Although occupational therapists (OTs) typically work with people who have chronic physical and cognitive conditions, they also play a key role in acute care. In fact, hospitals are the largest employer of OTs, engaging 27% of the OT workforce in the United States, or approximately 36,000 OTs. This blog post outlines the role of occupational therapy in acute care and how OTs can contribute to better patient care and outcomes.
What Is Acute Care? ((American Occupational Therapy Association, “ Occupational Therapy’s Role with Acute Care,” 2017: https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/Acute-Care.pdf))
Acute care is a category of healthcare that encompasses the treatment of sudden, emergent injury and illness. It includes a range of clinical healthcare settings, such as emergency medicine, trauma care, urgent care, intensive care, and inpatient critical care. Acute care provides patients who have severe or even life-threatening medical conditions with short-term, immediate treatment.
The goal of acute care is to rapidly treat patients and, when appropriate, stabilize them and transfer them to long-term rehabilitative care. If you choose to work as an OT practitioner in this setting, you must be knowledgeable about treating conditions resulting from a variety of causes, from strokes to falls to motor vehicle accidents.
Occupational Therapy in Acute Care vs. Traditional Rehabilitation Settings
If your job is in acute care (such as a hospital setting), you will probably treat more patients during a shift than you would in a traditional rehab setting (such as a skilled nursing facility).2 Given that acute care is short-term, you won’t get to know your patients as well as you would in a traditional rehab setting. Also, because patients in acute care are typically in an unstable condition, you will have added pressure to make the right decisions quickly. Acute care OTs focus on helping to medically stabilize patients, facilitate early mobilization, perform therapeutic interventions, and create discharge plans. By contrast, patients in rehab settings have chronic issues that OTs treat over time.
What Do Occupational Therapists Do in Acute Care?
In your occupational therapy practice, your role is to help patients who have physical or cognitive challenges develop or recover their ability to perform meaningful activities of daily living. Acute care occupational therapists begin working with patients early in their recovery process to determine the best treatments. Given their knowledge of anatomy, kinesiology, and neurology, occupational therapists are important members of the acute care team.
Interventions by Occupational Therapists in Acute Care
Occupational therapists also work on interprofessional teams with physical therapists, speech-language pathologists, nurses, and physicians to determine the best course of action. For example, if the PT recommends that the patient spend several minutes standing twice a day, an OT may suggest that the patient pair this likely challenging weight-bearing activity with an enjoyable activity of daily living such as eating a meal. Or the OT may bring in the SLP to teach patients who are unable to verbalize how to use adaptive communication devices.
Below are some of the responsibilities of occupational therapists in acute care.
For critical care patients:
- Evaluating joint integrity and the need for splints, positioning devices, and assistive technology
- Determining the safety of eating and swallowing
- Educating patients and caregivers about mobility techniques, home safety precautions, and skin check procedures
For surgery, neurology, and orthopedic patients:
- Creating performance-based goals for the patient, while considering the patient’s individual lifestyle in order to determine the need for adaptive equipment or home modifications
- Providing preventive splinting that allows for the necessary range of motion
- Evaluating the need for mobility assistance
- Showing patients and caregivers how to use assistive devices
- Educating patients and caregivers on self-care activities, mobility, and home exercise programs
For mental health patients:
- Offering client-centered stress management and coping strategies
- Contributing to discharge planning and offering suggestions for next-level care, such as therapy groups
- Helping the client set goals for community re-entry and self-care
For pediatric patients:
- Helping families develop and implement intervention plans to keep the child safe in various environments
- Teaching families best practices for reducing the risk of further injury
- Considering developmental milestones when setting goals
Benefits of Occupational Therapy in Acute Care
Having occupational therapists on acute care teams has significant benefits for patients and hospitals. OTs can help patients improve function by creating treatment plans that outline next steps for care, such as home exercises, continued therapy, and adaptive methods for performing activities of daily living.
Occupational therapists can help hospitals reduce readmission rates by lessening patients’ risk of further or future injury, which ultimately lowers costs. One study suggested that higher occupational therapy spending is associated with lower readmission rates because occupational therapy uniquely places an immediate focus on patients’ functional and social needs, which, if left unaddressed, are common reasons for readmission.
Why Work as an Occupational Therapist in Acute Care?
Working in acute care is not for everyone. As an acute care OT, you must be resilient and flexible, with strong attention to detail and the ability to thrive under pressure. You need to be able to deliver optimal, efficient care under stressful conditions.
That being said, you will have opportunities and experiences you would not have in a traditional rehab setting. You will refine your skills and learn new ones, such as:
- Diagnosing, treating, and managing patients under pressure
- Assessing risk and making decisions quickly
- Communicating with various stakeholders, including patients, family members, and physicians
After spending two and a half years practicing in acute care, David S. McGuire, OTR/L, told OT Potential:
What Education Do You Need to Become an Acute Care OT?
If you envision a future career as an acute care OT, it’s best to start with a bachelor’s degree in occupational therapy or a health sciences field. Next, you must earn your graduate degree in OT: either a Master of Occupational Therapy (MOT) or a Doctor of Occupational Therapy (OTD). Both degrees include several months of mentored, hands-on fieldwork and prepare you to enter clinical practice. However, the OTD degree includes expanded studies on research, advocacy, and policymaking within the profession. After graduation, pass the national licensing exam (administered by NBCOT), and you’ll be ready to practice!
Working in acute care can be exciting and stimulating. It’s a fast-paced environment where no two days are the same, and you’ll have the opportunity to work closely with a variety of specialized medical professionals. You’ll be part of a team that’s doing life-saving work, which can be an incredibly rewarding experience.
The largest OT graduate school in the United States,* the University of St. Augustine for Health Sciences (USAHS) offers hands-on Master of Occupational Therapy (MOT) and Doctor of Occupational Therapy (OTD) degrees. Practice with mock patients in our state-of-the-art simulation centers and learn anatomy with our high-tech tools. Prepare for clinical practice with patients across the lifespan, as well as advanced roles in research, practice leadership, and policymaking. Residential and Flex (online/weekend) paths are available. We also offer an online Post-Professional Doctor of Occupational Therapy (PPOTD) program designed for working clinicians and healthcare educators, with optional on-campus immersions and an annual interprofessional trip abroad.
*Based on total MOT and OTD degrees conferred, as reported by the Integrated Postsecondary Education Data System (IPEDS). Data is captured by IPEDS through interrelated surveys conducted annually by the U.S. Department of Education’s National Center for Education Statistics (NCES). https://nces.ed.gov/ipeds/
RESNA, “Outcome Measures Used In Acute Care By Occupational Therapists,” 2018: https://www.resna.org/sites/default/files/conference/2018/outcomes/Wang.html