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When it is holiday time, many Occupational Therapy practitioners want their hard earned time off.  However, some treatment settings go by a seniority status or lottery.  Trying to minimize your work week can be easy or difficult, depending on your OT treatment setting.  Here are some tips:

• Be Proactive: Find out if there are any registry Occupational Therapy practitioners or other OT staff that would be willing to work for you.  You can also swap a day with another OT practitioner.
• PTO:  You want time off, but you have not accrued enough PTO (paid time off).  You may have the option of working a weekend day for the holiday.  This has some advantages and disadvantages.  Some of the disadvantages are:  1.)  You may be the only OT practitioner working an 8-hour day on a weekend.  2.)  You may not have another therapist to assist with transferring a client.  3.)  You may need to perform OT treatments in the patient’s room due to safety concerns of being the only healthcare professional in the Occupational Therapy gym.  4.) If working in certain Occupational Therapy treatment settings, you may need to be aware of MDS reference periods.  In this instance, you need to ensure you are treating OT clients where there is not a conflict with their reference dates.  If you accidentally see a client and their reference period starts the following day or later, the client may be short the amount of minutes needed to categorize them in a specific RUG level (Resource Utilization Group).

For additional information on capturing minutes, follow this link

• Plan Ahead:  If you are beginning a new job, request holiday time off when you negotiate the terms of your contract.  In this respect, you have your time off in writing and can relax around the holiday.
• Choose Your Time Wisely:  Many OT practitioners cannot have it all.  Choose a holiday you want time off for and work the other holidays or days around them.  This will create a pleasant work environment and delegate the time among all the OT professionals.
• Split Your Time:  Your OT caseload may work out in your favor.  For example, say you only have 4 hours of OT treatment time.  In this case, you could start your work day a bit early and finish early.  You can return home in time to continue with the holiday celebration.
• Utilize Your Time Wisely:  Remember that you are allowed to group your OT clients a percentage each week, usually up to 25% of their comprehensive Occupational Therapy treatment time for the week.

For ideas on group interventions, follow this link

Common Mistakes:

• RUG Assessment Periods:  As previously stated, you may encounter a problem where you did not check the reference dates ahead of time.  Possible problems that could occur are a client will not receive the necessary amount of treatment minutes and/or days to qualify them for their needed Occupational Therapy treatment time.  A client must be seen 5 days in an assessment period, by at least one discipline to qualify them for a specific RUG level.
• Conflict with  a Doctor’s order:  Given the way the MD order was written, you need to ensure the OT client received the exact amount of treatment days.  For example, some may see a client for 4x/wk and the order was written for 5x/wk.  This is acceptable if the discrepancy is due to a recognized holiday by Medicare or another insurance company for the respective client.
• Call in Sick:  This is not an acceptable way to receive a day off.  In essence, you create more work on the other Occupational Therapy professionals working that day.
• Not Informing the Occupational Therapy Client:  Many forget to tell the OT client about the change in their weekly schedule due to a holiday.  It is easy to forget that an OT client becomes accustomed to their schedule; communication is welcomed when there is a change.  Also, many OT clients look forward to their rehabilitation treatments, as it prevents loneliness around the holidays.  Forgetting to communicate a change in their plan of care may create an emotional OT client.
• Fluctuate Treatment Minutes:  Remember it is fraudulent to reduce a client’s treatment minutes, when the facility is being reimbursed based on the OT client’s category.  Also, it is best to stay consistent with your treatment minutes, and not increase the Occupational Therapy client by 10-15 minutes each day to reduce the amount of treatment minutes on the day you want to leave early.

A good start to an Occupational Therapy treatment can be initiated with a warm-up.  Occupational Therapy practitioners choose their interventions focusing on the client’s immediate deficits.  A warm-up can help an Occupational Therapy client with modulating their senses, preparing their muscles for exercise, or initiate different areas of the brain for challenging activity.  Listed are some activities that may help as a client warms up for their OT treatment:

Review prior treatments plan of care:  Each Occupational Therapy treatment is developed to increase a person’s function with a daily task.  A client will better understand their progress if they identify with how their OT treatments are affecting their recovery. 

For example:

1. Review prior treatments plan of care.  If you educated the client on how to use adaptive equipment for dressing, ask the client to name the AE and what its use is.  This will allow the client to better understand their progress and identify how their OT treatments are affecting their recovery.
2. If you recently fabricated a splint, have the client show how to donn/doff it and recite the wear/care schedule.  This task informs the OT practitioner of the client’s ability to show return demonstration, their understanding of the splint and its use, and offers the clinician the ability to further educate if needed.
3. Have a plan or schedule in place to delegate household tasks, if addressing IADLs.  Each time your client attends an Occupational Therapy treatment, they will initiate the respective daily task; watering plants, making coffee, stowing groceries, or opening blinds or drapes.  This may help a client follow a schedule, assist with accountability, address sequencing and organization of tasks, visual scanning, or balance.
4. Ask the client to recite any precautions they may have (e.g., hip precautions, rotator cuff post-operative precautions, weight-bearing precautions).
5. Stretch or move affected extremity through various planes to prepare for exercise.  Due to spasticity, pain, or weakness AROM can help to prepare a client for higher level tasks.
6. If addressing handwriting, have the client sign-in on a log, write the date, and/or check a box for the day of the week.  This can be upgraded/downgraded accordingly (i.e., change utensil, write first name only, or circle a word to complete the log-in sheet).
7. If addressing various sensory stimuli, have the client pick a warm-up task from a bowl.  The tasks can vary from bouncing a ball, sitting on a theraball (with different types of support), manipulating textured or plain putty, washing hands with various textured soaps and towels, or jumping on a trampoline.
8. If addressing vision, ask client to sort through a deck of cards or organize play money for a board game.
9. When addressing cognition, have the client organize/sequence a simple photo task or a basic rote task.
10. List below a warm-up you have used in the clinic