Ideas and Discussions About Implementing Choosing Wisely Recommendations Into Your Occupational Therapy Practice

By Stephanie Yamkovenko posted 02-12-2019 13:23


Since AOTA released its list of five interventions OT practitioners should question, there have been a lot of conversations about the topic on CommunOT.

We wanted to round up some of those discussions here in case you wanted to catch up on what your colleagues are doing to fully implement the Choosing Wisely recommendations into practice. These go over everything from how to encourage your coworkers to be more occupation-based to ideas on how to select the best assessments. Please note: AOTA members must login to read these discussions.

If you want to get more involved with Choosing Wisely, you can sign up to be a part of an email list to get notified by AOTA about new initiatives and opportunities.

Encouraging Coworkers to Choose Wisely

Check out this conversation about how to bring up the recommendations with colleagues, especially the ones who are providing some of the five interventions that OT practitioners should be avoiding. 

Recommendation 1: Don’t provide intervention activities that are non-purposeful (e.g., cones, pegs, shoulder arc, arm bike).

How do you make sure you stay occupation-based in practice? These members are discussing the ways that they avoid non-purposeful activities.

Recommendation 2: Don’t provide sensory-based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information.

The recommendation about sensory assessments spurred quite a few conversations. There have been a couple of conversations about which assessments to use, including this thread about assessments for children and youth in mental health settings and this thread about tying assessments into documentation.

An AOTA member brought up the Choosing Wisely recommendation about sensory interventions in this thread about psychiatric hospitals.  

Is it a “sensory issue” or is it trauma? A member brought up the sensory recommendation in this thread about children who have experienced a significant amount of trauma and whose parents and teachers believe are having “sensory issues.”

Members also brought up the recommendation in this thread about a teacher using weighted vests without an OT monitoring the use and this conversation about schools that have sensory rooms.

Recommendation 3: Don’t use physical agent modalities (PAMs) without providing purposeful and occupation-based intervention activities.

Members are sharing some ideas for functional activities during PAMs like e-stim in this thread.

Recommendation 4: Don’t use pulleys for individuals with a hemiplegic shoulder.

AOTA members are sharing how they use purposeful activities in rehab for clients with a hemiplegic shoulder.

Recommendation 5: Don’t provide cognitive-based interventions (e.g., paper-and-pencil tasks, table-top tasks, cognitive training software) without direct application to occupational performance.

When working on functional cognition, these AOTA members share how they tie their interventions to occupational performance in this thread.

Have more questions or ideas around the Choosing Wisely recommendations? Start a new thread on CommunOT and start brainstorming with your OT colleagues!


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