INTEGRATIVE CARE 10/16a Teaching Workshop Flashcards
(44 cards)
Goals during documentation
- The goals should be updated regularly depending on the length of the episode of care.
- The goals also should be updated whenever there is a change in the patient’s or client’s progress or medical status.
- *Note: State laws and certain third-party payers may have specific expectations on how often goals are updated.
Why do we write goals?
- motivate patients with short term and long term goals
- To define and communicate the purpose of your plan of care (collaborative)
- To facilitate the management of your patient’s progression
- -> Understand if your interventions are progressing to the end goal - To determine the efficacy of your intervention
- To satisfy requirements for reimbursement and meet standards of accrediting bodies
Clinical documentation of goals
- Long Term Goals – (the end of the episode of care, multiple weeks)
- Return to prior level of function or new functional level
- Over a month - Short Term Goals – (several sessions, 1-2 weeks)
- Acute musculoskeletal injuries have short time periods - Session Goals – (that day)
- Focus for current session and what you want to achieve in that space
SMART Goals
Mr. Jones will walk 500’ independently with a SPC within 4 weeks.
Specific: 500’, device, time frame
Measurable: distance, level of assistance
Achievable: check long term and short term goals
Relevant
Time bound: defined in 4 weeks
-What sets you up for objectivity in goal setting?
Measurable goals, ensure that it isn’t an average, look at outcome measures, based on data that’s collected during initial examination
-What makes a measurement biased?
Towards age, to ensure that insurance/reimbursement policy doesn’t get cut
-Don’t make our plan based on what we think insurance is going to cover
what is the significance of functional relevance
Functional/Relevance
- Ensure that there is relevance to some functional aspect of life
- Need to tie objective to some form of function that the individual needs to do/adds value to them
Patient centered, functional goals promote
- actively facilitate the participation of the patient/client, family, significant others, and caregivers in the plan of care
- individually meaningful activities that a person cannot perform as a result of an injury, illness, or congenital or acquired condition, but wants to be able to accomplish as a result of physical therapy
why focus on patient centered and functional goals?
- meaningful to patients
- health care policy
- reimbursement practices
- standards of accrediting bodies increasingly require the goals of physical therapy and other professional services to be patient-centered and functional.
patient practitioner collaborative model
- Behavioral diagnosis
2. Initial rapport building
Desired outcomes of patient’s and families
- If you were to focus your energies on one thing for yourself, what would it be?
- What activities do you need help to perform that you would rather do yourself?
- What are your concerns about returning to work, home, school, or leisure activities?
- How can I help you to be more independent?
- Imagine it’s 6 months down the road. What would you like to be different about your current situation? What would you like to be the same?
how do you alter the following goal statements so that they are SMART goals
- Improve shoulder AROM
- Improve standing tolerance
- Improve walking distance
- In 2 weeks improve shoulder AROM by 20o to allow patient to brush hair on their own and cast overhead fishing rod
- In 4 weeks, report at least a 2 point improvement in the numeric pain rating scale during standing while fishing
- In 4 weeks, demonstrate the ability to ambulate 500’ with a SPC safely and independently to facilitate the ability to walk to the mailbox (make sure you put distance and functional goal)
define patient or client centered
tailored or customed to the unique needs of an individual
define objective
unbiased and based in fact
define measureable
quantifiable
define functional
relating to a particular use or purpose
define time-dependent
held accountable to a determined interval
what are the components of well written goals?
- Identification of the individual who is receiving therapy and will carry out the program. generally the patient or the client, but may also be the caregiver or family members
- description of the movement or activity
- connection of the movement or activity to a specific function
- specific conditions in which the movement or activity will be performed
- factors for measuring performance
- time frame for achieving the goal
steps needed when teaching a patient
- determine what you need to teach
- get to know barriers and factors influencing patient learning
- consider the method/mode
- allow practice/use/application
- assess your teaching
how do you determine what you need/want to teach the patient?
- goals help you direct what you need to teach
- begin with end in mind/final outcome
- make the session objectives based on short term tasks/goals
- use learning domains
- know the components of education
what are the learning domains?
- cognitive
- psychomotor
- affective
what is the hierarchy of cognitive learning domain?
moves from simple to more complex
◊ Knowledge (list, describe, name)
◊ Comprehension (summarize, discuss)
◊ Application (demonstrate, distinguish)
◊ Analysis (order, classify)
◊ Synthesis (create, design)
◊ Evaluation (assess, recommend)
what is the hierarchy for psychomotor learning domain?
skill acquisition ◊ Perception (detects, distinguishes) ◊ Set (shows, begins) ◊ Guided response (copies, reproduces) ◊ Mechanism (organizes, performs) ◊ Complex overt response ◊ Adaptation (alters, revises) ◊ Organization (composes, creates)
what is the hierarchy for affective learning domain?
learning attitudes, appreciation, and values
◊ Receive (identify, recognition)
◊ Respond (comply, perform)
◊ Valuing (consistently, demonstrates)
◊ Organization (justify, modify)
◊ Characterization (displays, serves)
