Occupational therapy practitioners have consistently demonstrated their unique skill sets and ability to adapt in the face of the COVID-19 pandemic. A wealth of knowledge, innovative ideas, practitioner stories, and demonstrations of support have been shown through the COVID-19 discussion on CommunOT. Early in the pandemic, we started reaching out to clinicians in multiple settings to understand the emerging needs and experiences of practitioners, and how AOTA could best support them. One of these practitioners was Tara Babe, OTD, OTR/L, who participated in the following Q&A. Tara is the Assistant Manager of Occupational Therapy at ChristianaCare.
Q. What types of challenges did you face as an OT practitioner as your facility began admitting patients with COVID-19?
A. Initially there was a lot of uncertainty about what our role would be in the treatment and care of these patients. We also faced a quickly declining census, which made it necessary to reallocate caregivers (at ChristianaCare, we refer to all our employees as caregivers), and reorganize how we managed caseloads for patients who tested positive or negative for COVID.
Q. How did the rehab department determine a strategy to address the challenges?
A. We took a team approach to address these challenges and shared resources, strategies, and new information via electronic formats. We used a multi-disciplinary approach both on our acute rehabilitation and acute care floors by coordinating caregiver staffing, scheduling, and resources in a manner that bests serves our patients as well as with other services including physical therapy, speech therapy, nursing, and the physician teams. Overall effective communication within the department has been the key to helping caregivers manage all of the stressors that are present with our current challenges.
Q. What were the most important factors in addressing the COVID response?
A. From a system wide perspective, ChristianaCare has encouraged us to uphold our core values of love and excellence. Transparency, communication, and support from our management teams have helped manage anxiety and concerns regarding this situation. We have a number of resources available including a COVID specific dashboard that keeps us informed of new cases and current testing numbers. There is also a frequently-updated website that addresses everything from how to don personal protective equipment to the Centers for Disease Control and Prevention’s most recent recommendations. This has made a considerable impact in the confidence of the caregivers. From an Occupational Therapy perspective, the ability to understand how COVID at each stage impacts a person’s ability to participate in daily activities has been vital. It has challenged us as a department to integrate the important components of our practice, such as therapeutic use of self and respect for the integrity of the patients, while still maintaining our own safety.
Q. How has OT practitioner involvement changed in the facility?
A. Our involvement has shifted on a number of levels. We have had to rearrange and redeploy caregiver staffing based on minimizing exposure to COVID patients and a frequently fluctuating census. Considerations are taken into account for caregivers assigned to COVID patients as they require additional time to don and doff personal protective equipment, require increased time to interact with patients, and with other disciplines to make sure we are meeting patient needs. We have also had to consider for all of our patients – both COVID and non-COVID patients – that the potential for social isolation is high because of limited visitation. Everyone has been taking the extra step to spend more time with each patient to provide that human interaction.
Q. Are there areas of continuing education that OT practitioners have pursued and found useful?
A. We have used a number of online resources including ChristianaCare’s COVID portal for real time information, AOTA’s website for updates, and online forums and educational platforms. We have also had a number of caregivers share multidisciplinary information from their national organizations such as the American Speech-Language-Hearing Association and the American Physical Therapy Association. Everyone has pitched in to help provide support and up to date information as it becomes available.
AOTA greatly appreciates the stories, insights, and experiences that OT practitioners have shared with us over the past months. For information on AOTA’s response and related tools, you can access resources and news related to OT and COVID-19, including a series of Decision Guides related to varying practice settings and guides for reopening, and a guide for Practitioner Well-Being. We invite you to direct your Coronavirus-related questions and insights to coronavirus@aota.org.