What additional skills Are Needed in Acute Care vs SNF or home health?

What skills are needed working in a hospital vs working in skilled nursing or home health?

In acute care, the OT role is much the same, evaluating a patient for OT needs, making a treatment plan, progressing a patient to increased independence, and caregiver training. The goal is slightly different.

The goal of an acute care therapist is to work with the medical team to expedite a patient’s discharge out of the hospital and to reduce the likelihood of readmission due to the inability to perform ADLs safely or adequately at home. That means assessing for the appropriate discharge setting and needed equipment, and informing the medical team in a timely manner so they can make the preparations by the time the patient is stable to leave.

It is important to learn how the hospital triages patients, i.e. determine which patient is most important to see first. Patients are prioritized in a way that will clear out rooms for new patients waiting to be admitted. In addition, hospital therapists work cooperatively with each patient’s medical team, which necessitates learning the work culture and role of different medical professionals.

The important skill set of acute care therapists is sufficient medical knowledge to recognize signs and symptoms of medical instability in the chart review and during a session. Hospital OTs are generalists that know how to work with a broad range of diagnoses in the acute stage, where the patient is not yet stable enough to leave the hospital. The higher acuity, the more important these skills are like, for example, in the ICU.

In summary, the additional skills that would need to be acquired is:

• The ability to triage hospital patients (determine who is a priority to be seen)
• The medical knowledge to allow you to:
  • Perform a thorough chart review and spot a patient who may not be safe to see
  • Assess the medical stability of a patient and know when to make the session less or more challenging
• Work collaboratively with the hospital medical team to expedite discharge

Transitioning to the hospital will require going through a learning curve. Take heart that EVERYONE working there has been through it. It is important to set reasonable expectations, that it may take some time to get the hang of the new work environment. Even if you aren’t able to understand everything right away, confidence comes with time and experience.