Supporting Occupational Therapists in Predischarge Home Visit Decision-Making: Development and Evaluation of a...

Area of Science:

• Occupational therapy
• Clinical decision-making
• Healthcare innovation

Background:

• Occupational therapists face challenges in deciding whether to conduct predischarge home visits due to limited evidence.
• This decision-making process impacts patient care and resource allocation.

Purpose of the Study:

• To evaluate a new decision support tool for predischarge home visits.
• To assess the tool's impact on therapists' confidence, ease, and accuracy in decision-making.
• To examine the tool's clinical utility, reliability, and stakeholder satisfaction.

Main Methods:

• A pre-post study design was employed with occupational therapists across five facilities.
• A newly developed decision support tool was trialed.
• Data collected included questionnaires on decision-making practice, case study evaluations for accuracy, and clinical utility/reliability assessments.

Main Results:

• Therapists' confidence and ease in decision-making did not significantly change.
• Decision-making accuracy improved irrespective of therapist experience.
• The tool demonstrated moderate interrater reliability (Fleiss' kappa = 0.51) and good internal consistency (α = 0.83).

Conclusions:

• The developed tool enhances the accuracy of predischarge home visit decisions for occupational therapists.
• It serves as a reliable resource to support clinical reasoning and practice.
• The tool is considered timely and easy to use, indicating good clinical utility.