5 minute read
OTs Offering a Hand in Our Communities
Nick Criticos, Occupational Therapist and Certified Hand Therapist, Action Rehab
Hand therapy is the art and science of rehabilitation of the upper extremity. It has developed from the professions of occupational therapy and physiotherapy, and requires comprehensive knowledge of the upper extremity, and special skills in assessment and treatment.
The aim of hand therapy is to prevent dysfunction, restore function, or reverse the advancement of pathology in the upper limb. The Australian Hand Therapy Association (AHTA) is Australia’s only professional association representing and accrediting practitioners. It supports members through continuing education, professional development, networking, and representation at state and national levels.
From September 2020, almost 75 per cent of hand therapy practitioners were occupational therapists by trade—a statistic on a steady upward trend. I am an occupational therapist and certified hand therapist who has, for the past decade, worked in private practice with Action Rehab, a hand and upper limb rehabilitation provider across metropolitan Melbourne and regional Victoria. Our passion at Action Rehab is ensuring our patients feel supported, and that the outcomes we achieve for them are timely, affordable, and of the highest quality possible. We are able to achieve this consistently by working as a team—in partnership with the referrer, patient, and therapist.
Amid this global COVID-19 pandemic and looking forward, I am thankful to both OTA and AHTA for supporting us in continuing to provide essential care services. Now, more than ever, has the need for supporting our communities been so important. COVID-19: Experiences and the Opportunity
Since the beginning of the COVID-19 outbreak, healthcare providers have been shown more support, solidarity, and gratitude than ever before. Ensuring access to health services is the cornerstone of a successful health response.
The pandemic put some health systems under immense pressure, and stretched others beyond their capacity. Before 2020, most patients were directly referred by specialists. Last year, particularly at the height of the pandemic, we witnessed three distinct changes—a reduction in elective surgeries, an increase in general practitioner referrals, and an increase in new patient introductions through word of mouth.
While the results from individual cases may vary, the common trend witnessed throughout my experience, and significantly
As straight as Verity’s elbow could go early stages of rehab When full elbow extension was possible
emphasised in 2020, is for hand therapy practitioners to be empowered to act as the injury triage clinician. The patient experience yields superior outcomes in recovery, return to function, overall wellbeing, and peace of mind.
To accomplish this requires mutual trust. We must deliver on the promise to effectively assess, navigate, and recommend the most appropriate treatment. Achieving trust involves the development of deep, lasting partnerships with all health care providers in the communities within which we operate.
Bringing this to Life
Let me introduce you to Verity, a five-yearold kindergarten child who lives in regional Victoria. Verity is super active—well into horse riding and calisthenics. Adventuring at home on her cubby house, Verity lost her balance and fell to the ground, sustaining a nasty fracture to her elbow region.
Her parents rushed her to the local hospital emergency department, where she was x-rayed. The fracture was confirmed, and needed manipulation under general anesthetics. Typically, in a case like this, the elbow would likely be immobilised in a plaster of Paris and the client subsequently sent back to the GP or orthopaedic specialist for repeat scans weeks later.
Verity’s parents were concerned for her overall wellbeing. How could you expect an active five-year-old, with such a thirst for life, to spend the following weeks or months idle? There were unanswered questions, and uncertainty about what lay ahead with injury management and rehabilitation. This led Verity’s parents to self-refer to our clinic upon word of mouth.
Verity presented with an elbow that was stuck with a total of 35 degrees motion (see image one). This impacted her ability to get dressed, brush her teeth, and comb her hair, not to mention being unable to take part in extra-curricular activities, horse riding, or even playing with her brother in the backyard.
We immediately focused on restoring elbow motion, function, and coordination by liaising closely with Verity’s family, specialist, GP, primary school, and sporting clubs. A commitment to months of regular rehabilitation, along with a functional home exercise program, resulted in a return to 145 degrees total active motion, full rotation, full loading, and strength for Verity—an exceptional result, especially compared to the risk of permanent loss of function in the event that she continued down the full immobilisation path (see image two).
While we were thrilled with the outcome, the smile on Verity’s face when told she could return to all her favorite activities was the icing on the cake (see image three).
Opportunities
Verity’s story made us think there were indeed opportunities to do more. We imagined what could be achieved if the lines of communication, engagement, and partnership across all links in the health care chain were solid and aligned to the patient’s speedy and effective recovery.
It is therefore incumbent on us to forge lasting relationships with our counterparts in the health care system—to relieve the burden the system currently encounters, and to balance the sources of patient inflows that a practice such as ours experiences.
At Action Rehab, we are leaning into relationships with the health care community as we passionately believe this is the cornerstone of developing the trust required to build lasting connections. We engage early, communicate transparently, provide knowledge, skilling, advice, and feedback—and expect and encourage the same from our counterparts. Together, we can be brilliant. About the Author Some of the most lovable aspects of my career are building community relationships with medical practices, universities, sporting clubs, and hospitals. I see great value in hosting professional networking nights, and providing hand and upper limb education seminars to general practitioners and other relevant allied health professionals. Above all, I strive for best recovery for patients living with hand and upper limb injuries or dysfunction. I cannot see myself doing anything else.
All smiles when back to riding earlier than expected
GET IN TOUCH
If you would like to connect, or if you have any questions, please reach out on nick@actionrehab.com.au
