Transcript Competencies and Outcomes in Therapeutic Recreation Chapter 1

Competencies and Outcomes in
Therapeutic Recreation
Chapter 1
HPR 453
Professional Competency /
Service Outcomes







Questions to ask….
What does the profession do?
How do we provide care?
Are we a system or a single modality? Why? How?
How is it similar to/different from other healthcare
professions?
Who do we treat? Range of
conditions/diagnoses/illnesses/disabilities?
How do we measure up to external norms?
What is professional
competence?





Ability to provide patient-centered care
Ability to work in interdisciplinary teams to provide
continuous, reliable care
Utilize evidence-based practice through best practices,
clinical expertise, and patient preferences
Ability to incorporate quality assessment and quality
improvement
Ability to utilize informatics to communicate, manage
data and reduce error
Professional Competence
defined


“the habitual and judicious use of
communication, knowledge, technical
skills, clinical reasoning, emotions,
values, and reflection in daily practice for
the benefit of the individual and
community being served.”
 Epstein and Hundert (2002)
See dimensions of Professional Competence – pg 5 in text



A professional’s competence is closely related to his or
her ability to provide high-quality services that help the
client achieve desired and meaningful outcomes.
“The individual recreation therapist has a considerable
impact on outcomes, both in research and in practice
settings. Being the best clinician possible is, therefore,
important in advancing evidence-based practice.”
 Buettner and Fitzsimmons (2007)
Professional competence must be monitored to prevent
putting the client at risk.
What are Client Outcomes?

“The documentable changes in client behavior,
skills, and/or attitudes that can be attributed to
active participation in the therapeutic
recreation intervention program”


Dunn, Sneegas & Carruthers, 1991, Stumbo and Peterson, 2009;
Shank and Kinney, 1991; Stumbo, 1996
The differences in the client from the beginning
compared to the end of treatment
Healthcare Outcomes
Categories

Clinical status – Measured at organ level
• ie. Blood pressure, temperature, white blood cell count,
respiration, fitness

Functional status – ability to fulfill social
and role functions; successful,
productive and satisfying life
• ie. ADLs; leisure lifestyle, life and self-care skills, safety;
stability of living environments; relationship abilities, such as
marriage, parenting and sibling interactions; school or
employment status; and engagement in at-risk behaviors

Well-being or Quality of Life (QoL) –
Satisfaction with living conditions, work or school, leisure,
finances and whether basic and fundamental needs are
met


Satisfaction – (with services rendered)
•
Pts opinion on whether care is accessible, affordable,
effective and professional
Costs and resource consumption – Balance
the need to reduce costs with unfavorable impacts on the
quality of care
Outcome Measuring Criteria







Be widely accepted
Be comprehensive
Be suitable or meaningful
Be sensitive to change
Be psychometrically sound
Be statistically amenable
Be practical or actionable
Evidence-Based Practice



The services delivered to clients should be
based on the best available scientific evidence
of treatment efficacy or effectiveness
Designed or delivered using research evidence
to implement “best practices”
Moving clients toward desired outcomes in the
most effective and efficient way possible




Advance quality of care and services
RTs provide
Have fewer variations in RT practice
Have cost savings that flow from
appropriate and timely RT intervention
use
Improve health outcomes in general



Effectiveness – everyday circumstances,
routine, real world
Efficacy – Ideal, more controlled
circumstances, research
EBP – provider should feel confident that he or
she is providing the best possible care that is
known to produce the most desirable,
intended, and meaningful outcomes