self-reported scale)

• Functional assessments as indicated

• Therapist completion of the AusTOMs for Occupational Therapy as an outcome measure

The patient is provided with an activity log to document activities undertaken during their day/week and asked to note any physical or cognitive fatigue experienced following these activities. Daily or weekly goals are developed in conjunction with the patient. This information is used to draft a weekly timetable which incorporates specific energyconservation principles and memory strategies specific to the individual patient’s needs.

Over the following weeks, these goals and timetables are adjusted until the patient feels empowered to independently implement strategies and adjust these as required. Outcome measures are repeated at the completion of treatment before discharge from the service.

Barriers to service delivery

Several barriers have been negotiated in developing this service while the health system responded to a new and ever-changing pandemic. These have included the following:

• Mutating strains of COVID-19 and unknown impacts of each new variant

• Limited worldwide evidence of the cause of long COVID and effective treatment modalities

• Providing a service via telehealth while face-to-face services and home visits were cancelled due to lockdowns

• Increasing awareness of the service to patients who had not needed to access hospital services while acutely unwell with

COVID-19 but who had their occupational performance impacted by long COVID

• Uncertainty of ongoing funding and resources to continue to provide services to this cohort of patients

• Few other occupational therapy services in the country or around the world to provide an example of a service delivery model for patients with long COVID

Looking to the future

Evaluating this new and evolving occupational therapy service is the next step to ensure we are delivering appropriate and effective services to this cohort of patients with long COVID. Outcome measures will be compared before and after intervention, including the PROMIS-29, Fatigue Severity Scale and AusTOMs for Occupational Therapy. Occupational therapy intervention will also need to be flexible as new evidence emerges about the cause of long COVID and available treatments. Ongoing advocacy is also currently occurring to ensure this service attracts

permanent funding to provide appropriate health care to patients experiencing this new and changeable condition.

In summary, patients who have had COVID-19 and develop long COVID have limited access to health care specific to their needs, and little evidence exists supporting service delivery methods and treatment modalities. With the impacts caused by the pandemic, healthcare providers need to be adaptable and flexible as new and emerging health needs become evident. Occupational therapists already have a sound body of knowledge to assist this cohort of patients and should be included in any post-COVID services developed.

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References can be viewed by scanning the QR code

Bridging the assistive technology divide through online training in Australia

Occupational therapists know that “assistive technology (AT) is a powerful enabler of participation” (Desmond and Layton et al., 2018). But what happens when occupational therapists research ideal products only to find limited options to trial them? How can they be confident that AT recommendations are the best fit for their clients? As an online trainer to occupational therapists across Australia, outlined below are some challenges and opportunities noted by the occupational therapists we support.

Challenges identified by clinicians with AT provision

1. Geographical location

There are limited AT options for therapists in rural and remote locations, or areas with limited AT suppliers. The occupational therapy AT process may differ for therapists who only receive monthly visits compared to those who can access multiple AT suppliers regularly. Fewer visits require significant pre-planning and telehealth consults, outlining all features of AT using detailed referral forms and liaison with suppliers. Occupational therapists with limited AT suppliers available must be confident with their requests, completing extensive research before the trials or risk lengthy waits before trialling other options.

2. Reduced hire options

Many clinicians outside metropolitan areas have minimal hire options. This impacts clients’ decisions to buy the best options, particularly when certain funding schemes expect AT to last five years. Choices are based on the best evidence available to match a client’s needs; however, sometimes it is difficult to be confident items will work if they have not been hired or trialled for longer periods.

3. Funding scheme impacts

Working across various funding schemes may impact occupational therapists’ knowledge and practice working with AT, as some funding systems only offer low co-contributions and a reduced range of AT options. Therapists who previously provided AT to clients through schemes such as state-based equipment loan pools and My Aged Care have identified challenges in transitioning to NDIS participants. There are often greater AT options available for NDIS participants, including more costly AT. Occupational therapists have had to expand their knowledge to meet changing expectations of NDIS participants who express greater demands and “choice and control” for their requests.

Overcoming challenges

To overcome these challenges, the following opportunities were identified during online professional development with occupational therapists across Australia:

1. Learning how interstate occupational therapists practise using AT

Through attending online training with occupational therapists from across Australia, we are exposed to a variety of AT solutions that clinicians regularly use in their local areas. Therapists with decades of experience are grateful for training with interstate clinicians, as their view is broadened on AT solutions and approaches to solving challenging clinical scenarios using novel and creative ideas.

2. Norms in expectations of AT suppliers

Occupational therapist and AT supplier communication is crucial to maximise trial options and optimise efficient AT trials. Clinicians from different geographical areas may be unaware of their expectations of

suppliers. For example, an occupational therapist outlined that an AT supplier showed their clients a complex wheelchair without setting it up for a trial. A complex wheelchair is costly and needs to last several years, so it is appropriate to ask the supplier to provide a trial to ensure a best-fit seating option for the client. Other clinicians across Australia confirmed this expectation was normal, and the occupational therapist was empowered to communicate their needs so they could make an informed decision about this high-cost investment.

Australia’s vast geography significantly impacts AT occupational therapists due to limited AT options for trial, hire and purchase. Benefits are found by attending ongoing professional development with occupational therapists who live in different geographical areas to broaden knowledge and understanding of options available to meet clients’ situations and needs.

About the Author

Karen Maurer is the founder of Capable Spaces, a community occupational therapy service in Newcastle, NSW. Karen and her team support adults with neurological conditions and provide training and clinical supervision for occupational therapists in AT and home modifications. Find out more at capablespaces.com.au

Karen Maurer, Occupational Therapist and Founder of Capable Spaces in Newcastle, NSW

References can be viewed by scanning the QR code

Assistive technology to develop skills needed for driving: The DriveFocusTM app

Occupational

Learning to drive with a physical/psychosocial disability, returning to driving after an accident, and maintaining driving through ageing are all rated as top priority goals for people in these situations. With the roll-out of the NDIS, exploring the feasibility of learning to drive has become a possibility for many young Australians on the autism spectrum or with other psychosocial disabilities.

Historically, there haven’t been many strategies or tools available to optimise this population’s chances of being successful with their goal, other than driving lessons. At the start of the COVID-19 pandemic, I connected with Dr Miriam Monahan from the Driver Rehabilitation Institute in California and learned about her Potential to Drive approach and the DriveFocusTM app, which she co-founded. Together, we facilitated Potential to Drive workshops for driving occupational therapists and driving instructors, webinars for generalist occupational therapists, AHAs and support workers, and collaborated to bring the DriveFocus app to Australia.

The tablet-based DriveFocus app teaches visual search and reactiontime skills through interactive videos. Driving occupational therapists working with clients with cognitive, physical and psychosocial disability frequently find visual search skills are compromised – they “look but don’t see”. DriveFocus is designed to develop skills in the information-processing cycle, which explains the complexities of the driving task – a constant repeating cycle of vision, processing/ decision-making, motor response. In the DriveFocus app, users learn to identify, prioritise and react to 11 categories of critical items (including give-way signs, traffic lights, pedestrians and brake lights) through tapping on items in videos from a driver’s perspective.

About the DriveFocusTM app

• A university study identified that six, one-hour sessions of DriveFocus significantly reduced driving errors among learner drivers (Alvarez et al., 2018). The subjects also rated DriveFocus as valuable for improving their driving skills.

• Users watch high-definition videos from a driver’s perspective, and tap on critical items as quickly as possible while prioritising the correct order.

• The American app has tours of several cities, with a Brisbane tour available on Android and iPad versions, and a Melbourne tour available on Android. The tours include seven drives that level up and can be practised repeatedly.

• The user’s score is presented at the end of each practice, and Android users can email the results to their occupational therapist.

• The app costs about $20AUD, a once-off fee that includes access to all tours. There is no renewal fee or ongoing membership fee.

• There are other studies currently taking place in the USA and Canada to examine the efficacy of DriveFocus with populations

such as people who have had strokes, people with autism, and combat veterans with post-traumatic stress disorder.

Award-winning DriveFocus won the Technology category of the 2021 Australian Road Safety Foundation Awards and was a finalist for Best Assistive Technology Product of the 2022 Australian Disability Services Awards (held in November 2022).

About the author

Jenny Gribbin is an occupational therapy driver assessor in Brisbane. She founded her business Driving Well Occupational Therapy in 2017, and has a small team working with clients with driving and vehicle modification needs across the lifespan. Contact details: jenny@drivingwell.com.au

References can be viewed by scanning the QR code

Jenny Gribbin,

Therapy Driver Assessor, Driving Well Occupational Therapy, Brisbane

Exploring the experiences, perceptions and attitudes of therapists delivering physical rehabilitation in a group format

Annemieke Clark, Lorrie Mohsen, Dr Jayanthi Raman, Prof. Michael Pollack, Bosiljka Vukovic, Kaitlin Bonner, Jennifer King, Rebecca Jepson

Background

Group-based therapy has become a feasible option for delivering rehabilitation economically and efficiently in an overstretched health system1. Emerging evidence also supports many patientreported benefits and acceptance2 However, research is limited in exploring the opinions and attitudes of therapists involved in delivering group rehabilitation. This study sought to address this gap and identify therapist-reported barriers and enablers impacting effective delivery of physical rehabilitation in a group format.

Methods

This qualitative study used focus group interviews conducted at two private rehabilitation hospitals. Eleven allied health professionals (exercise physiologists, physiotherapists, occupational therapists and allied health assistants) who provide physical therapy to rehab patients consented to participate in the focus groups. The interviews were audiotaped, transcribed verbatim and analysed using a primarily reflexive approach to thematic analysis (TA) (Braun and Clarke, 2006)3

Results

The following four major themes were identified:

1. Social benefit: Therapists highlighted that companionship between patients made therapy more enjoyable and motivating. Therapists felt group cohesiveness was essential for success, but sometimes difficult to manage.

2. Acuity matters: Therapists reported that grouping patients with homogenous ability, common goals and needs was favourable. Achieving this in the acute stages of rehabilitation was considered difficult.

3. Factors informing practice: Discussion found a large variance of undergraduate training and education between allied health disciplines, and even academic institutions, on how to facilitate group-based therapy, and knowledge of literature or clinical guidelines to help inform practice was vague. Therapists spoke of organisational and health system pressure to utilise group therapy, conceding that the use of groups was primarily financially driven.

4. Rhetoric vs reality: Therapists reported a belief that groups weren’t always more efficient and could lead to more burden on therapists than conducting treatment one-to-one. Of note, all therapists valued patient-centred care, and there was consensus that a group format may not, by nature, be individualised enough in order to achieve personal goals for some patients.

Discussion

With an expected increase in group utilisation for delivery of physical therapy, it is important to ensure allied health professionals facilitating such groups offer patients treatment that is as effective and person-centred as individual therapy. This study supports that therapists are accepting of group therapy utilisation and favour the psychosocial benefits arising in the group context. Therapists believed group therapy was more successful in the later stages of

rehabilitation, and with a more homogenous cohort focused on common goals. With a high variability of undergraduate training and education on group therapy facilitation, organisations would benefit from increasing support and training within the workplace. The development of processes, systems and resources were reported to enable therapists to deliver efficient and effective group therapy at the point of care.

Tips for practice

• Group therapy has many psychosocial benefits for rehabilitation.

• Group therapy may be more successful for patients with lower acuity, common goals and similar function.

• Therapists benefit from education and training on group management.

• According to therapists, a combination of individual and group therapy is the preferred model of therapy delivery

Acknowledgements

This study was partially funded by the Ramsay Hospital Research Foundation Enable Grant and supported by the Hospital Network Research Committee. The time and contribution by the participants of the study are gratefully acknowledged. HREC: Ramsay Health Care NSW/VIC Research Ethics Committee 2021/ETH/0009

References can be viewed by scanning the QR code

Social media risks when running a small business

Maintaining integrity when posting on social media

If you’re in a profession in which your personal and professional brands are the same, posting on social media can pose risks to your business. What you say in a personal capacity can impact your professional reputation, sometimes negatively. In extreme situations, it can lead to lost clients, complaints or allegations leading to an insurance claim. Here are some social media best-practice tips you might find useful.

Controversial content

Sharing or posting content on your personal social media profile can impact your professional reputation. Content and posts that may seem innocuous to you may cause offence to others, and this could reflect poorly on your business. Even if your profile has appropriate privacy settings, a screenshot taken by someone could easily be used against you to cause reputational damage. The easiest way to avoid any damage is to follow this simple rule: If you wouldn’t share it on your professional/business profile, don’t share it on your personal profile.

Difficult client stories

No matter what your profession, you probably deal with your fair share of difficult (or interesting) clients. Recently trending formats on social media platforms might tempt you to jump onboard and share stories of these clients. However, this could land you in hot water if you don’t ensure the client is anonymous. You don’t want to go viral for all the wrong reasons and end up with a lawsuit or fine from a regulator.

posting

sharing content

Unrealistic offers or claims

When using social media to promote your business or any offers, remember to ensure your advertising adheres to appropriate laws and regulations. Making unrealistic claims in your advertising, regardless of channel, can lead to your business being fined or liable for misleading conduct. The same applies if you’re advertising offers and promotions. For example, calling an offer or price that is always available a “special offer” in your advertising can lead to fines, lawsuits or reputational damage.

Negative client reviews

Have you received a negative review from a client that you feel is unfair? Avoid the temptation to clarify the situation by replying or responding negatively. Your response might unintentionally breach confidentiality and reveal too much information about a client, which could escalate the situation further. It could be safer to invite them to send you a message and try to resolve the matter privately offline.

Commenting and following

When posting and sharing content on social media – including posting or commenting in groups, commenting on public posts, and even making your interests public – it’s important to bear in mind the associated risk. The public can see these activities, which may influence their opinion of your business. Sometimes it doesn’t take much to elicit an angry public response.

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When

and

on social media – including posting or commenting in groups and commenting on public posts – it’s important to bear in mind the associated risk.

Managing risk: The importance of documentation in AT assessment and prescription

Karen Brown, NSW/ACT Divisional Manager, Occupational Therapy Australia

Tom Ballantyne, Principal Lawyer, Maurice Blackburn

Michelle French, Director and Principal Occupational Therapist, Michelle French & Associates

Documentation is an important part of occupational therapy practice across all settings and funders. When prescribing assistive technology (AT), it is essential that clinicians thoroughly document the assessment and clinical reasoning behind their recommendations. By doing so, occupational therapists can proactively minimise the risk of a successful legal challenge being made against their prescription.

OTA’s Karen Brown spoke with Tom Ballantyne, Principal Lawyer, Maurice Blackburn Lawyers and Michelle French, Director and Principal Occupational Therapist, Michelle French & Associates, to discuss defensible documentation in the context of AT. Tom and Michelle shared their insights and practical strategies to support occupational therapists to minimise their risk when it comes to AT assessment and prescription.

Karen: Tom, could you start by telling us a bit about the Australian Consumer Law and how it affects occupational therapists?

Tom: Under the Australian Consumer Law, products and services come with automatic guarantees that they will work and do what you paid for. If a business fails to deliver the guarantees they can be liable for repair, replacement, refund and/or compensation.

Products (such as pieces of AT) must be of acceptable quality and fit for purpose; and services (such as occupational therapy assessments and recommendations) must

Lawyers

be provided with acceptable care and skill or technical knowledge and taking all necessary steps to avoid loss and damage. They also have to be fit for the purpose or provide the result the client wants the service to achieve.

Karen: A common challenge for occupational therapists is that their prescription may be impacted by a number of factors that are outside of their control. For example, a client may go against the clinician’s advice, or the client may have a degenerative condition that renders a piece of AT no longer fit for purpose by the time it arrives. What could occupational therapists do in circumstances like these?

Tom: The good news is there are exceptions and defences for these kinds of situations. While I can’t speak for specific cases, broadly speaking, an occupational therapist would not be liable if:

• The client was unclear about what result they wanted to achieve or did not say;

• A client goes against your advice;

• The breach of the guarantee was caused by the advice/actions of someone else; or

• The breach of the guarantee was caused by factors beyond human control that occurred after the services were supplied.

This is one of the reasons why it’s so important to keep good records of your assessment and clinical reasoning when you prescribe AT.

Karen: So what exactly can an occupational therapist do to minimise their risk

of a successful legal challenge being made against their prescription?

Tom: From a legal perspective, you can minimise risk by conducting and documenting thorough assessments and clinical reasoning which justifies your prescriptions.

According to the AHPRA Shared Code of Conduct, clinicians should keep accurate, up-to-date, factual, objective and legible records that report relevant details of clinical history, clinical findings, investigations and information given to patients.

These should be kept in a form that can be understood by other health practitioners and, importantly, should be made at the time of events or as soon as possible afterwards.

Karen: If a claim did need to be defended what sort of documentation and information is likely to be relevant?

Tom: It’s important to note that anything which contains health information could be relevant to a legal claim. This may include client records, assessment and testing results, emails with suppliers, as well as less formal modes of communication such as texts and messaging services such as WhatsApp.

If a claim needs to be defended, the kind of information in your documentation which is likely to be relevant are things like:

• Details of assessment, including results of any testing;

• Discussions with client, including about options;

• Client instructions, including about expectations for device; and

• Your advice and recommendations, including pros and cons of various options.

Karen: Michelle, could you provide some insights into what should be included in OT documentation from a clinical perspective?

Michelle: Good documentation should be in chronological record, telling the readers who did what and when. It should tell the story of the AT in a clear sequence of events, including conversations, trials and decisions.

Documentation should clearly detail the client’s progress at any point in time, as well as the progress in delivering an AT solution. It should detail the client’s environment and the need for the requested AT, inclusive of any potential risks.

Karen: Can you describe the AT journey further, including what it looks like and how this can be documented?

Michelle: I like to think of AT prescription in three parts. In the beginning, it is the OT’s job to undertake assessments to clearly articulate what is needed and why. Go back to basics and think about the person, their environment and their occupational performance.

In the middle, identify and engage appropriate suppliers. If possible, trial the AT in all known environments and activities and document the outcomes of these trials. Use photos to supplement written documentation.

And finally, allow the time you need to write the AT implication. Make sure you have all the information you need and that you seek assistance and advice when you need it.

Karen: It’s great that you mentioned suppliers as I know this can be a tricky

Maurice Blackburn offers OTA members free telephone advice and a free first consultation. For more information, contact Andrew McKenzie, National Relationship Manager:

Phone: (07) 5430 8746 Email: AMcKenzie@mauriceblackburn.com.au Website: www.mauriceblackburn.com.au/partnerships/ota/

space to navigate. Do you have any tips for working effectively with suppliers?

Michelle: I think of AT prescription as a triangulated process which involves the clinician, the supplier or manufacturer, as well as the end user or client. As an AT prescriber, it is essential that you build strong relationships with prescribers and have a mutual understanding of what is needed. Communicate clearly and often: pre-trial, post-trial, during supply and post supply.

Karen: Do you have any final words of wisdom for occupational therapists working in this space?

Michelle: Remember that good documentation is not just about protecting yourself against liability. In many cases, such as in the NDIS, your expert opinion is drawn on to make a funding decision and the quality of your report will influence that decision. Be sure to proofread your AT application as words can make a difference.

And finally, make sure that you have access to the support that you need to support your clients. Professional associations and industry groups such as OTA and the Australian Rehabilitation and Assistive Technology Association (ARATA) are great resources. Build your professional networks and recognise that you can benefit from mentoring at any stage in your career.

Karen: Thank you, Tom and Michelle, for sharing your knowledge and insights with us in relation to the importance of documentation in AT assessment and prescription.

About the authors

Tom Ballantyne

Tom Ballantyne is a Principal Lawyer and the head of Maurice Blackburn’s Victorian medical law practice. Tom joined the firm as a trainee lawyer in 2006 and has practiced exclusively in medical negligence since 2007. He is also a member of the Law Institute of Victoria Council and the Australian Lawyers Alliance Victorian committee.

Michelle French

Michelle French is a leader in the area of occupational therapy medicolegal practice, having worked both nationally and internationally for over 30 years. She is the Director and Principal Therapist for Michelle French and Associates.

Karen Brown

Karen is the Divisional Manager for NSW and the ACT at Occupational Therapy Australia. Karen has over 20 years of experience as an occupational therapist working primarily in public health across acute and rehabilitation hospitals, transition care and in the community in clinical, project and health management roles.

The content of this article is drawn from a Hot Topic presented by Tom Ballantyne and Michelle French in May 2022. For more information about OTA’s Hot Topic series, go to otaus.com.au/cpd-and-events/hot-topic-events

An HR view of digital tech in your practice

Anna Pannuzzo, WorkPlacePLUS

Digital technology is essential in modern workplaces – from computers, software, smartphones, tablets and apps to websites, social media, and video conferencing and recording.

Here are some key HR considerations involving the risks and benefits of digital technology in the workplace.

Privacy and Work Health and Safety

The use of the internet, email and social media can have privacy and Work Health and Safety (WHS) implications in your practice. It’s important to have a code of conduct, a privacy policy, a suite of WHS policies and an IT and social media policy to guide employees on appropriate use of technology and online platforms.

Any personal information collected in your workplace must be kept secure. This includes images and any information that can be used to identify someone. A data breach, privacy breach or any mishandling of personal information could trigger a range of serious consequences for your practice and the individuals involved.

Practice owners can be held liable for any harm caused by mishandling personal information. For example, the following scenarios pose serious risks:

• An employee distributing discriminatory or offensive content, such as comments or images, about the practice or clients/ colleagues via email or social media

• An employee disclosing personal information about clients or colleagues via email or social media

Disclosing or mishandling personal information can expose the practice, employees or clients to increased risk of harm, for example from stalking, bullying or family and domestic violence.

Businesses increasingly use technology such as CCTV surveillance, apps, monitoring software and tracking devices to protect and supervise employees/clients. This can have potential legal implications. For more information on using technology to monitor employees/clients, refer to the Surveillance Devices Act in your state or territory.

Performance and hybrid working arrangements

In the allied health sector, the increasing use of technology such as telehealth allows practitioners to maintain flexible or hybrid working arrangements away from home or the usual workplace. Managing staff remotely presents a range of HR challenges and considerations, such as being able to effectively do the following:

• Track and measure staff performance

• Implement changes to workplace systems and processes

• Address workplace conflict

• Protect employees’ mental and physical health and safety

Practice owners should ensure their workplace policies and processes are up-to-date and reflect the use of digital technology in relation to remote or hybrid working arrangements, health and safety checks, performance management and ongoing supervision.

Protecting your technological assets

It’s important to have systems in place to protect your technological assets such as your hardware and software. Conducting a risk assessment can help identify the key business risks associated with the technological assets in your practice.

All employees have a general duty to not intentionally or recklessly interfere with or misuse anything provided in the workplace, including technology. When new employees

are inducted into your practice, they should receive information and training on accessing and appropriately utilising the technology in your practice. When a staff member ends their employment with your practice, make sure they return any business property or access to technology, including digital files.

Does your OT practice shut down over the Christmas holidays? Use these tips to protect your technological assets

• Make sure your IT systems are backed up and secure, including functioning generators

• Turn off any equipment that won’t be needed

• For equipment that will be needed, ensure it has been serviced and the power supply is backed up

• Check all security and emergency procedures

With the right policies, systems and processes in place, along with regular staff training, occupational therapists and practice owners can safely reap the exponential benefits of digital technology in the workplace. For more information and professional HR advice, contact an HR consultancy that works closely with the allied health sector such as WorkPlacePLUS.

All OTA members receive special OTA member benefits through WorkPlacePLUS for support with HR and IR issues. For more information, contact Anna on (03) 9492 0958 or visit WorkPlacePLUS.com.au.

About the Author

Anna Pannuzzo has more than 25 years of senior HR management experience in the healthcare and social services sectors. Her nursing background provides a unique insight into the HR challenges facing many employers.

Student Careers Forum wrap-up

Occupational Therapy Australia’s Virtual Student Careers Forum held on Thursday 25 August provided a unique opportunity for soon-to-be graduating fourth-year and second-year masters occupational therapy students to come together from universities across the country to support their transition to practice.

DELEGATES BY UNIVERSITY

University Number

Australian Catholic University 20

Central Queensland University 2

Charles Darwin University 5

Charles Sturt University 4 Curtin University 5 Deakin University 9 Edith Cowan University 3 Flinders University 5 Griffith University 2

James Cook University 1 La Trobe University 12 Monash University 12 Southern Cross University 4 Swinburne University of Technology 1 Sydney University 1

The University of Queensland 8 The University of South Australia 10 The University of Sydney 17 University of Canberra 19 University of Newcastle 1 University of the Sunshine Coast 6 Western Sydney University 4

REGISTRATIONS BY STATE

Enthusiastic forum MC Faustina (Fuzzy) Agolley really embraced the day, engaging with participants in the EventStream, starting a thread of animal posts, and sharing a photo of her golden retriever Wally!

GAMIFICATION PRIZES

On the day, participants got competitive in scoring points in the gamification. They were able to enjoy some of the fantastic prizes from our sponsors.

The highest point scorers won:

1. New Graduate Membership (valued at $357) from OTA

2. A 60-minute career coaching session (valued at $150) thanks to Everyday Independence

3. A “1:1 Online review of your CV and pointers with a HR expert” (valued at $100) thanks to Northwestern Mental Health

4. A pre-paid VISA card (value of $100) thanks to Early Start Australia

5. A KeepCup to keep drinks hot and cold

TESTIMONIALS

“A supportive, encouraging and informative event that provided me the opportunity to prepare for my future in a highly accessible and comfortable way! So grateful for the experience.”

– Sheyda, Flinders University

“Loved this forum! It was insightful to connect with potential employers, hear from different organisations in different practice areas, and gain advice on transitioning into professional practice.”

– Caitlyn, UniSA

Support Sponsors

We would also like to acknowledge the support of our major sponsors:

Talk to Aon, the small business insurance specialist. Our occupational therapy industry and broking expertise helps you make more confident decisions when using us to arrange your insurance purchase.

Visit aon.com.au/ota or call 1800 805 191.