fieldwork site profile (fs-pro): learning opportunities and …spot.mcgill.ca/siteapproval_pdf/ot...

Fieldwork Site Profile (FS-PRO): Learning Opportunities and Resources

Please fill in and return to your affiliated university occupational therapy program.

Site and Contact Information

Name of site: MUHC- Montreal General Hospital

Name of programlsector: Phvsical Medicine

Name of contact person: Francine Desrosiers

Title of contact person: Occupational Therapist

Address: 1650 Cedar Ave., room C2-144

Montreal, QC H3G 1A4

Phone*: 1514) 934-1 934 ex.42892 Fax*: (514) 934-8371

E-mail address*: [email protected]

Web site: nla

Supporting material about the site and occupational therapy services attached

(e.g. pamphlet, brochure, fact sheet)

*of contact person

If you have any questions or comments, please contact your university representative:

A member of the Coordinators

a sub-committee of

The MUHC is a fusion of 5 hospitals. The Montreal Children Hospital is a stand-alone; all adult

services are integrated under one director. For the purposes of clinical supervision, adult services are organised in 4 sections. Each section has its own

FS-PRO, namely: - Physical Medicine MGH: Francine Desrosiers

(Responsible) -Physical Medicine RVH*: Priscilla Lam

(Responsible) -Psychiatry MGH: Hiba Zafran

-Psychiatry RVH-AMI: Hiba Zafran *includes MNH and MCI

University Fieldwork Committee (UFCC) , the Association of

(2005 revised edition)

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1 2. System(s) / services in which you practice: Public sector Private practice

Rehabilitation centre Outpatient clinic (XI Hospital Long term care centre Home care Day hospital Insurance industry Community setting School

Other:

3. Occupational therapy roles: Direct care IXI Indirect care Consultation IXI Research

Administration IXI Other: Teaching

4. Client life span: Children Adolescents IXI Adults Older adults

UFCC- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edition 3

Site:

Characteristics of Occupational Therapy Services (continued):

5. Client conditions: Mental health Physical health Combined Other

Please list common client issues :

1 . Physical andlor cognitive impairments

2. Ability to manage basic ADLs

3. Ability to perform IADLs

4. Safety for DIC home and or need for outpatient Flu andlor need for inpatient rehabilitation

Most frequently seen diagnostic categories:

-Surgery

-plastic surgery

-0rthopaedic surgery (hip replacement, etc.) (MGH only)

-vascular surgery

-transplant

-ear, nose and throat specialities

-Medicine

-general medicine (de-conditioning, pneumonia, etc.)

-rheumatology

-cardiology (chronic heart failure, etc.)

-active geriatrics

-palliative care (MGH only)

-hematology 1 oncology

-Respiratory

-Acute and chronic pulmonary conditions (COPD, etc.)

-Neuroscience

-Neurology (multiple sclerosis, stroke, etc.)

-Neurosurgery (brain tumors, spinal stenosis, etc.)

-Traumatic Brain Injury (MGH only)

-Epilepsy

I Site:

Occupational therapy focus:

1 Please describe common areas of practice, interventions and programs :

Occupational therapy is a practice that utilizes the analysis and application of functional activities in order to promote andlor maintain independence in the ares of self-care, productivity and leisure. Occupational therapy components (physical andlor cognitive status mainly) as well as the patients' environment and their impact on occupational performance are assessed. Through the interpretation of evaluations, a plan of intervention is developed in collaboration with the patient, family and other members of the interdisciplinary team. For the inpatient population, the goal of the intervention is to promote functional independence and facilitate a prompt and safe discharge. Fo the outpatient population, the goal of the intervention is to facilitate participation in occupational performance. The Canadian Model of Occupational Performance is used as our frame of reference. Different models of practice (biomechanical, rehabilitaiton, motor control, neurobehavioral, etc.) are used to guide our interventions. The choice of the model depends on the patient's diagnosis.

MEDICINE There are 5 therapists to cover all medical referrals (RVH and MGH). Typical client groups include respiratory (COPD) pneumonia, CHF, general de-conditioning and oncology. Clients are primarily referred for functional assessments to evaluate safety and ability to return home. The functional assessment includes evaluations of eating and feeding. When patients are experiencing swallowing problems (dysphagia) the OT performs a bedside assessment and occasionally Modified Barium Swallows are used. ADL evaluations, IADL screening (Barthel index), Driving Screening (Trail making A and B, MVPT, etc) and recommendations for improving function are provided. Periodic re-evaluation is done as time permits. The average L.O.S. is 11 days and about 3 weeks for complex.

Types of patients include cardiac, transplant, polytrauma, multiple #'s, amputees, and spinal cord injury. (Note: orthopaedic is exclusive to the MGH). The OT's role is to assist in determining functional capacities, provision of aids, positioning splints (e.g. footdrop) and facilitating discharge from hospital to home, rehab centre, or LTC residence.

ACUTE GERIATRICS

Services are provided by one full time OT in both the MGH and RVH, where a strong interdisciplinary approach is used. Family meetings and education to caregivers is an important part of the service. The overall goals are to increase functional autonomy and to co-ordinate discharge planning. Referrals are from the Emergency room and in-hospital transfers from other wards. Clients are generally 75 and over, frail, with general deterioration of function. Typical admissions are for falls, acute confusional states, dementia work-up, pneumonia and de- conditioning. Transfers from other floors include post MI and post fracture clients. Typical evaluations used include Barthel, OARS, cognitivelperceptual screening and dysphagia evaluation. Average L.O.S. is 40 days.

I I I


1 GERIATRIC DAY HOSPITAL 1 The OT at the RVH is a member of an interdisciplinary team, and is responsible for the assessment, planning and implementation of specific treatment for a geriatric out patient population. This includes preventing disability, and assisting clients to achieve optimum function and independence in ADL, IADL and mobility, in a clientele with physical and mild cognitive impairments. The OT completes an evaluation with recommendations, provides rehabilitation and re-assessment when indicated, and undertakes home visits to assess safety and function when necessary. The OT at the GDH also participates in team meetings, and participates in decision- making and problem solving with other team members. Assessment reports include functional and measurable goals, and outcome measures are regularly used in assessment and in clinical decision making. The average length of stay can vary from 2-4 weeks for an evaluation to 3-4 months for rehabilitation.

TRANSITIONAL CARE UNIT

A part-time OT offers services to long term care patients (0.5 F.T.E on the S7W unit of the RVH) and by consultation (geriatric OT) at the MGH. Patients are awaiting placement in a long-term care facility outside of the acute care hospital. The OT is an active member of the multidisciplinary team. Interventions undertaken by OT include dysphagia assessmentlrecommendations, positioning and wheelchair clinics, functional re-assessment and recommendations to improvelmaintain autonomy and quality of life on the unit. The average length of stay of patients is 2-4 months.

NEUROSURGERY

Occupational Therapists provide services to the neurosurgery in and out patient population of the MNH. The vast majority of patients are seen on an in-patient basis and suffer from a wide variety of conditions such as cerebral haemorrhage, aneurysm, brain tumour, spinal stenosis andlor compression, etc ... The main goal of OT is to monitor patients' functional status pre and post- operatively and asses ADL in order to assist with decision making pertaining to discharge planning. The OT acts as a consultant on the pre-admission and peri-operative unit and is an active member of the brain tumour multidisciplinary team.

NEUROLOGY

Neurological clients are located on the 14th floor of the MGH as well as at the Montreal Neurological Hospital. Typical clients suffer from CVA, MS, ALS, Guillain Barre Syndrome, myasthenia gravis, neuropathy and spinal cord injuries. Evaluations include eating, feeding and dysphagia (bedside exam and occasionally MBS), general motor assessment (ROM, balance, strength, co-ordination), ADL function (Barthel, in-house evaluation), cognitivelperceptual function (OSOT, PECPA, MOCA,MMSE, CCT). Most patients are seen on an in-patient basis and the overall goals of OT are to improve ADL independence and to assist with appropriate discharge planning. The length of stay varies with condition, but the average for the Neurosciences is 12 days. Strong multidisciplinary approach is used.

:C- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edition 5

TRAUMATIC BRAIN INJURY PROGRAM

The TBI program has a strong interdisciplinary approach and includes 1.4 F.T.E. OT at the MGH. Clients have an average length of stay of 12 days. Typical evaluations used include cognitive screening (CCT, PECPA, in house cognitive battery), perceptual evaluation (MVPT, OSOT, Bell's test) and functional evaluation (FIM). The goal of OT within the service is to evaluate the client's functional status (motor, cognitivelperceptual functions, ADL and IADL ...), and to provide recommendations for safe return home or identify the need for rehab follow-up.

OUT-PATIENTS

Five occupational therapists (MGH and RVH) offer services to the hand injured out patient population. The majority of the caseload is referred by plastic surgery, but referrals are also received from rheumatology, orthopaedics and out patient clinics. The OT assists the client in the evaluation and treatment of oedema, scar adherence and hypertrophy, decreased range of motion and strength, impaired sensation, etc.. . The focus is to return the client to this former level of functioning in selfcare, work and leisure activities. The OT's are an integral part of the plastic surgery team and cover the plastic surgery clinics.

INPATI ENT-PLASTICS

The inpatient plastic referrals are seen by the hand specialists at the RVH and MGH. Referrals include individuals with trauma of the hand (e.g. burns, replantation and severe fractures). The average length of stay for these clients is 3-5 days, with out patient follow-up afterwards. OT interventions consist primarily of splinting to immobilize and protect healing structures and early range of motion if applicable to prevent stiffness and deformities. A multidisciplinary approach is used.

7. Hours of operations: 7h00-16h30 Mondav to Friday

8. Total number of occupational therapists working atlfor your site:

[XI Full Time: 5 Part Time: 4

9. Support personnel (e.g. OTAide, rehab assistant)? yes [XJ no If yes, how many:

UFCC- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edition

I Site:

Learning Opportunities and Resources for Students:

1. Access to a library (either on or off-site) : [XI yes no

2. Internet access: yes no

3. Other learning opportunities and resources for students (please list):

(e.g. interprofessional contacts, field trips, resource binders): MGH library: 6th floor - Textbook are available in the department for reference - Ward Rounds, surgical clinic attendance (plastic) - Grand Rounds - Presentations (from Suppliers of medical equipment) - Meetings with other health care professionals - Utilization of standard evaluations (e.g. Jamar dynamometer, MMSE, Bells Test, PECPA, etc.) - Fabrication of splints (mainly in outpatient hand therapy) -Wheelchair and positioning clinics - Utilization of patient education tools (e.g. energy conservation pamphlet, etc.) - Observation of surgery, time permitting

4. Please state your general learning and performance expectations of students (other then the ones from the University) to assist them in preparing for fieldwork education at your site.

I UFCC-AcOTUP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edition

-

S~te

Administrative Resources:

1. Orientation session offered upon students arrival:

[Xl yes no, it will be available on (specim date):

2. Space and resources available to students (phone, desk, computer, work station, etc.):

Desk and locker available.

3. Policies and procedures information available:

yes, location: C2-173.1

no, it will be available on (specim date):

4. Health and safety policy in place:

yes no, it will be available on (specify date): C2-173.1

5. Emergency procedures information available:

yes, location: C2-173.1

no, it will be available on (specify date):

6. Contingency plan available (for absent fieldwork educator during placement):

no, it will be available on (specim date):

yes. Please outline its major characteristics:

Whenever the supervising occupational therapist is absent, arrangements will be made for the student to be supervised by one of the other occupational therapists.

In the event of a long-term absence from the supervising therapist (longer than 5 days), the student's supervision and evaluation will be re-assigned to one of the other therapists.

UFCC- ACOTLJP F~eldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edition 9

I Site. .-

Administrative Resources (continued):

Amenities Available to Students:

7. Continuing education plan in place for occupational therapists on site:

no, it will be available on (specify date):

yes. Please outline its major characteristics:

1. Cafeteria: (Xl yes no

/

2. Kitchen facilities: IXJ microwave oven (XI refrigerator other:

3. Locker: [Xl yes no

4. Bicycle rack: [Xl yes no

5. Parking: IXJ yes, cost: $1 5 per dav no

6. Public transportation available: IXJ yes no

7. Other (please list):

Please outline your site's continuing education policy or describe how occupational therapists remain current in issues that impact their professional practice. Also, describe use of evidence based practice:

1. See attached copy of the Departments Policy and Procedure on professional development.

2. See attached list of courses attended by staff in the previous fiscal year which supports the above policy.

3. In addition to the above, on a persoanl basis, 3 staff are pursuing post-graduate studies.

4. In-service in OT department and journal clubs within programs.

5. Financial support is also available through bursaries awarded by MUHC.

6. Evidence based practice. OT interventions change with each new evidence brought forth by OT staff (information obtained at conferences or for example in the litterature). Review of litterature combined with clinical expertise are key factors in the discussions regarding new suggested intervention approaches.

(e.g. accommodation for students)

BuslMetro access

Metro: Sherbrooke, bus 144

Metro: Guy, bus 165 or 66


Site.

Site Requirements for Students:

1. Immunization: yes no If yes, specify in box below.

2. Criminal / police record check: yes no If yes, specify in box below.

3. Dress code: yes no If yes, specify in box below.

4. A car is required during placement hours: yes no

If yes, describe the site "gas reimbursement" policy for OT students, in the box below.

Please specify additional information and/or requirements (e.g. mask fit testing):

No jeans, no low risers, no cleavage, no see throughs, no halter tops, no flip flops, no shorts,

minimal jewlery, closed shoes to protect from injury.

Professional attire required at all times.

Message to Students: Please add anything else you would like students to know or prepare for prior to starting a placement at your site.

-Pease write, call or e-mail the clinical coordinator of education at least one week prior to start of stage to ensure you are expected.

1. Reports: At mid term, you will be expected to give verbal feedback to your supervisor. For the f -1 report, you will EXCHANGE reports with your supervisor. You will, PRIOR TO THIS MEETING, have c lpeted and printed a copy of the McGill evaluation, as well as the department evaluation. The department ap miates

report, as it has already been written.

+= receiving honest feedback so we can improve the learning opportunity and your honesty cannot influence your

1 Pre-placement information package sent to student (e.g. reading list or material, schedule): yes no

UFCC- ACOTUP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - ZOOS Revised Edition 8

Addendum:

Please note the following requirement for all MUHC (network) placements

MANDATORY pre-requisite

All students must complete the OASIS training module in advance of beginning their assigned clinical course at an adult MUHC site. All supervisors expect students to be familiar with the MUHC electronic charting system.

Please refer to this link:

http://formationoacis.com/muhc/

Student must advise the AACCE once they have completed these mandatory on-line modules.

https://exchange.mcgill.ca/owa/redir.aspx?C=nUraddX_AESwQpvRc2WMEV527Ywu6NEI5kxAos06cQs8Y3SnssCsIF50jvd6zuXidyZJuTS4JE8.&URL=http%3a%2f%2fformationoacis.com%2fmuhc%2f

Site:

Signatures:

Profile completed by: date: (Name and tile)

My organization wishes to offer placements to occupational therapy students from:

my affiliated University Canadian universities International O.T. programs

For fieldwork education purposes, I hereby authorize my affiliated university occupational therapy program to forward the information included in the FS-PRO to students and fieldwork coordinators from other occupational therapy programs.

I shall ensure that students will be supervised by qualified occupational therapists who have a minimum of one year of professional experience, and hold credentials with their provincial regulatory body.

Signature: date:

I "FCC- ACONP Fieldwork Site Profile: Learning Opportunities and Resources - E-version - 2005 Revised Edit~on 9

-- - m Centre universitaire de santk McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MUHC

PAGE: 1 OF: 2

POLICY: The MUHC is committed to improving the skills and knowledge of employees, to enhance their contribution to patient care, as well as to increase employee job satisfaction and development. The employee is equally responsible (see code of ethics and job description) for self-continuing education to ensure competence and develop proficiency in the therapeutic areas of their profession. It is therefore, expected that all staff will attend and participate in the educational inservice program within the department as well as attend continuing education programmes offered to professional groups internal and external to the institution.

If a course is held on the weekend (either one or both days) time off in lieu from the therapist's professional development bank can be taken. But it MUST be taken immediately before or after (i.e. not a week later).

REVISION #

3

EFFECTIVE DATE

.

Every staff member has a schedule (days and hours of work). Unless there is a stat holiday, approved vacation or leave of absence all staff are thus expected to be "at work.

SECTION: 8 TEACHING EDUC. & PROFESSIONAL DEVELOPMENT

REVISED DATE

When possible (financial restraints as well as coverage issues) each employee is accorded study leave comparable with the number of hoursldays worked per week. This is not in the collective agreement and may be recinded. If the course occurs on a day when a part-timer is not scheduled to work, then they can a) take

Time reported on the Non Patient Care Activities (NPCA) sheet for professional development, education etc. are activities LESS THAN 2 HOURS e.g. participation in Grand Rounds, department in-services etc. Regardless of location (internal or external to the MIJHC) if more than two hours will be spent on NPCA activities a request for time off must be submitted and approved PRIOR to the event. Failure to do so may result in non-payment of the time spent away from the job.

YEAR 2006

DAY 0 1

YEAR 2006

the course on their own time or b) take a scheduled work day off in lieu of or c) request to be paid an . , additional day.

Staff MUST get approval for TIME OFF and before proceeding to requestlsubmit for funding. Focus for staff development and allocation of resources (pending availability) is dependent or identified through QA activities, performance appraisals and hospital and department needs.

MONTH 04

MONTH 0 1

DATE 06

When possible department resources will be made available to support staff in addition to the paid time off.

---

I PROCEDURE:

Staff are encouraged to apply for Grants and Bursaries. 1) Gustav Levinschi Foundation Award: Aim -to provide funds for staffing, equipment or other materials

1. Each section of the department will maintain a list of ward rounds and meetings. Participation is encouraged when time away from patient treatment permits. Time spent attending ward rounds will be documented daily according to the stats policy of the department.

for projects which cannot be established due to lack of funding. It is anticipated that the project will be funded in the future through other means. Applications to request funding will be sent to departments beginning of October to be submitted mid November (RVH ONLY).

2) Aitken or 'Laidley Fellowship Awards (members des ordres only): Aim - help professionals in their training and increase expertise. Candidate expected to contribute a new skill or body of knowledge. Applications to request funding will be sent to departments beginning of April to be submitted mid May (RVH ONLY).

3) Muldisciplinary Council: Aim -these bursaries are to be used by ALL members of the MDC within the MUHC to attend a conference, workshop, course or to being in a speaker on a particular topic. Applications to request funding will be sent two timelyear 1 - August due mid September 2 - January due mid February

2. All staff attending staff in-service training, seminars, lectures (informal internal to the institution) will record time in stats NPCA , if it is less than two hours. All requests for activities of more than two hours must be submitted on a time off request sheet.

- 1

3. All staff wishing to attend formal courses (usually with cost and time implication) should be prepared to , present the material at an in-service education session to arrange a series of lectures. Time off to attend a

course must be submitted in writing and approved BEFORE applying for funding. 4. The department Head is responsible for the compilation and reporting of educational activities.

Please note that staff can request (from the union) access to the unused funds set aside for union liberation to pay their salary for the day at the MGH.

OCCUPATIONAL THERAPY PROFESSIONAL DEVELOPMENT

2005 - 2006

GRAVEL, S. ANNUAL MEETING DYSPHAGIA SOCIETY

HARTROPP, B. NON VIOLENT CRISIS INTERVENTION

COGNITIVE BEHAVIOR THERAPY

ANDRIUK, M.L. PECPA 111-EVALUATION COGNITIVE A L'AIDE DU PECPA LEVEL 2R

COMPETENCE & RESPONSIBILITIES PROFESSIONNELLES

INTRODUCTION TO EVIDENCE BASED O.T.

ROBERTSON, B. 1 l'H ANNUAL INTER-HOSPITAL STROKE TEAM CONFERENCE

EVIDENCE BASED KNOWLEDGE

ALS-MONTREAL NEUROLOGICAL INSTITUTE

ALFANO, M. JOINT MOBILIZATION FOR WRIST AND STIFF HAND

SCOTTSDALE ARIZON.

MUHC

MUHC

MONTREAL

MCGILL

MONTREAL

MCGILL

MNI

MONTREAL

DAY (S)

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2005 - 2006

PECPA 2R LEVEL 111 COGNITION

NEUROPSYCHOGERIATRICS COURSE

WEB SEARCHING WORKSHOP

GELLER, S. CONSTRUCTING A NEW SELF A COGNITIVE APPROACH TO PERSONALITY DISORDERS

LAMB, J.

C.B.T. TRAINING

OPTIMAL BIO PSYCHOSOCIAL INTERVENTIONS FOR ISSUES OF TREATMENT RESISTANCE AND CRISIS IN MENTAL HEALTH

8 STEP COACHING MODEL

ZAFRAN, H. SYMBOLISM & THERAPEUTIC TECHNIQUE

CHAMPOUX, M.C. SAAQ PROGRAMME REVIEW

TBI AND ERGOTHERAPY

COUTURIER, C. INNOVATION IN STROKE REHAB

SLYWYNSKYJ, A. 1 lTH ANNUAL INTER-HOSPITAL STROKE TEAM CONFERENCE

MONTREAL

MONTREAL

MONTREAL

OTTAWA

MUHC

MONTREAL

MONTREAL

MONTREAL

MONTREAL

MONTREAL

LAVAL

MONTREAL

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2005 - 2006

JULIEN, N. CONGRES EN SANTE MENTALE

NON VIOLENT WORKSHOP

CBT SEMINARS

B.P.D. & COGNITIVE BEHAVIOR THERAPY B.P.D. & SUICIDALITY

LAM, P. SPRING CLINICALY DAY

OUTIL D'EVALUATION STUDENT SUPERVISION

CHOUINARD, L. REGIME DE PROTECTION ET D'EVALUATION PSYCHOSOCIALE

SHAW, M. GETTING BETTER RESULTS

DAY(S)

GATINEAU 2

MUHC 1

MUHC 5

MONTREAL 2

MCGILL 1

UNIVERSITY DE 1 MONTREAL

MONTREAL


2005 - 2006

GELLER, S. TENNUE DE DOSSIERS

LAMB, J. CHARTING REQUIREMENTS

ROLBIN, N. AND STANDARDS

JULIEN, N. ORDRE DES ERGOTHERAPEUTES

PAYEmE, R. DE QUEBEC

RANDOLPH, P.

MALO, V.

PENTNEY, H.

GINGRAS, B.

MEHRZAD, M.

BOULOS, M.

MUHC

MUHC

MARY LYNN ANDIRUK MASOUD MEHRZAD M. BOULOS Y. HUI R. CAMPOS B. ROBERTSON G. PETERS F. DESROSIERS M. KRUG C. COUTURIER J. NEWMAN M. ALFANO P. LAM K.BAIG B. HARTROPP A. SLYWYNSKYJ R. GROSSMAN


2005 - 2006

DAY (S)

CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION CPR RECERTIFICATION

MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC MUHC

OCCUPATIONAL THERAPY U-I CONTRACT - HAND THERAPY

STUDENT: SUPERVISOR: SECTION: DATE:

ROLE OF THE COORDINATOR

1. Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty 5 . Responsible to forward all the evaluation forms to the university upon completion of the

placement.

ROLE OF THE SUPERVISOR

1. Will orient the student to the specific clinical program with emphasis on: - Tour of the physical environment of department - Orientation to the evaluation forms - Orientation to the treatment modalities and patient education materials - Orientation to the team members - Demonstrate the education materials (library, books, journals, etc) - Orientation to the medical chart

2. On the first day, will clarifL with the student: - Student learning techniques i.e. visual observations vs. reading vs. demonstration

Objectives and expectations - Contracts - Competency based fieldwork evaluation

3. Will schedule a minimum of one weekly formal supervision session.

4. Whenever possible, will demonstrate, explain and provide rationalization to the intervention prior to expecting the student to perform the same task.

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f ) Analyse the results of the assessments with maximum assistance Moderate-minimal assistance

g) Develop treatment objectives in accordance with assessment results with

Maximal assistance Moderate-minimal assistance

h) Implement treatment plan to reach objectives (choose frequency and activities)

Maximal assistance 1 1 Moderate-minimal assistance

i) Assess need for splint with maximum assistance Moderate-minimal assistance

j) Fabricate slmple splints (wrist, thumb, digit, hand based) with


k) Instruct patient on splint care and wearing schedule with supervision Independently

1) Write up of evaluation notes, intervention plans, progress notes appropriate with

Maximal assistance I 1 Moderate-minimal assistance

m) Communicates and asks for relevant information fiom team members and family with

Maximal assistance Moderate-minimal assisatance

The student is expected to be responsible for a minimum of three active cases per day by the end of the placement. The student will have performed the peviously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will present a 15 to 20-minute case presentation (5 minutes for questions).

4. Students may be required to perform other tasks depending on the area of the placement. This is to be discussed with the supervisor at the beginning of the placement.

5. Other specific tasks to be discussed.

Student Signature Supervisor Signature

Date

OCCUPATIONAL THERAPY U-I1 CONTRACT - HAND THERAPY



1. Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital 3. Onentation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty 5 . Responsible to forward all the evaluation forms to the university upon completion of the

placement.



2. On the first day, will clarify with the student: - Student learning techniques i.e. visual observations vs. reading vs. demonstration - Objectives and expectations - Contracts

- Competency based fieldwork evaluation



Contract

Cannot do Maximum assistance-tnoderate Minimal assistance and supervision Independent Proficient

R o l e of U-11 Student - Hand therapy

1 Midterm 1 Final

1. The student is expected to demonstrate a professional attitude through : punctuality respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

The student is expected to be responsible for following 3 patients per day by mid-term (e.g. mallet, simple fractures, de quervain's, and carpal tunnel syndrome) having performed the following tasks :

a) Review chart and write the database independently. Independently

b) Review the literature and understand the medical conditions independently. Independently

c) Perform the initial interview independently. Independently

d) Plan and determine the evaluations - assessments to be performed with minimal assistance and supervision. 1 1 1

Independently I e) Administer the following assessments :

edema (volumetric, circumferential) AROMPROM Handgriplpinch Sensation (2-point discrimination, Semrnes Weinstein) Hypersensitivity ADL, functional hand evaluation such as Jebsen Vocational

- with moderate assistance supervision Independently

i) Analyse the results of the assessments with moderate-minimal assistance Supervision


Moderate-minimal assistance Supervision


Moderate-minimal assistance 1 1 Supervision

I I

i) Assess need for splint with moderate-minimal assistance Supervision

j) Fabricate simple splints (e.g. wrist, thumb, digit, hand based) with

Moderate-minimal assistance

I Supervision

k) Instruct patient on splint care and wearing schedule independently Independently

I 1) Write up of evaluation notes, intervention plans, progress notes as appropriate with I 1 Moderate-minimal assistance Supervision

m) Communicates and asks for relevant information fiom team members and family with

Moderate-minimal assistance Supemision

The student is expected to be responsible for a minimum of 5 cases per day by the end of the placement. The student will have performed the peviously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will make a 15 minute presentation of a project (5 minutes for questions).

1 5. Other specific tasks to be discussed. I l l

4. Students may be required to perform other tasks. This is to be discussed with the supervisor at the beginning of the placement.

Student Signature

-

Supervisor Signature

Date

!!I!!! OCCUPATIONAL THERAPY v U-I11 CONTRACT - HAND THERAPY



1. Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of dificulty 5 . Responsible to forward all the evaluation forms to the university upon completion of the

placement.



2. On the first day, will clarify with the student: - Student learning techniques i.e. visual observations vs. reading vs. demonstration - Objectives and expectations - Contracts - Competency based fieldwork evaluation



PEOT's Contract Cannot do = Cannot do Assistance = Maxirnum assistance-nloderate Supervision = Minimal assistance arld supervisior~ Independent = Independent Proficient = Proficient

R o l e of U3 Student - Hand therapy

1. The student is expected to demonstrate a professional attitude through : Punctuality Respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

I Midterm

2. The student is expected to be responsible for following 5 patients per day by midterm (e.g. mallet, simple fractures, DeQuervains and Carpal Tunnel Syndrome) having performed the following tasks :

Final



c) Perform the intitial interview independently. Independently

d) Plan and determine the evaluations - assessments to be performed with minimal assistance and supervision.

Independently

e) Administer the following assessments : edema (volumetric, circumferential) AROMPROM Handgriplpinch Sensation (2-point discrimination, Semmes Weinstein) Hypersensitivity ADL, functional hand evaluation such as Jebsen Vocational

- Independently Independently

f) Analyse the results of the assessments with minimal assistance to supervision. Independently

g) Develop treatment objectives in accordance with assessment results with minimal assistance to supervision.

Independently

h) Implement treatment plan to reach objectives (choose frequency and activities) with 1 minimal assistance to supervision.

Independently

i) Assess need for splint with minimal assistance to supervision. Independently

Fabricate simple splints (e.g. wrist, thumb, digit, hand based) with minimal assistance ') to supervision

Independently

k) Instruct patient on splint care and wearing schedule independently I I Independently

1) Write up of evaluation notes, intervention plans, progress notes as appropriate - minimal assistance to supervision.

Independently

m) Communicates and asks for relevant information from team members and family - minimal assistance to supervision.

Independently

The student is expected to be responsible for a minimum of 8 cases per day by the end of the placement. The student will have performed the previously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will make a 15 minute presentation of a project. (5 minutes for questions).

4. Students may be required to perform other tasks. This is to be discussed with the supervisor at the beginning of the placement.

1 5. Other specific tasks to be discussed. I I


Date

OCCUPATIONAL THERAPY U-I CONTRACT - PHYSICAL MEDICINE




placement.






SCORING CONTRACT Cannot do Maximum assistance-moderate Minimal assistance and supervision Independent Proficient

7

ROLE OF STUDENT: M F I I

1. The student is expected to demonstrate a professional attitude through: I I - punctuality - respect of the dress code - respect of confidentiality - approach patients in a respectful manner - advising the supervisor if late or absent - taking full therapeutic responsibility for patient caseload assigned - not removing patient charts from the hospital - seeking feedback appropriately from supervisor - not initiating patient interventions prior to discussion and getting authorization from the supervisor

I I

2. The student is expected to be responsible for 2 active cases by midterm having performed the following tasks: a) Review chart and write the database independently

. independently I b) Review the literature and understand the medical conditions supervision

. Independently

c) Perform the initial interview with maximum assistance I . Mod.-min. Assistance

d) Plan and determine the evaluations - assessments to be performed with . Maximum assistance . Mod.-min. assistance

e) Administer - bedside dysphagia - ADL and functional mobility - physical status - cognitive (including emotional status) - for neurological TBI placements adm. perceptual assessment

(Pepca, MVPT, etc.. .) - social situation and environment assessments with max. assistance

. Mod-min. assist

f) Analyse and determine an intervention plan for dysphagia with maximal assistance . Mod-min. assist.

g) Analyse the limitations of the physical status (risk of contracture and skin breakdown) and the possible complications and determine a plan of

I intervention with . maximum assistance . Mod.-min. assistance

h) Analyse the impact on ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan for DIC planning with .maximum assistance

. mod.-min. assistance

I) Analyse the ADL, IADL, mobility, social and environmental status and determine an intervention plan for DIC planning with maximum assistance

(eg: resources, equipment needed, rehab potential) mod.assistance . mod-min assistance

j) Implement the intervention plans for - dysphagia - physical status - ADL, WDL autonomy - DIC planning - cognitivelperception - with max. assistance

Mod-min. assistance to supervision

k) Write up of evaluation notes, intervention plans, progress notes as appropriate with .maximum assistance

Mod.- min. assistance

1) Communicates and asks for relevant information from team members and family with . maximum assistance

. Mod-min. assistance

The student is expected to be responsible for a minimum of 3 active cases by the end of the placement. The student will have performed the previously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will make a fifteen minute case presentation (5 minutes for questions).

4. Students may be required to perform other tasks such as fabrication of simple splints depending on the area of the placement. This is to be discussed with the supervisor at the beginning of the placement.

5 . Others specific tasks to be discussed.

Student Signature: Supervisor Signature: Date:

REF\A\STUDENTS\CONTRACT-U 1

OCCUPATIONAL THERAPY U-I1 CONTRACT - PHYSICAL MEDICINE




placement.



2. On the first day, will clarifj with the student: - Student learning techniques i.e. visual observations vs. reading vs. demonstration - Objectives and expectations - Contracts - Competency based fieldwork evaluation




ROLE OF STUDENT: M F 1 I I I

1. The student is expected to demonstrate a professional attitude through: I - punctuality I - respect of the dress code

- respect of confidentiality

I - approach patients in a respectful manner - advising the supervisor if late or absent - taking full therapeutic responsibility for patient caseload assigned

I - not removing patient charts fiom the hospital I - seeking feedback appropriately fiorn supervisor

- not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for 3-4 active cases by midterm having

I performed the following tasks: 2) R-eview chze a ~ d w&e the d&&me ind-qecdestf-j'

. independently

1 I I b) Review the literature and understand the medical conditions independently

. Independently

I c) Perform the initial interview with minimal assistance and supervision . Independently

-

I d) Plan and determine the evaluations - assessments to be performed with . Maximum-moderate assistance . Minimal assistance and supervision

t e) Administer - bedside dysphagia - ADL and functional mobility

I - physical status - cognitive (including emotional status) - for neurological TBI placements adm. perceptual assessment

1 , (Pepca, MVPT, etc ...) - social situation and environment assessments with max-mod assist

I . Min assist to sup


f) Analyse and determine an intervention plan for dysphagia with max-mod assist . Min. assist to sup

g) Analyse the limitations of the physical status (risk of contracture and skin breakdown) and the possible complications and determine a plan of

I intervention with . maximum-mod assistance . min. assistance to supervision

I h) Analyse the impact on ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan for

D/C planning with .maximum-moderate assistance . min. assistance to supervision

I) Analyse the ADL, IADL, mobility, social and environmental status and

I determine an intervention plan for D/C planning with maximum assistance (eg: resources, equipment needed, rehab potential) maxirnal-mod.assistance

. min. assistance to sup

j) Implement the intervention plans for - dysphagia

I - physical status - ADL, IADL autonomy

1 - D/C planning - cognitive/perception - with ma.-mod. assistance

I min. assistance to supervision

k) Write up of evaluation notes, intervention plans, progress notes as appropriate with .maximurn-moderate assistance

. min. assistance to supervision

1) Communicates and asks for relevant information from team members and family with . maximum-moderate assistance

. min. assistance to supewision

The student is expected to be responsible for a minimum of 5-6 active cases by the end of the placement. The student will have performed the previously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will make a fifteen minute case presentation (5 minutes for questions).


t 5 . Others specific tasks to be discussed.




1. ' Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty 5 . Responsible to forward all the evaluation forms to the university upon completion of the

placement.






PEOT's Contract Cannot do = Cannot do Assistance = Maximum assistance-n~oderate Supervision = Minimal assistance and supervision Independent = Independent Proficient = Proficient

R o l e of ~3 Student

1. The student is expected to demonstrate a professional attitude through : Punctuality Respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

Midterm

2. The student is expected to be responsible for 4-6 active cases by midterm having performed the following tasks : 1 1

Final

a) Review chart and write the database independently. Independently (20 minutes to do database)



d) Plan and determine the evaluations - assessment to be performed with mininum assistance and supervision.

Independently

e) Administer : ADL and functional mobility physical status cognitive for neurological TBI placements administer perceptual assessment (Pepca, MVPT, etc.) social situation and environment assessments with (minimum assistance and supervision applies to all of above for midterm) bedside dysphagia

Independently (applies to all except dysphagia)

f ) Analyse and determine an intervention plan for dysphagia with minimal assistance to supervision.

Independently

g) Analyse the limitations of the physical status (risk of contracture and skin breakdown) and the possible complications and determine a plan of intervention with minimal assistance and supervision.

Independently

h) Analyse the impact of ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan - minimal assistance.

Independently

i) Analyse the ADL, IADL, mobility, social and environmental status and determine an intervention plan for DIC planning with maximum assistance.

Independently

j) Implement the intervention plans for dysphagia physical status ADL, IADL autonomy DIC planning cognitivelperception (minimum assistance and supervision applies to all for midterm)

Independently

k) Write up of evaluation notes, intervention plans, progress notes as appropriate - minimal assistance.

Independently

1) Communicates and asks for relevant information from team members and family - independently.

Independently

The student is expected to be responsible for a minimum of 6-8 active cases by the end of the placement. The student will have per$ormed the previously mentioned tasks but with the supervision level written in bold letters.

3. During the last week of placement the student will present a 15 to 20-minute project (5 minutes for questions).



Student Signature Supervisor Signature .-

Date

McGill University Health Centre

OCCUPATIONAL THERAPY SERVICE

MGH

TO THE REVIEWER

Several hospitals recently merged to form the McGill University Health Centre. Madeleine Shaw was appointed Director of Occupational Therapy Services on the adult sites of the MUHC. Each hospital (site) has its own clinical co-ordinator.

Julia Newman, Montreal General Hospital (MGH) - physical medicine Josee Lemoignan, Royal Victoria Hospital and Montreal Neurological Hospital (RVH and MNH) - physical medicine

The above mentioned people collaborated to complete the FESAP manuals. The process of responding to the FESAP questions, helped us clarify the similarities and differences and infact FESAP became a tool which has facilitated the consolidation of the student programme on the different sites.

The FESAP manuals from the MUHC are thus organized, using colored paper:

1. White = MUHC and applicable to all sites 2. Pink = SpeczJic to the MGH 3. Blue = SpeczJic to the R VH and MNH 4. Yellow = Section separators

MUHC The Montreal General Hospital

Fieldwork Education Site Approval Program

Application

April 2000

M.U.H.C. FIELDWORK EDUCATION SITE APPROVAL PROGRAMME

TABLE OF CONTENTS

APPLICATION FORM - CAOT AND ACOTUP

CRITERIA

1. The sitelprogramme has a student education program to guide the students' learning experience.

A. 1.1 Orientation to the MUHC (McGill University Health Centre) and its sites

A. 1.2 Orientation Programme to Occupational Therapy Department

A. 1.3 Orientation Check List

A. 1.4 Student Package Form

A.2.0 Student Contracts A.2.1 U-I Physical Medicine A.2.2 U-I1 Physical Medicine A.2.3 U-111 Physical Medicine A.2.4 U-I Hand Therapy (O.P.) A.2.5 U-I1 Hand Therapy A.2.6 U-I11 Hand Therapy

A.3.0 Learning Opportunities

A.4.0 Safety: Health: Accidents

A.4.1 Overview

A.4.2 Policies and Procedures (from Department Policies and Procedures) Policy and Procedure 10.1 - Accidents Policy and Procedure 10.2 - Incidents Policy and Procedure 10.3 - Emergency Procedures Infection Control Manual b Section 3-B-30 b Section 3-C-20 b Section 3-C- 10 b Section 7-D-30 b Section 7-D-40 b Section 7-D-50

Policy and Procedure 10.4 - Patient Safety Policy and Procedure 10.8 - Occupational Health & Safety Policy and Procedure 10.10 - Theft

A.5.0 Off Site Supervision not applicable

A.6.0 Supervision - Contingency Plan

B. The sitefprogramme identifies whom it serves and how it serves this population.

B.7.1 Mission

B.7.2 Philosophy

B.7.3 Goals

B.7.4 Patient Hand Book

B.8.1 Scope and Limitations

B -8.2 Programme Descriptions

C. The sitelprogramme has current guidelines that guide client servicefprogramme delivery.

C.9.0 Professional standards and guidelines - Policies and Procedures

Policy and Procedure 6.1 - Access to Occupational Therapy Policy and Procedure 6.6 - Confidentiality Policy and Procedure 7.7 - Referrallcharting Policy and Procedure 6.14 - Patient Discharge/Discontinuation Policy and Procedure 6.15 - Priority of Treatment In-Patients Policy and Procedure 6.16 - Priority of Treatment Out-Patients

C.9.1 OEQ Code of ethics

D. SitesIProgrammes Employing Occupational Therapist(s) are Organised to Address Occupational Therapy Professional Issues

D. 10.0 Organizational Charts

D. 10.1 Corporate organization Structure

D. 10.2 McGill University Health Centre

D. 10.3 Department of Occupational Therapy

D. 1 1.0 Job Description

D. 1 1.1 Manager of Occupational Therapy

D. 1 1.2 Generic Occupational Therapist

D. 1 1.3 Student Occupational Therapy Co-ordinator

D. 12.0 Professional Development

D. 12.1 Policy and Procedure 8.3 Professional Development Policy and Procedure 1.1 1 Clinical Activity Report Policy and Procedure 9.1 Professional Inspection

D. 12.2 Continuing Education Activities

CAOT & ACOTUP

Occrlpational Therapy Fieldwork Education Site Approval Programme Application Form

McGi-11 University Health Centre 1. Nameofagency/program: Montreal General Hospital Site

Name of agencylprogram contact person: ~adeleine Shaw Address: Dept. of Occup. Therapy C2.50, 1650 Cedar Ave., Montreal H3G 1A4,PQ Telephone: (514) 937-6011 10c. 2919 FAX: (514) 934-8371 E-mail: [email protected]

2. Type of Setting: Physical Health - University Teaching Hospital . -

2. Name of contact person at the agency regarding issues about occupational therapy &/or fieldwork education (if this is different fiom the person named above). Name: JULIA NEWMAN Position: CLINICAL COORDINATOR Telephone: As above FAX: As above E-mail:

4. Are there occupational therapists employed by the agency/prograrn: Yes XX No

If yes, indicate the number and status (e.g.: employee, self-employed/contract) of: a) full time occupational therapists: 6 b) part time occupational therapists (include dayshours worked per weeWmonth etc.):

1 x -6 FTE =(21 hrs x3days/week) 1 x .8 FTE =(28 hrs./4days/week) c) consultation i.e.: contract with private practitioner No

5. Please confirm that all occupational therapists employed by this organization meet standards established by the appropriate regulatory body

MADELEINE SHAW /' ,,,.,..,??A -J - $?id.

(>." 1 fl Name of the DirectorIManager Signature of the Directorhlanager

6. Name of person who completed the application: Name: MADELEINE SHAW AND JULIA MEWMAN

Position: Dir. of Occuaational The apv & CJ -a1 Cnerdinatnr . . r

Telephone: (514) 937-6011 local 2919 FAX: (514) 934-8371 E-mail: [email protected] Name of employer (If other than the agency named above):

7. Name of University Fieldwork Coordinator who has collaborated with site personnel in the completion of this application (where there is no occupational therapist employed on this site.)

Name: N/A University: Telephone: FAX: E-mail:

Orientation to the McGill University

Health Centre

A.1

McGill University Health Centre

Department of Occupational

Therapy

Adult Services (MGH, RVH, MNH, MCI)

Student Manual

JANUARY 2000

The McGill University Health Centre

The McGill University Health Centre (MUHC) represents the first and largest voluntary

merger of university teaching hospitals in Canada. The five partners include the McGill

University Faculty of Medicine, three institutions serving adult patients- The ~ o n t r e a l General

Hospital, The Royal Victoria Hospital (including The Montreal Chest Institute) and the Montreal

Neurological Hospital. The Montreal Children's Hospital, an institution serving children is the

5"' partner of this merger and together with their respective research institutions, constitute the

MUHC.

A leading edge academic health centre, the MUHC benefits form its association with one

of Canada's top medical schools, integrating patient care, teaching and research as its tripartite

mission. The MUHC has 1 1,000 employees, combined operating budgets of $400 million and a

$70 million research budget. There are 910 active staff doctors, 1,277 total beds, 23,000 day

surgeries annually, and 870,000 ambulatory visits annually, including 140,000 ER visits.

A bilingual and multicultural institution, the MUHC serves an increasingly diverse

community. One-third of the patients seen each year come from regions in Quebec outside the

island of Montreal, from elsewhere in Canada or from the United States for the ultra-specialized

care that is provided. The MUHC accounts for one third of all pediatric and one fifth of all adult

admissions to Montreal hospitals.

Our vision consists of a single facility offering care of the highest quality to patients of all

ages, and offering continuity of care across settings in the health care network. The patient and

family are central to the way care is organized, participating actively in the healing process.

Patient care will be co-ordinated by multi-disciplinary teams of care providers working to treat

patients with increasingly complex problems. The vision also recognizes that the

environment/institution/building is a tool in the healing process which can complement and

enhance the skills, expertise, caring dimension and high-tech support of caregivers.

McGill University Faculty of Medicine

Established 1829

The Faculty of Medicine was established in 1829 as the first Faculty of McGill

University - and the first medical school in a Canadian University. It was a direct continuation of

the Montreal Medical Institution, founded in connection with the Montreal General Hospital in

1822. Considered to be one of the top medical faculties in the world, it trains approximately 550

students and 800 residents and fellows annually in its medical programs. The Schools of

Nursing, Physical & .Occupational Therapy and Human Communication Disorders as well as the

Faculty of Dentistry also train approximately 600 more students. Graduates are in demand - and

have made outstanding contributions to their respective fields- throughout the world. One of the

most notable graduates was Sir William Osler, internationally known for having made clinical

practice both a field of research and a pedagogical tool. McGill's medical faculty receives

significantly more research funding per capita than any other medical faculty in Canada, and

accounts for 55% of the University's total research funding. The research spans a wide spectrum

of activities, from molecular biology to applied clinical research and environmental studies. All

four MUHC partner institutions are principal teaching hospitals of the Faculty of Medicine.

The Montreal Children's Hospital

Founded 1903

The MCH offers a full range of health care services to children and adolescents, and is the

teaching and research site for McGill's pediatric programs. It has particular strengths in

specialized surgery, trauma, intensive care, injury prevention, developmental problems,

ambulatory care and home-based programs, and has been designated as a Pediatric Trauma

Centre in Quebec. The Children's has 214 beds and, in a typical year, admits approximately

9,000 patients. The ambulatory services receive more than 200,000 visits annually (80,000

through the Emergency Room and about 14.0,000 in the clinics, day surgery and intensive

ambulatory care).

The Montreal General Hospital

Founded 1821

The MGH introduced bedside teaching and founded the first medical school in Canada-

later to become the Faculty of Medicine at McGill University. Today, this Level 1 Trauma

Centre has a wide range of specialities. The hospital has a bed permit of 533. Annually, there

are approximately 15,000 admissions and 3 17,000 visits to Emergency and out-patient

departments, including day surgery and day treatment.

The Montreal Neurological Hospital

Founded 1934

The MNH began with the establishment of the Montreal Neurological Institute (MNI) in

1934 by Dr. Wilder Penfield. The Montreal Neurological Hospital was incorporated as a

separate institution in 1963. The MNH specializes in treating'patients with diseases of the

nervous system -- Epilepsy, Parkinson's disease and ALS among many other -- as well as injuries

to the spine and to the brain. The hospital has 96 beds and more than 25,000 ambulatory visits

annually.

The Royal Victoria Hospital

Founded 1894

The RVH offers a wide range of specialized and ultra-specialized services, and is a leader

in basic and clinical research. Together with the Montreal Chest Hospital, which merged with

the RVH in 1994 to become an Institute of the RVH, the institution has a total of 680 beds and

receives a total of 21,322 admissions annually. In addition, the RVH receives 444,162

ambulatory visits per year including outpatients, emergency, day surgery and day treatment.

Centre universitaire d e sant9 McG311 M c G l l l U n i v e r s i t y H e a l t h C e n t r e

ORIENTATION INFORMATION Dept of Occupational merapy

Welcome to the Department

At the Montreal General Hospital

The types of patients primarily seen by OT can be roughly divided into the following categories: Plastic surgery in and out patients Orthopaedic in and out patients (including Trauma)

Medicine Rheumatology Neurology (M.S., Stroke) Traumatic Brain Injury Geriatrics

At the Royal Victoria Hospital

. Plastic surgery in and out patients General surgery Ear, nose and throat specialities Medicine Geriatrics in and out patients Palliative care unit Transitional care unit

At the Montreal Neurological Hospital

Neurology in and out patients Neurosurgery in and out patients

At the Montreal Chest Hospital

Acute and chronic pulmonary conditions in and out patients HIV and AIDS in and out patients Long term unit

Topics to be discussed during initital orientation

Hours of Work - Normally 8 am to 4 pm. This will depend on your supervising therapist.

Coffee break - you are entitled to 30 midday if time permits. This can be taken in the morning or in the afternoon.

Lunch is normally fkom 12 noon to 1 pm. At the MGH, it may be taken in the cafeteria as staff room is restricted to staff due to its small size. At the RVWMNWMCI lunch may be taken in the cafeteria or in the department.

Absences - If you are unable to attend due to illness or other valid reason, you must notify your supervisor or the Clinical Coordinator by 8 am. Phone numbers : MGH - 937-601 1, local 2900 or 2892, RVH - 843-1573, MCI - 843-2309. Also inform your supervisor about any outstanding concerns regarding your patients.

Dress Code - Students are expected to dress in a professional manner at all times - ie. No jeans, and no excessive jewelry. Closed shoes should be worn to protect from potential injury.

Personal belongings - At RVH -a cupboard is available. At MGH, you will. be assigned a locker located in the sub-basement. Personal belongings are not to be left unlocked in the department. Desk space is limited; however, your therapist will provide an area where charting may be done. All students will have access to their supervisors locked cupboard.

Emergency Procedures - For full details of Emergency Procedures, accidents and incidents refer to the appropriate section of the student manual. These will all be discussed during the orientation.

In and Out Patients - Patient's time should be scheduled so as not to interfere with other departments, and to allow appropriate time for the patient to complete his Rx (ie. Allow time for construction of slings, splints, etc.)

Equipment - Students loaning equipment to patients should notify their supervising therapist. It is your responsibility to see it continues to be used appropriately and is not damaged or lost.

Library - The medical library is open to all students. AJOT's are kept in the O.T. Dept and are not be removed. Binders of articles on various conditions are also available for reference in the different departements. Please do not remove individual articles, as this often results in misplacement or loss.

Keys - The O.T. Dept is locked at the end of each work day. Students are not allocated a key.

Maintenance - All students are expected to return items to their appropriate place and see that cupboards and drawers are kept orderly. It is the student's responsibility to find out what belongs in what cupboard and return misplaced items to their proper place.

Charting -Each therapist is responsible for teaching you their method of charting which may vary from the SOAP method to the method based on the COPM.

OT dossiers are kept on individual patients in the O.T. Dept. These are not to be left in unsecured areas of the department. These include copy of initial assessment, progress notes, Rx program and various assessment forms. All students are expected to keep these up to date for their individual patients while patients are on treatment.

Complete charting information will be found in the student manual.

Forms to be Completed Before the End of the Placement

Objectives of the placement are as per student contract and CBFE. They will be reviewed in the first week of placement with your supervising therapist. These, as well as the student evaluation of placement, must be completed and signed prior to the end of the placement.

First and Second Year Students - One case presentation to be done on a patient that has been followed by you for part of the rotation (15 minutes including questions).

Third Year Students - Special project andlor case presentation (15 minutes including questions).

Revised 15/06/1999

O C C U P A T I O N A L T H E R A P Y D E P A R T M E N T

Student Orientation Checklist

Date : Student :

Schedule for a.m. Handout and review content of student package, hours etc.

0 r i e n t a t i o n t o H o s p i t a l

MONTREAL GENERAL HOSPITAL

C] Visit to lockers (women: Rm 01 0 # I 77, # I 85) (men: See Physio coordinator)

1 " floor : Pine Ave, ER, Admitting, Medical Records 2"d floor : Med. Clinic, Ortho, Speech Path., OT, PT 3rd floor : Pathology, Dentistry, terrace 4lh floor : cafeteria

ROYAL VICTORIA HOSPITAL

OT PTat RVH Library

MONTREAL NEUROLOGICAL HOSPITAL

C] ICU Day Center 4 NorthlEastlSouth MS Clinic

0 r i e n t a t i o n t o W a r d

Nursing station and role Unit coordinator area and role Charts (current and old) Chart divisions OT referral sheets Utility room Linen room

Review MUHC historylpolicies re. OT services . etc.

5th floor : Radiology - Modified Barium Swallow Rm 6' floor : Cedar Ave, library, coffee shop, gift shop, Osler Amphitheatre, Livingston Hall, bank machine ICU Ward PT Department

C] Cafeteria Organization of different pavillions Bank Machine

OTIPT at MNH Library Out Patient area Coffee shop

Medication room - fridge "thickit"lfood Patient rooms - 4-bedded (ABCD)

- semi-private and private - alarm in bathroom - precaution cards - isolation

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STUDENT PACKAGE

Q.A. CHECK LIST

I NAME:

/ ADDRESS: I TELEPHONE NUMBER (during placement):

I I

I LEVEL: DATES: 1 I TOTAL NUMBER OF WEEKS: TOTAL NUMBER OF HOURS:

I SUPERVISOR: AREA:

Yes No

ORIENTATION: BY: TIME:

I.D. BADGE:

KEYS (AMI)

Returned: Signature of Supervisor:

REPORTS ATTACHED:

1. FINAL CBFE

2. UNIVERSITY EVALUATION OF DEPARTMENT AND DEPARTMENT EVALUATION OF PLACEMENT

3. I.D. BADGE

4. STUDENT ONENATION CHECKLIST

5. ORTENTATION MANUAL EVALUATION FORM

6. CONTRACT

OCCTJPATIONAL THERAPY

v U-I CONTRACT - PHYSICAL MEDICINE



1. Orientation to safety procedure 2. Orientation to the OT department, the 01' staff and the hospital 1 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty .

5 . Responsible to forward all the evaluation forms to the university upon completion of the placement.

ROLE OF THE SUPERVISOR .-

Will orient the student to the specific clinical program with emphasis on: - tour of the physical environment of department - orientation to the evaluation forms - orientation to the treatment modalities and patient education materials - orientation to the team members - demonstrate the education materials (library, books, journals, etc) - orientation to the medical chart

2. On the first day, will clarify with the student: - student learning techniques i.e. visual abservations vs. reaciing vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation


4. Whenever possible, will demonstrate, explain and provide rationalisation to the intervention prior to expecting the student to perform the same task.


ROLE OF STUDENT: Pv'l

1. The student is expected to demonstrate a professional attitude through: - punctuaiity - respect of the dress code - respect of confidentiality - approach patients in a respectful manner - advising the supervisor if !ate or absent - taking full therapeutic responsibility for patient caseload assigned - not removing patient charts fiom the hospital - seeking feedback appropriately from supervisor - not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for 2 active cases by midterm having performed the following tasks: a) Review chart and write the database independently

.-- . I . independently . . t. -:;

b) Review the literature and understand the medical conditions supervision . Independently

c) Perform the initial interview with maximum assistance ' . Mod.-min. Assistance

d) Plan and determine the evaluations - assessments to be performed with . Maximum assistance . Mod.-min. assistance

e) Administer - bedside dysphagia - ADL and functional mobility - physical status - cognitive (including emotional status) - for neurological TI31 placements adm. perceptual assessment

(Pepca, MVPT, etc ...j - social situation and environment assessments with assistance

. Supervision

The student is expected to be responsible for a minimum of 3 active cases by the end of the placement. The student will have perfo-med the previously mentioned tasks but with the supervision level written in bold letters.

r f ) Analyse and determine an intervention plan for dysphagia with maximai assistance . Mod-min. assist.

1 I g) h a l y s e the limitations of the physical status (risk of contrscture md skin \ breakdown) and the possible complications and determine a plan of

intervention with . maximum assistance . Mod.-min. assistance

h) Analyse the impact on ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan for D/C planning with .maximum assistance

. mod.-min. assistance

I) Analyse the ADL, IADL, mobility, social and environnlental status and determine an intervention plan for DIC planning with maximum assistance

(eg: rcsources, equipment needed, rehab potential) mod.assistmze . mod-min assistance

j) Implement the intervention plans for - dysphagia - physical status - ADL, IADL autonomy - D/C planning - cognitivelperception - with max. assistance

Mod-rnin. assistance to supervision I

k) Write up of evaluation notes, intervention plans. progress notes as appropriate with .maximum assistance

Mod.- min. assistance

1) Communicates and asks for relevant information from team members and family with . maximum assistance

. Mod-min. assistance

1 3. During the last week of placement the student will make a fifteen minute case 1 1 I

I

presentation (5 minutes for questions).

4. Students may be required to perform other tasks such as fabrication of simple splints

/ 5 . Others specific tasks to be discussed.

depending on the area of the placement. This is to be discussed with the supervisor at the beginning of the placement.


I




1. Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital J . Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty :



1. Will orient the student to the specific clinical program with emphasis on: - tour of the physical environment of department - orientation to the evaluation forms - orientation to the treatment modalities and patient education materials - orientation to the team members - demonstrate the education materials (library, books, journals, etc) - orientation to the medical chart

2. On the first day, will clarify with the student: - student learning techques i.e. visual obsen~ations vs. reading vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation




ROLE OF STUDENT:

1. The student is expected to demonstrate a professional attitude through: - punctuality - respect of the dress code - respect of codidentiality - approach patients in a respectful manner - advising the supervisor if late or absent - taking full therapeutic responsibility for 22tient caseload assigned - not removing patient charts fiom the hospital - seeking feedback appropriately fiom supervisor - not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for 3-4 active cases by midterm having performed the following tasks: a) Review chart and write the database independently

. independently

I b) Review the literature and understand the medical conditions independently . Independently --

c) Perform the initial interview with minimal assistance and supervision . Independently

d) Plan and determine the evaluations - assessments to be performed with . Maximum-moderate assistance . Minimal assistance and supervision

e) Administer - bedside dysphagia - ADL and functional mobility - physical status - cognitive (including emotional status) - for neurological TBI placements adm. perceptual assessment

(Pepca, MVPT, etc ...) - social situation and environment assessme;lts tvith mas-mod assist

. Plin assist to sup I

f) Analyse and determine an intervention plan for dysphagia with min.assist to sup . Independent

g) Analyse the limitations of the physical status (risk of contr~cture and skin - ( breakdown) and the possible complications and determine a plan of

Y

- - -

j) Implement the intervention plans for - dysphagia - physical status - ADL, IADL autonomy - D/C planning - cognitivefperception - with mu.-mod. assistance

min. assistance to supenrision

. .. . . . .. k) Write up of evaluation notes, intervention plans, progress notes as appropriate with .maximum-moderate assistance


1) Communicates and asks for relevant information from team members and family with . maximum-moderate assistance


1 3. During the last week of placement the student will make a fifteen minute case 1 1 1

intervention with . maximum-mod assistance . min. assistance to supervision

h) Analyse the impact on ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan for D/C planrung with .maximum-moderate assistance


I) Analyse the ADL, IADL, mobility, social and environmental status and determine an intervention plan for D/C planning with maximum assistance

(eg: resources, equipment needed, rehab potential) maximal-mod.assistance . min. assistance to sup

The student is expected to be responsible for a minimum of 5-6 active cases by the end of the placement. The student will have performed the previously mentioned tasks but with the supervision level written in bold letters.

I (5 minutes for questions). I ! I I

-

i

I 1

4. Students may be required to perform other tasks such as fabrication of simple splints depending on the area of the placement. This is to be discussed with the supervisor

I

5 . Others specific tasks to be discussed.

at the beginning of the placement.


I

I I I I

OCCUPATIONAL THERAPY U-I11 CONTPACT - PHYSICAL bZEDICINE

STUDENT: i SUPERVISOR:

SECTION: DATE:


1. Orientation to safety procedure 2. Orlentation to the OT department, the OT staff and the hospital 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty :




2. On the first day, will clarify with the student: - student learning techques i.e. visual observations -is. reading vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation

3. Will schedule a minimum of one weekly formal supenision session.


Cannot do = Cannot do Assistance = ~ t f r ~ ~ i ~ n t l r n assistance-modzmre , .

Supervision = Minimal assistance and supervision Independent = Independent

Proficient = Proficient

R o l e of ~3 Student

1. The student is expected to demonstrate a professionai artirude through : punctuality respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expectcd to be responsible for 4-6 active cases by midterm having performed the following tasks :



c) Perform the intitial interview independently. Indenendentlv

d) Plan and determinz the evaluations -assessment to be performed with mininum assistance and supervision.

Independently

e) Administer : ADL and functional mobility physical status cognitive for neurological TB1 placements administer perceptual assessment (Pepca. MVPT, etc.)

o social siruacion and environment assessmenrs with (minimum assista~lce and szipervision applies to all of above for midterm) bedside dysphagia

Independently (applies to all except dysphagia)

Final

f) Analyse and determine an intervention plan for dysphagia with minimal assistance to supervision.

Independently i g) Analyse the limitations of the physical status (risk of contncture and skin breakdown)

and the possible complications and determine a plan of intervention with minimal assistance and supervision.

Independently

I Independently I 1 I

I

1 i) - Analyse the ADL, IADL, mobility, social and environmental status and determine an 1 I 1

h) Analyse the impact of ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine a n intervention plan -minimal

' assistance.

1 intervention plan for DIC planning with maximum assistance. 1 1 1 1 Independently

I

j) Implement the intervention plans for dysphagia -

physical status ADL, IADL autonomy DIC planning cognitivelperception (minimzmt assisrance and strpervisiott applies to allfor ntidtert~z)

Independently


Independently

I) Communicates and asks for relevant information from team members and family - independently.

Independently

The strldeirt is expected lo be respottsible for a ntinitnzmt of 6-5 active cases by the end of the plncetnent. Tlte stzldertt tvill hove perfort7ted the previozlsly tneiltioned tasks bz~r wirh the szrpe7visio~r level written in bold letters.

3. During the !ast week of placement the student wil! present o 15 to 20-minute project (5 minutes for questions).


5. Other specific tasks to be discussed. i l l

Student Signature Supervisor Si, anature

Date

OCCUPATIONAL THERAPY U-I CONTRACT - HANI3 THERAPY

STUDENT: SUPERVISOR SECTION" DATE:



placement.



2 . On the first day, will clarify with the student: - student learning techniques i.e. visual observations vs. reading vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation



Contract

Cannot do Maximum assistance-moderate Minimal assistance and supervision Independent Proficient

R o l e of UI Student - Hand therapy

Midterm I Final

1. The student is expected to demonstrate a professional attitude through : punctuality respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for a minimum of two active cases per day by midterm e.g. mallet, simple fractures, de quervain's, and carpal tunnel syndromeslhaving performed the following tasks :


b) Review the literature and understand the medical conditions with supervision. Independently

c) Perform the intitial interview with moderate assistance. Supervision

d) Plan and determine the evaluations - assessment to be performed with maximal assistance.

Min. assistanceSupervision

e) Administer the following assessments : edema (volumetric, circumfenretial) AROMPROM Handgriplpinch Sensation (2-point discrimination, Semmes Weinstein) Hypersensitivity ADL Vocational

- with maximum-moderate assistance Supervision

t) Analyse the resuls of the assessments with maximum assistance Moderate-minimal assistance




Maximal assistance

Moderate-minimal assistance

i) Assess need for splint with maximum assistance Moderate-minimal assistance

j) Fabricate simple splints (wrist, thumb, digit, hand based) with


k) Instruct patient on splint care and wearing schedule with supervision Independently

1) Write up of evaluation notes, intervention plans, progress notes appropriate with


m) Communicates and asks for relevant information from team members and family with

Maximal assistance Moderate-minimal assisatance

The student is expected to be responsible for a minitnum of three active cases per day by the end of the placement. The student will have performed the peviozlsly mentioned tasks bzrt with .the supervision level written in boll letters.


4. Students may be required to perform other tasks depending on the area of the placement. This is to be discussed with the supervisor at the beginning of the placement.



Date

OCCUPATIONAL THERAPY U-I1 CONTRACT - HAND THERAPY



1. Orientation to safety procedure 2. Orientation to the OT department, the OT staff and the hospital 1 3. Orientation to the student manual 4. Acts as a third party between student and supervisor in case of difficulty 5. Responsible to forward all the evaluation forms to the university upon completion of the

placement.



2. On the first day, will clarify with the student: - student learning techniques i.e. visual observations vs. reading vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation



Contract Cannot do ~kfaximum assistance-moderate Minimal assistance and supervision Independent Proficient

R o l e of U-11 Student - Hand therapy

I Midterm ( Final

1. The student is expected to demonstrate a professional attitude through : Punctuality respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts from the hospital seeking feedback appropriately from supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for a minimum of three active cases per day by mid-term e.g. mallet, simple fractures, de quervain's, and carpal tunnel syndromeshaving performed the following tasks :


b) Review the literature and understand the medical conditions with supervision. lndependently

c) Perform the intitial interview with minimal assistance. Inde~endentlv

d) Plan and determine the evaluations - assessment to be performed with minimal assistance and supervision

Independently

e) Administer the following assessments : edema (volumetric, circumfenretial) AROMIPROM Handgriplpinch Sensation (2-point discrimination, Semmes Weinstein) Hypersensitivity ADL Vocational

- with moderate assistance - supervision Independently

Analyse the resuls of the assessments with maximum assistance Moderate-minimal assistance

Develop treatment objectives in accordance with assessment results with

Maximal assistance I 1 1 Moderate-minimal assistance

Implement treatment plan to reach objectives (choose frequency and activities)

Maximal assistance I I I Moderate-minimal assistance I

Assess need for splint with maximum assistance I 1 I Moderate-minimal assistance I 1

Fabricate simple splints (wrist, thumb, digit, hand based) with . -


Instruct patient on splint care and wearing schedule with supervision '

Inde~endentlv

Write up of evaluation notes, intervention plans, progress notes appropriate with


Communicates and asks for relevant information from team members and family with Maximal assistance Moderate-minimal assisatance 1 I I

The student is expected to be responsible for a nzinimum of three active cases per day by the end of the placement. The student will have performed the peviozrsly mentioned tasks but with the supervision level written in bold letters.





Date

?!!I7 OCCUPATIONAL THERAPY v U-I11 CONTRACT - HAND THERAPY

STUDENT: SUPERVISOR SECTION" DATE:



placement.



2. On the first day, will clarify with the student: - student learning techniques i.e. visual observations vs. reading vs. demonstration - objectives and expectations - contracts - Competency based fieldwork evaluation



Contract Cannot do Maximum assistance-moderate Minimal assistance and supervision Independent Proficient

R o l e of ~3 Student I Midterm 1 Final

I I I

1. The student is expected to demonstrate a professional attitude through : Punctuality Respect of the dress code respect of confidentiality approach patients in a respectful manner advising the supervisor if late or absent taking full therapeutic responsibility for patient caseload assigned not removing patient charts fiom the hospital seeking feedback appropriately fiom supervisor not initiating patient interventions prior to discussion and getting authorization from the supervisor

2. The student is expected to be responsible for 4-6 active cases by midterm having performed ~ the following tasks :


b) Review the literature and understand the medical conditions independently. I 1 I


d) Plan and determine the evaluations - assessment to be performed with mininum assistance and supervision.

Independently

e) Administer : ADL and functional mobility physical status cognitive for neurological TBI placements administer perceptual assessment (Pepca, MVPT, etc.) social situation and environment assessments with (minimum assistarice and supervision applies to all of above for ~nidterm)

independently (applies to all except dysphagia) bedside dysphagia with max-moderate assitance

Min. assistance and supervision

f) Analyse and determine an intervention plan for dysphagia with minimal assistance to supervision.

Independently

g) Analyse the limitations of the physical status (risk of contracture and skin breakdown) 1 1 1 imd the possible complications and determine a plan of intervention with minimal 1 1 I assistance and supervision. I I I

Independently I I

h) Analyse the impact of ADL and IADL of any physical, cognitive, perceptual and social and environmental limitations and determine an intervention plan - minimal assistance.

Independently

i) Analyse the ADL, IADL, mobility, social and environmental status and determine an intervention plan for DIC planning with maximum assistance.

Independently

j) Implement the intervention plans for dysphagia physical status ADL, IADL autonomy D/C planning cognitivelperception (minimum assistance and stlpervision applies to all for midterm)

Independently


Independently

1) Communicates and asks for relevant information from team members and family - independently.

Independently

The student is expected to be responsible for a minimzrm of 6-8 active cases by the end of the placement. The student will have performed the previously mentioned tasks bzrt with the szpewision level written in bold letters.

3. During the last week of placement the student will present a 15 to 20-minute project (5 minutes for questions).


Date

aa\stafljn\stndenrs\stddu3.doc


5. Other specific tasks to be discussed. !

v LEARNING OPPORTUNITIES AVAILABLE

This is a list of possible opportunities. Each student is not expected to achieve all of these opportunities in one placement. It will depend on timing of placement and student interestfobjectives and performance during the placement.

1. Assessment and interventions related to:

a) Occupational Performances areas i.e. self-care, productivity, leisure

2. Utilization of standardized evaluations such as:

Jamar Dynamometer F.I.M. Jebsen Test Smith Test Videofluroscopy PECPA Trail Making Test McGill Geriatric Profile

3. Fabrication of Splints e.g. for:

CarpaI Tunnel De Quemain's Resting Hand Splints Plastazote Collar Dynamic splitting Insoles, etc.

4. Fabrication of Adaptive Equipment

5 . Wheelchair orderingtpositioning through wheelchair clinics

6. Patient education tools such as for:

Edema Control R.A. slides -joint protection

-energy conservation Relaxation techniques Splint caretskin care Protection of the neck and back Dysphasia Videofluroscopy

Fef\a\FESAP\Learning opportunities

7. Active Interventions

Scheduled workshop exercise group cooking group family meeting

Unscheduled - if particular evaluations and/or treatment procedures are of interest to students, it may be organized through the student co-ordinator in collaboration with the OT staff.

8. Interviewing techniques/evaluations

9. Observation of surgery

Orthopaedics/plastics Neurosurgical

10. Visits to other multidiciplinary team members

Social workers Physiotherapists Speech therapists Nurses Music therapists Recreational therapists

1 1. Visits to different units

Palliative care unit (PCU) RVH geriatric out-patients unit (day hospital) Geriatric in-patient unit Plastic clinic MGH traumatic brain injury unit Neurological unit Montreal Chest Hospital Psychiatric Unit ALS clinic

12. Various rounds-meetings-clinics

Neuro Grand Rounds, Neuro Multidisciplinary meetings, Neuro OTIPT in services Plastics/surgery in-services Medical Grand rounds; multidisciplinary meetings Geriatrics intercity rounds, geriatrics teaching rounds

ADAPTED FROM: Women's College Hospital, OT Department

RERA\FESAP\LEARNING OPPORTUNITIES

MUHC OCCUPATIONAL THERAPY STUDENT MANUAL

SAFETY AND HEALTH AND ACCIDENTS

1 . ACCIDENTSIILLNESS

If you sustain an injury, you must advise your supervisor immediately. In her absence, contact either the student co-ordinator, or department head. If you require medical attention (trauma) you should go to the E.R. If you are feeling unwell, but it is not an emergency you may choose to go to the Student Health Service on Campus - or go to an outpatient clinical held in the hospital. (Based on MUHC OT Policy and Procedure 10.1).

2. INCIDENTS

An incident is any condition or occurrence which deviates from normal hospital procedure. This can include, a patient having a fall or sustaining any injury, a piece of equipment that falls or is missing, thefts etc.

All incidents must be reported immediately to your supervisor, who will initiate completing the incident report. In the absence of your supervisor tell the clinical co-ordinator or department head who will advise the Quality and Risk Department, if the incident is significant. (Based on MUHC OTpolicy and procedure 10.2).

3. EMERGENCY PROCEDURES

Please ensure you read the following policies. It is your responsibility to check the location of fire equipment in the department (MUHC OT Policy and Procedure 10.3)

4. INFECTION CONTROL

In order t o prevent the tr9nsmission of pathogens and to ensure the safety of patients and staff all students must review the following policies which are part of the MUHC Infection Control Manual, but found in the student manual.

1 ) Basic Standard Precautions - Handwashing 2) Transmission Based Precautions (MRSA - C - Diff)

Section 3-C-20 page 1 of 6 3) Patients on VRE Contact Precaution

Section 7-D-30 page 1 of 7 4) Section 3-B-30 page 1 of 3

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Centre universitaire de sante McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MUHC SITE

TITLE: ACCIDENTS

I Y E R I MY2TH

( YEAR 1 MONTH I DATE I HEALTH AND SAFETY I

POLICY:

POLICY I PROCEDURE #: 10.1

EFFECTIVE DATE I I

Any accident incurred by staff on hospital premises must be reported immediately (by telephone and by completion of an accident form) by the employee PRIOR to leaving the hospital. The OHMS will determine the actions required of the employee (e.g. go to Emergency, Clinic etc). The accident form must be signed by the manager who is responsible to forward it to the OHMS.

PAGE: 1 OF: 1

REVISED DATE

I I '

REVISION #

Further details are maintained in the staff orientation manual.

SECTION: 1 0

SAFETYISECURITY.

In the case of "trauma" the student should be referred to the Emergency. For illness the students should refer themselves to Health Services at the University. If not appropriate the student should be sent to

outpatient clinic.

, b Centre universitaire de santC McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES -MUHC SITE

An incident is defined as any condition or occurrence which deviates from normal hospital procedure. An incident includes - patient accidents, falls, thefts, equipment failure. All incidents are to be reported on the hospital incident form A l - I 223

The employee or staff member involved in the incident shall initiate the report.

PROCEDURE:

Complete the form as identified and submit to the manager. If the manager is not present and if the incident is significant, the employee must advise the Quality and Risk Department by telephone, the same day.

Centre universit?i;g.de santC McGill McGill University;';Health Centre

' EV,

) POLICY AND PROCEDURE

q*OCCUPATIONAL THERAPY SERVICES - MGH SITE 8

All staff must be aware of general hospital emergency procedures to ensure quick response t o emergency situations within the OT department and/or involving OT staff. NOTE: For all emergencies dial 5555.

PROCEDURE:

1.0 CARDIAC ARREST - Code Blue If you suspect a patient is having a stroke or a heart attach (indications include collapse, loss of consciousness): 1 .I call local 5555 and state problem. Give your exact location - room #, building. 1.2 give the operator your name and the telephone local you are calling from. 1.3 i f possible, assign someone t o a strategic location t o provide direction t o the team

- when they arrive.

OTHER MEDICAL EMERGENCIES - CODE 2-3 To be called for non-cardiac medical emergency. Call local 5555 and state problem indicating a "code 2-3" Oxygen network shutdown - code 0-2.

2.0 PAEDlATRlC CARDIAC ARREST - Code Pink. As per instructions for code BLUE.

3.0 MISSING PATIENT - Code YELLOW. Call 5555 and state the name of the patient and the name of the unit looking for the patient.

4.0 VIOLENT PATIENT - Code WHITE. Code White = Violent unarmed. Code White STAT = Violent armed. Call 5555 and state exact location. Specify the nature of the intervention.

5.0 FIRE - CODE RED

General Alarm: The person who discovers the fire is responsible for the following: 5.1 Remove patientslstaff from immediate danger 5.2 Activate nearest fire alarm 5.3 Call 5555 and report location of fire, specifying room number, pavilion and floor 5.4 Close all doors in the area 5.5 Try t o extinguish fire if appropriate

5.6 If you are with patients and need to evacuate the premises, use the stairs. Do not use the elevator.

5.7 Location of Fire Equipment - MGH - There are five fire extinguishers. See over for detail

+ CO, extinguisher - Room C2-149 + CO, extinguisher - Clinic B - next to door to room C2-150.1 + Water extinguisher - next to staff room door (C2-159) + CO, extinguisher - in hall way opposite clinic A + H,O extinguisher - near Pine elevators + Two (21 water hoses: - in hall way (outside clinic B)

- near Pine elevators

6.0 BOMB THREAT - CODE BLACK

If a call is received concerning a bomb threat take as much information as possible and call 5555. When a Code BLACK is announced initiate a search for a suspect/unusual parcel, package. If such is found

Call 5555 and specify location of parcel Do not touch parcel Open doors and windows

7.0 CHEMICAL SPILL - CODE BROWN The spill will be reported immediately to the switchboard operator as a "Code Brown". The location of the spill and the material involved if known, should be reported as well as the approximated volume of the spill. The immediate area should be evacuated, barriers created or doors closed to prohibit exposure, and unauthorized persons not permitted to enter the area. Affected individuals should be treated immediately, depending upon the nature of the material spilled. In case of inhalation danger, bring the victim to fresh air. In case of dermal or eye exposure, flush the affected area with copious amounts of water. The response team notified by the switchboard operator will consist of representatives form Occupational Health and Safety, Security, Housekeeping. Laboratories and Material Management who will identify and coordinate appropriate clean procedure. An incident report must be completed by the staff who caused or found the spill.

8.0 EXTERNAL DISASTER - CODE ORANGE Trauma team on alert.

9.0 EXTERNAL TOXIC GAS - CODE GRAY

PROCEDURES I POLICY1 PROCEDURE #:I 0.3

PAGE: 3 OF: 3 .

I . .

10,O EVACUATION - CODE GREEN

. ,

EFFECTIVE ,DATE I I

YEAR 2000

Circulation of traffic to the right hand side of corridors and stairwells. Avoid transferring patients in their beds in order to prevent traffic congestion Use evacuation equipment or move patients on blankets on the floor, keep as close as possible to corridor walls in a sitting or crawling position.

REVISED DATE I I

REVISION # SECTION: 10

MONTH 0 1

DATE 20

YEAR MONTH DATE SAFETY /SECURITY

Standard Precautions. Section: 3-8-30

"BASIC" STANDARD PRECAUTIONS (BSP) Handwashina

Handwashing is the single most important procedure for preventing the transmission of pathogens from one person to another, or from one site to another in the same patient. It is a simple procedure that protects patients, HCWs and the environment.

1 POLICY I 1) HCWs Must Wash Their Hands:

I !

a) Before and immediately after patient contact (feeding, bathing, carrying out aseptic andlor invasive procedures etc.).

b) Between different procedures on the same patient. c) After contact with mucous membranes, blood and body fluids,

secretions and excretions. d) After removing gloves. e) After touching objects or surfaces contaminated with blood or

I body fluids.

f) Before preparing or sewing food.

Other Indications for Handwashing: g) Before eating or drinking h) Whenever hands appear soiled. i) After using the toilet, blowing one's nose, touching one's face,

hair, etc..

2) Handwashing products are to be used as follows:

a) Regular liquid soap Regular liquid soap, (together with warm water and friction), is considered sufficient to remove transient microorganisms which may colonize the hands after simple contacts with patients andlo:

I the environment.

Used for all general handwashing.

Available in wall dispensers adjacent to sinks

I Approved by: Infection Control Committee ( Issued: April 1997 I Revised:

Standard Precautions. Section: 3-C-20

Subject: TRANSMISSION-BASED PRECAUTIONS Contact Precautions

Page 1 of 6

PURPOSE

To protect HCWs, patients and visitors from infections that are spread via the contact route of transmission.

DEFINITION

This is a strategy which involves the use of barrier precautions aimed specifically at reducing the transmission of pathogens that are spread either by direct contact (during patient-care activities) or by indirect contact (touching contaminated environrnental surfaces or used patient-care material).

Diseaseslconditions requiring Contact Precautions include: rn MRSA rn Major uncontained abscesses w Scabies

Clostridium Difficile (C. diff.) in incontinent patients, etc.

(For details, see Table I - Recommended Precautions for Specific Diseases / Conditions, Section 3-0-20).

NOTE: Contact Precautions are used as an adjunct to "Basic" Standard Precautions.

PROCEDURE

A. Room allocation (Implement one of the following options as warranted by the situation).

1) Place the patient in a single room OR

2) Cohort (place in same room) patients infected with the same organism providing that they do not otherwise pose a risk to each other (not infected with any other transmissible disease; minimal possibility of reinfection with the same organism).

OR 3) Place the patient in a multi-bedded room with noninfected patients

Revised: Approved by: Infection Control Committee Issued: April 1997

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~ T b ' i ) a X CC.Wuk --CD(1Y Diseases. Section: /-u-ou

Subject: Vancomycin Resistant Enterococcus (VRE) MANAGEMENT OF PATIENTS ON VRE CONTACT PRECAUTIONS

/Page1 of3 / PROCEDURE:

1. Place patient in a single room. ' I 2. Complete TBP card for VRE Contact Precautions and place on door

frame. I 3. Wear a clean cloth isolation gown. If there is a risk of soiling clothing

then impervious gowns are to be worn.

4. . Use double glove technique ( two pairs of gloves are worn) when entering the room. The outer pair is removed once direct patient care is completed and before the HCW touches the environment).

5 . Masks are required if the patient is placed on Droplet Precautions by Infection Control. (if VRE is found in the respil-atory tract)

6. Remove second pair of gloves and wash hands thoroughly for 30 seconds with an antiseptic soap before leaving the room. (see hand washing procedure Section 3-b-30).

As an alternative or adjunct "waterless hand washing solution" can be used. I 7. All non critical iterris such as thermometers, BP machines and cuffs

and stethoscopes must be left in the room until the VRE contact precautions are discontinued, or the patient is discharged. Any equipment that must leave the room will be disinfected (as per #9 of this procedure)

8. Patient Screening And Culturing For VRE l a) identify clearly with "VRE SCREEN" all cultures for diagnostic

or epideiniologic purposes.

b) decontaminate the outside of the culture tubes with Javel 1/10 or 70% alcohol, or place specimen in a plastic bag being careful 1 not to contaminate the outside. I

Approved by: Infection Control Committee Issued: April 1997 Revised:

1. It is preferable that patients remain in their room. Whenever possible diagnostic testslprocedures are performed in the room. Diagnostic tests/ procedures are arranged in consultation with Infection Control.

Subject: Vancomycin Resistant Enterococcus (VRE) I TRANSPORT OF PATIENTS ON VRE PRECAUTIONS

2. If the patient must have a test in another department: I

Page 1 of 2 I

Role of Unit Staff

I a) Advise the staff doctor and slhe will determine if it is necessary.

b) Schedule procedures for the end of the day, if possible.

c) Assign stretchers or wheelchairs to be used strictly for patients on VRE precautions.

d) Complete and send Transport Card with the patient.

e) Transport patients directly for their procedure in an empty elevator.

f) Notify the receiving unit and send the appropriate personal protective equipment with the patient.

I Role of Staff in .Receiving Unit

g) Prepare in advance for the patient's arrival and remove all unnecessary equipment from the room.

h) Perform the procedure with minimum delay to eliminate the patient waiting in the hallway.

i) Wear long sleeved gowns and 2 pairs of disposable gloves. (This applies to all personnel involved in the procedure.)

j) Transfer the patient to histher room immediately following the procedure.

Approved by: Infection Control Committee Issued: April 1997 Revised:

Diseases. Section: 7-0-50

DAILY HOUSEKEEPING:

Subject: Vancomycin Resistant Enterococcus (VRE) HOUSEKEEPING PROCEDURES

1 Leave the following in the patient's room: bucket for the floor basin for surface cleaning bottle of TOR measuring container for water mop pole

Page I of 3

2. The following supplies are required on a daily basis 4 cleaning rags a clean mophead ,

3. Put on two pairs of disposable gloves and a gown before entering room.

4. Bring the clean rags and mophead into the room

5. Clean each patient's room in THREE STEPS:

STEP ONE:

Clean with TOR and water:

1 Clean all the surfaces in the room, with one rag, paying special attention to surfaces which come into contact with hands (e.g. call bell, phone, door and cupboard handles, bed rails etc.)

2. Change outer gloves, clean the bathroom in the usual manner, with special attention to surfaces that come into contact with hands (door handles, light switches, sink handles, paper towel dispensers, toilet paper holders, toilet flusher)

3. Clean the toilet last. After cleaning the toilet, discard the TOR and water from the basin, into the toilet and flush.

, 4. Rinse the basin with hot water

5. Change outer gloves again.

Revised: Approved by: Infection Control Committee Issued: April 1997

+ Centre universitaire de sant6 McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MUHC SITE

TITLE: PATIENT SAFETY MANAGEMENT POLICY 1 PROCEDURE #: 10.4 PAGE: 1 OF: 1

SAFETYISECURITY. YEAR MONTH DATE YEAR MONTH DATE HEALTH AND

00 02 15 SAFETY - -

In order to ensure safety of patients, the following rules should be observed:

1. Spills on the floor should be attended to immediately by calling housekeeping

2. Patients should not be left unattended

3. Equipment should not be left in traffic areas

4. Any damaged equipment should be reported to the secretary for immediate action

5. Patients must not return to their ward unaccompanied

6. All staff should be aware of precautions associated with the patients condition

7. All staff should be aware of hospital emergency procedures

8. All staff must comply with the infection control policies and procedures.

Centre universitaire de santC McGill McGill University ~ e a l t h Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES -MUHC SITE

TITLE: OCCUPATIONAL HEALTH AND SAFETY

The MUHC Occupational Health and Safety Department has been established (mis sur pied) following the adoption of Law 17, an act respecting Occupational health and safety. This act provides the employee with the right to work in a safety environment and provides mechanisms to prevent and/or eliminate the causes of work accidents. If you feel that your safety is being compromised, it should be reported to the Occupational Health and Safety Department.

See policy 10.1 and 10.2 for the reporting of accidents/incidents.

PAGE: 1 OF: 1

SECTION: 10

SAFETY /SECURITY

REVISION # EFFECTIVE DATE

POLICY1 PROCEDURE #:I 0.8

REVISED DATE

YEAR DATE 2 0

YEAR 2000

MONTH 0 1

MONTH DATE

Centre universitaire de santB McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - RVH-MNH SITE

TITLE: THEFT

POLICY:

To ensure that no loss of personal belongings occur, staff must use designated areas which have locks (i.e. desks, lockers, etc).

PROCEDURE:

Locked areas are available for the personal possessions of staff. Any theft must be reported to the Department Head and to Security, and an incident report (#AH223A-4) must be completed. The department doors are kept locked during non working hours. If staff do not have their key they may call security, who will admit them t o the department provided the employee has their ID card.

PAGE: 1 OF: 1

SECTION: 1 0

SAFETY/SECURITY,

HEALTH AND SAFETY


POLICY I PROCEDURE #: 10.1 0

REVISED DATE

YEAR

00

YEAR MONTH

0 2

MONTH DATE

1 5

OATE

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Function and Purpose of the Site/Program

B.7

DEPARTMENT OF OCCUPATIONAL THERAPY MUHC

MISSION STATEMENT

Occupational Therapy is a practice which utilises the analysis and application of functional

activities in order to promote andlor maintain independence in the areas of self-care,

productivity and leisure. The Occupational Therapists assess the impact of illness, injury,

psycho social dysfunction and ageing on the aforementioned areas of occupational

performance. Through interpretation of evaluations, a plan of intervention is developed in

collaboration with the patient, family and other members of the team in order to promote

functional independence and facilitate a prompt and safe discharge of the il-I-patient

population. The out-patient services offer areas of expertise not readily found in the

community. The staff of the Occupational Therapy Departments of the McGill University

Health Centre are committed to providing the highest standard of care to its clients. The

departments act as a resource of expertise and offer educational program to hospital

patients, staff and the community at large. In addition, through established links with the

universities and the professional associations we are committed to the advancement of

patient and student education and training, staff development and clinical research.

February 2000

ReRa\poIicies\mission. 1 Version2 - March 21,2000

DEPARTMENT OF OCCUPATIONAL THERAPY M.U.H.C.

PHILOSOPHY

1. We believe that Occupational Therapy intervention facilitates restoration of optimal functioning in daily life tasks of those experiencing physical and/or psycho social dysfunction.

2. We believe that a balanced integration of physical, mental, social,'cultural and spiritual elements is essential for restoration of health.

3. We believe that engagement in meaningful activities facilitates this integration.

4. We believe in a client centered approach to care delivery and that the client should be an active participant within the therapeutic relationship, accepting responsibility for themselves within their limitations.

5 . We believe Occupational Therapy makes a unique contribution to multidisciplinary team interventions with regard to a client's current and projected level of function which encourages an interdisciplinary approach.

6. We believe that good communication between healthcare team, patients, their families and significant others is essential for effective care.

7. We believe each patient must be treated with respect and that all information related to the individual must be held in confidence.

8. We believe ongoing education and professional development is required of each staff.

9. We believe in and support staff involvement in committee activities at the departmental, hospital, professional association and university levels.

10. We believe clinical education of Occupational Therapy students is a professional responsibility.

11. We believe in our responsibility in the education of other staff, professional and the community at large.

12. We believe in research activities to assess the efficacy of our intervention, promote evidence- based practice and obtain objective measures of an individual's performance.

13. We believe that the services must be provided in accordance with accepted standards of clinical practice and professional code of ethics.

FEBRUARY 2000 REF\A\POLICIES\PHILOSOPHY-1 VERSION 2 -APRIL 18, 2000

DEPARTMENT OF OCCUPATIONAL THERAPY M.U.H.C. GOALS

1. PATIENT CARE

To provide quality client centered Occupational Therapy services through the application of evidence based intervention.

To foster a network of care partners including the client, the family, the multidiciplinary care team and the community.

• To evaluate and monitor delivery of Occupational Therapy services to ensure client access, acceptability of services, safety of the environment and effective use of available resources.

To foster cross-site communication, collaboration, integration and the exchange and sharing of resources respecting the speciality of each centre.

2. EDUCATIONISTAFF DEVELOPMENT

To participate in relevant hospitaVcommunity activities which aim to improve quality andlor delivery of care and to actively promote awareness of Occupational Therapy contributions to patient care and discharge planning.

To promote and develop a high quality educational program and to provide a stimulating clinical environment for the academic programs of universities offering courses in Occupational Therapy.

To promote a high and consistent quality of Occupational Therapy services and ensure professional competence.

To provide opportunity and support for continuing education, staff development and achievement of job satisfaction.

To participate in clinical studies and research in order to demonstrate effectiveness of occupational therapy interventions.

FEBRUARY 2000

FEF\A\POLICIES\GOALS- 1 version 2 - march 21, 2000

OCCUPATIONAL THERAPISTS

As a result of an illness or injury you may have to change the ways in which you cany out day-to-day activities. The goal of Occupational Therapy is to help you become as independent as possible in looking after yourself and enjoying your work and leisure time. The Occupational Therapists will work in collaboration with you, your family and the medical team to make your return home as easy as possible.

PATIENT HANDB001<.

. Scope and Limitations

of Occupational Therapy Services

B.8

CENTRE UNIVERSITAIRE DE SANTE MCGILL McGILL UNIVERSITY HEALTH CARE

OCCUPATIONAL THERAPY SERVICES DESCRIPTION SCOPE AND LTMITATIONS

1. PATIENT CARE

Occupational therapy services shall be regularly available and readily accessible to meet the needs of patients with physical and/or psychological disabilities within the limitations of physical and human resources. Services offered include assessment and treatment of those patients with physical dysfunction to promote functional independence and facilitate prompt and safe discharge of the in-patient population. Utilisation of service will be authorised by a written referral signed by an attending physician. Referrals must include a diagnosis and other relevant information. In physical medicine, Occupational Therapy coverage is extended to:

a) Medical including rheumatology , cardiology, respiratory, oncology, dermatology, P.C.U.

b) Surgical including general surgery, orthopaedics , plastics in and out-patient c) Geriatrics in and out-patient d) Neurological and neurosurgical conditions, including Traumatic Brain Injury

Interventions includes:

1. Activities of daily living A. To assess the patient's capabilities and degree of independence in the ADL including:

1. Personal hygiene and grooming 2. Feeding and swallowing abilities 3. Dressing 4. Transfers 5. Mobility and wheelchair management 6. Communication skills 7. Instrumental ADL (cooking, laundry, housecleaning, etc.. .)

B. To train the patient in ADL and, if necessary, suggest modified techniques and/or aids and adaptations to promote optimal functional independence.

2. Home assessment A. To evaluate the patient's capabilities to function in the home environment.

B. To evaluate the feasibility of the patient to return home. A home evaluation in the

community is allowed under specific circumstances only

C. To train the patient using modified techniques aids or adaptations to maximise independence at home (e.g. joint protection techniques, one-handed techniques).

3; Prevocational and vocational skills A. To assess the patient's capabilities for returning to previous employment.

B. To assess the patient's work skills such as attention, tolerance, etc.. .

C. To help determine the type of employment the patient is capable of returning to.

D. To provide therapeutic tasks which aim to encourage the patient's return to a working situation.

4. Physical status A. To assess the patient's:

1. active and passive), presence of contractures 2. Skin statusloedema 3. Muscle tone 4. Sensation 5. Co-ordination 6. Balance(sitting, standing) 7. Tolerancelendurance 8. Pain

B, To provide therapeutic activities to maintain andlor improve physical functioning including:

1. Reduction of oedema 2. Increase joint ROM 3. Strengthening muscleslencoufaging return of appropriate motor control 4. Increasing physical tolerance 5 . Sensory retraining

C. Splinting to maximise hnction or to prevent the developments of deformities and reduce contractures by:

1. Immobilising certain joints to help decrease pain, permit healing and/or protect injured tissues or newly repaired structures (e.g. reinforced collar)

2. Preventing or arresting the development of contractures 3. Gradually stretching contractures or assisting in maintaining ROM achieved in

therapy 4. Assisting weal muscles or substituting for lack of muscle power allowing increased

function

5. Perception A. Evaluation to determine presence ofcognitivelperceptual deficits resulting from cerebral

dysfunction or trauma. B. Training to compensate for andfor overcome difficulties in order to maximize the patient's

functional capabilities.

The Occupational Therapy Services provided to the patients shall include: 1. Evaluation upon referral 2. Development of intervention plan in co-ordination with the patient, team and

family 3. ' Regular and frequent reassessment 4. Discharge planning 5. Maintenance of records 6. Periodic assessment of quality and appropriateness of care provided

11. EDUCATION PROGRAMMES

An extensive education programme exists for both staff and patients.

i 1. To assist patients achieve maximum independence, activities of daily living are taught to patients, family and staff providing care. Audio visual and written material has been developed to facilitate learning.

2. When appropriate patients andlor family are provided with written instructions for home-care programmes, and prevention of complications.

3. When appropriate patients and/or family are provided with written material to facilitate discharge i.e. discharges package.

4. Educational sessions are organised for patients in PCU so that they and their families may gain an increased understanding of their illness, symptoms and develop coping mechanisms.

5 . Prior to and after reconstructive surgery, patients are instructed in the procedures, consequences and necessity for compliance in rehabilitation to enhance optimum outcomes.

6. Throughout the hospital, 0.TPts provide in-service lectures for other staff and students.

7. The department receives and trains students for approximately 2-3,000 hours per

annum.

8. Staff hold joint faculty positions facilitating the exchange of information and the presentation of relevant, up to date clinical experience for students.

9. Continuing education is both expected and encouraged of all staff. Financial assistance is provided when possible.

10. An extensive in-service education programme is established to ensure the sharing of expertise and to increase the proficiency and knowledge of staff. As well a mentoring system exists to assist all new staff or staff new to an area to acquire the necessary expertise to provide quality care.

111. QUALITY ASSURANCE

To ensure excellence in all aspects of the service the following are undertaken.

1. Credentialing:

All personnel will be members in good standing with the Ordre des Ergotherapeutes du Quebec. All new personnel will participate in an organised orientation programme and job training is. provided as required.

. .

2. Accreditation:

Staff are responsible for the excellence of the programme related to the clinical training of students and the department will request re-accreditation of its student program every five years to ensure its quality and excellence of content and performance.

3. Quality Assurance:

Ongoing activities e.g. chart audits, reporting of indicators, etc. take place throughout the year to evaluate patient care, outcome and satisfaction. Quality improvement activities are implemented as requested.

4. Utilisation:

Period review to ensure optimal utilisation of resources.

5. Performance Review :

All staff establish annual professional objectives and receive feedback on performance - including statistical data.

LIMITATIONS

The goal of occupational therapy in a tertiary care centre is to prevent complications,

facilitate discharge and maximise the patient's rehabilitation potential given the limited

resources available. Policy 6.14 and 6.15 identifl the treatment priorities for both in and

out patients referred to O.T. In addition to the above as per policy 6.7, outpatient clients

referred for dysphagia by a physician of the MUHC will be seen as soon as possible.

Patients already known and evaluated will be a priority. Home visits are regularly

undertaken by the Geriatric Day Hospital and occasionally by the O.T. on the geriatric

services. Any other visits will be undertaken on an exceptional basis only (Policy and

Procedure 6.10). It is not within our mandate nor do we have the resources to treat

medical and neurological patients such as CVA's and spinal cord injuries who require

I ' : long standing follow-up. These patients should be referred to the appropriate

rehabilitation facility.

MUHC DEPARTMENTS OF OCCUPATIONAL THERAPY PROGRAM DESCRIPTION

MEDICINE The equivalents to 1.5 FTE in each hospital (MGH-RVH) cover medical referrals. Cases are usually distributed to all staff members as the caseload fluctuates greatly. Typical client groups include respiratory problems (COPD, pneumonia), CHF, general deconditionning and oncology. Clients are primarily referred for dysphagia assessment and functional assessment for discharge planning. The bedside dysphagia assessment and occasionally Modified Barium Swallows are used. Dietary recommendations and periodic follow-up is provided. ADL evaluation/IADL screening (Barthel index, in-house evaluation) and recommendations for discharge planninglimproving function are provided. Periodic re-evaluation is done as time permits. The average length of stay for ADL referral is under one week and about 1 month for complex dysphagic clients.

SURGERY One occupational therapist allocated to the in-patient surgery population of the RVH. Types of patients include amputees, transplant, cardio-thoracic, ear-nose and throat surgeries, etc.. . The initial interventions of the O.T. often address dysphagia. The O.T. also acts as a consultant to assess the patient in order to determine the functional capacities and assist with decision making pertaining to discharge planning. The average length of stay of patients is 17 days.

PALLIATIVE CARE UNIT A part-time O.T. (0.5 F.T.E.) practices on the palliative care unit of the RVH, which offers care to terminally ill patients suffering from diseases such as cancer. The professionals of the PCU work as an interdisciplinary team. The main interventions undertaken by the O.T. aim at preserving autonomy, decreasing pain and improving comfort and quality of life. In some cases, the O.T. will assist in discharge planning when return home is possible. The average length of stay of patients is 13 days.

TRANSITIONAL CARE UNlT A part-time O.T. offers services to long term care patients (0.5 F.T.E on the S7W unit of the RVH). Patients are awaiting placement in a long-term care facility outside of the acute care hospital. The O.T. is an active member of the multidisciplinary team. Interventions undertaken by O.T. include dysphagia assessment/recommendations, positioning and wheelchair clinics, functional re-assessment and recommendations to improvelmaintain autonomy and quality of life on the unit. The average length of stay of patients is 45 days.

OUT-PATIENTS Two occupational therapists at each hospital (MGH and RVH) offer services to the hand injured outpatien~population. The majority of the caseload is referred by plastic surgery but referrals are also received from rheumatology, orthopaedics and outpatient clinic. The O.T. assist the client in the evaluation and treatment of oedema, scar adherence and hypertrophy, decreased range of motion and strength, impaired sensation, etc.. . The focus is to return the client to his former

level of functioning in selfcare, work and leisure activities. The O.T.'s are an integral part of the plastic surgery team and cover the plastic surgery clinics.

INPATTENT-PLASTICS The inpatient plastic referrals are seen by one of the two outpatient hand specialists at the MGH. Referrals include individuals with trauma of the hand (e.g. burns, replantation and severe fractures). The average length of stay for these clients is 3 to 5 days, with outpatient follow-up afterwards. O.T. interventions consist primarily of splinting to immobilise and protect structures and early range of motion if applicable to prevent stiffness and deformities. A multidisciplinary approach is used.

NEUROLOGY Approximately 1.5 O.T. offer services to neurology clients located on the 14"' floor of the MGH and 1.0 FTE offer services to the neurology patients of the MNH. Typical clients include CVA, MS, ALS, Guillain Barre Syndrome, myasthenia gravis, neuropathy and occasionally spinal cord injuries. Evaluations include dysphagia (bedside exam, occasionally MBS), general motor assessment (ROM, balance, strength, co-ordination), ADL function (Barthel, in-house evaluation), cognitive/perceptual function (OSOT, MVPT, MMSE, CCT). The overall goals of O.T. are to improve ADL independence and to assist with appropriate discharge planning. The average length of stay varies with condition, usually 2-4 weeks for CVA and 4-6 weeks for GBS or SCI. Strong multidisciplinary approach is used.

NEUROSURGERY Approximately 1.5 occupational therapist provides services to the neurosurgery in-patient population of the MNH. The vast majority of patients are seen on an in-patient basis and suffer from a wide variety of conditions such as cerebral haemorrhage, aneurysm, brain tumour, spinal stenosis and/or compression, etc.. . The main goal of O.T. is to monitor patients' functional status pre and post-operatively and assess ADL in order to assist with decision making pertaining to discharge planning. The O.T. acts as a consultant on the pre-admission and peri-operative unit and is an active member of the brain tumour multidisciplinary team.

NEUROLOGY OUT-PATIENT One occupational therapist is allocated to the outpatient population of the MNH. Patients seen have neurological conditions such as ALS, neuropathy, post-polio syndrome, multiple sclerosis or are seen following a neurosurgery. The O.T. is part of the multidisciplinary teams addressing the needs of ALS and multiple sclerosis patients. Interventions include functional assessment and brief follow-up of patients for ADL recommendations, energy conservation, etc.. . Patients who require more extensive rehabilitation or community services are referred to the appropriate resource.

TRAUMATIC BRAIN INJURY PROGRAM The TBI program has a strong interdisciplinary approach and includes 1.4 FTE O.T. Clients have an average length of stay of 12 days. Typical evaluations used include cognitive screening (CCT, PECPA, in house cognitive battery), perceptual evaluation (MVPT, OSOT, Bell's test) and functional evaluation (FIM). The goal of O.T. within the service is to evaluate the client's

functional status (motor, cognitive/perceptual functions, ADL and IADL.. .), and to provide recommendations for safe return home or identify the need for rehab follow-up.

GERIATRIC DAY HOSPITAL The O.T. at the GDH is a member of an interdisciplinary team, and is responsible for the assessment, planning and implementation of specific treatment for a geriatric outpatient population. This includes preventing disability, and assisting clients to achieve optimum function and independence in ADL, IADL and mobility, in a clientele with physical and mild cognitive impairments. The O.T. completes an evaluation with recommendations, provides rehabilitation and re-assessment when indicated, and completes home visits to assess safety and function when necessary. The O.T. at the GDH also participates in team meetings, and participates in decision- making and problem solving with other team members. Assessment reports must include functional and measurable goals, and outcome measures are regularly used in assessment and in clinical decision making. The average length of stay can vary from 3 days for an evaluation to 3 months for rehabilitation

ACUTE GERIATRICS Services provided by 1 FTE (MGH-13 east, RVH-8medical). A strong interdisciplinary approach is used. Family meetings and education to caregivers is an important part of the service. The overall gaols are to increase functional autonomy and to co-ordinate discharge planning. Referrals are from the Emergency room and in hospital transfers from other wards. Clients are generally 75 and over, frail, with general deterioration of function. Typical admissions are for falls, acute confusional states, dementia work-up, pneumonia and deconditionning. Transfers include post MI and post fracture clients. Typical evaluations used include Barthel, OARS, AMPS, cognitive/perceptual screening and dysphagia evaluation. Average LOS is 24-27 days.

PSYCHIATRY

Both the MGH and RVH offer Occupational Therapy Services in psychiatry. Separate departments exist and are not integrated with the Physical Rehab Section.

Psychiatry in patient and outpatient services are on each site. Average length of stay for acute in-patients provided is 3-4 weeks.

The following services are offered:

1. Activity oriented groups, used to assess the patient's ability to interact with others and to perform task oriented behaviors. Changes in syrnptomatology, contact with reality and coping mechanisms are evaluated. Goals for therapeutic interventions are set with the patient and worked on within the context of the group or in individual sessions when appropriate.

2. Evaluation for perceptual deficits. Training may be provided to help the patient compensate for perceptual deficits.

3. Level of functioning and degree of independence in Activities of Daily Living and Instrumental A.D.L. is assessed. Treatment is focused on helping the patient to obtain maximum independence to live in the environment of choice.

4. Projective assessments as an aid to diagnosis. 5. Pre-vocational assessments: The basic work competency, the interest, the aptitude and

the values of the clients are explored in order to help them set career goals. 6 . Psycho-social Rehabilitation: To help the clients set goals in relation to living,

learning and working environments, to explore their barriers, and to develop skills and supports which allow them to reach their goals.

7. Case Management

F.T.E. Services Offered

In-Patient Units 2 F.T.E. (1 MGH, 1 RVH) Out-Patient Service Transitional Day Programme 1 .O F.T.E. (MGH) Day Hospital 1.0 F.T.E (RVH) Rehab Day Center 1.8 F.T.E (MGH) Rehab Vocational 1.0 F.T.E. (RVH) Community Link 1.0 F.T.E. (MGH) Crisis Intervention .4 F.T.E. (MGH) General Psychiatry .4 F.T.E. (MGH) Substance Abuse 1.8 F.T.E. (MGH)

10.4 F.T.E.

Version 2- April 18,2000 A:IFESAPIPsyserv

6.3 saullaplng I I pue sp~repueqs ~euo~ssajo~d I

Centre universitaire de santB McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MGH SITE

TITLE: ACCESS TO MGH OCCUPATIONAL THERAPY

SERVICES

POLICY:

Occupational Therapy Services shall be regularly available (Monday-Friday) and readily accessible (patients are triaged and evaluated) within 4 8 working hours of receipt of referral. Services offered include assessment and treatment of those patients with physical dysfunction t o promote functional independence and facilitate a prompt and safe discharge of the in-patient adult population of the MUHC.

Utilisation of the service will be authorised by a written referral signed by a physician. Referrals must include a diagnosis, reason for referral and other relevant information on the patient's status. All occupational therapists must be registered with and remain members in good standing of the OEQ, as stated in Bill 250 - Code des Professions.

PROCEDURE:

Referral: Occupational therapy referral form stamped with the addressograph or equivalent written information and signed by M.D.

MGH In-Patients: Referral form (391 1402K88) completed with the necessary information should be left with the unit co-ordinator or call local 2900 to make arrangements t o have referral collected.

MGH Outpatients: Patients should be sent to C2.150 to register before 4:00 p.m. otherwise the referral should be mailed to the department. Please ensure that the patient's address and telephone number are clearly indicated.

Hours: Monday to Friday, 8H00 t o 16h00.

PAGE: 1 OF: 1

SECTION: 6

PATIENT CARE

REVISION #

POLICY / PROCEDURE #: 6.1

REVISED DATE EFFECTIVE DATE

YEAR DATE

1 0

YEAR

2000

MONTH MONTH

04

DATE

Centre universitaire de sante McGill McGill University Health Centre


PATIENTS:

All information regarding patients is confidential. An occupational therapist must respect the right of their client to consult occupational therapy documentation that is part of their chart unless this is prejudicial to the client.

TITLE: CONFIDENTIALI'IY - PATIENT INFORMATION

Any client wishing to access his or her entire chart must make a request to the hospital Registrar. Patients requesting the dates of treatment may be supplied with such a list. The therapist must ensure that a patient has authorized the release of information prior to forwarding information to another institution. See following guidelines for disclosure of information to patients and and/or their facilities.

See also Policy 7.4 - Press Release.

PAGE: 1 OF: 1

SECTION: 6

PATIENT CARE


POLICY/ PROCEDURE #: 6.6

REVISED DATE

THIRD PARTY

YEAR

No patient information relative to diagnosis, patient's physical status or requirements may be issued to a third party from this department. Any request for such information should be directed to the Department of Medical Records.

DATE 20

YEAR 2000

The only information that may be released directly is a list of dates the patient attended for treatment or a discharge summary being sent to an institution where the patient will be transferred to.

MONTH 03

MONTH

1 PROCEDURE: I

-

DATE

1. Upon receiving a request for release of information, forward it to the Medical Records Department.

2. A direct request form Medical Records for departmer~tal information concerning a patient is released only to the Medical Records Dept.

Centre universitaire de sant6 McGill McGill University Health Centre


All records must comply with the hospital policy and that of the OEQ. (Code of Ethics and Tenue de Dossiers). Receipt of the referral must be documented in the progress notes section of the patient's medical chart within one working day. All referrals will be screened within 24 to 48 hours (2 working days) with appropriate documentation. All patients will be prioritized according to the lists (policy 6.15, 6.16).

PROCEDURE:

I. REFERRAL

1 O.T. Referral

All O.T. referrals must contain the following information: Patient's name and unit number . Address and telephone number (home and work) Medicare number Diagnosis Date of birth Signature of physicianldate of referrallreferring service Room number when applicable CSST indicated when applicable Date when initial contact made by O.T.

2. Process of Referral

A. Inpatients Written in "progress record" section Include: date, time, service Write: "Consult received, assessment to follow"

B. Outpatients Use ambulatory care sheets Include: date, service Write: "Evaluation done, treatment in progress"

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II. ASSESSMENT AND INTERVENTION PLANNING

I. Database

A. Must include pertinent data concerning the client's environment and overall past and present functional

B. Can include: Age Sex Dominance H.P.I. (date of injury, date of admission, history ofpresent illness, etc.) P.M.H. (past medical history) Social profile/occupation Medications Test results O.R. date and procedure

2. Initial Assessment - write'up: Date of the assessment S.O.A.P.' or short narrative format, when appropriate Signed by 0.T.lstudent notes countersigned R.T.C. date (return to clinic) if applicable Record of initial assessment to be documented within 3 working days For out-patients, in the-case of consultation only, note should include "Active OT treatment not indicated -

patient considered discharged if has not contacted department within one monthn.

* S.O.A.P. method of charting guidelines

S stands for subjective and refers to what the patient or family tells you. This includes any social or medical history not previously recorded, patient's statements or complaints, loss ofhnction.

0 stands for object*e and refers to what you observe and do; any evaluation or observation you have made. This objective information is vergable by another occupational therapist. For example: R. O.M. strength, sensation, A. D. L. (Barthel), Folstein.

A stands for assessment and refers to what you think. A is your professional opinion inlight of the facts as recorded in the S and 0 sections and in the rest of the medical record

P stands for plan and r+s to what you want to do or what you will do. The plan should include frequency of intervention and re-evaluation schedule. The plan can be 1) short term or 2) long term (e.g. discharge planning, home program, equipment nee& follow-up care, rgerral to another agency, etc.).

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Ill. INTERVENTION

1. Progress Notes

A. Inpatients Written in "progress record" section Write date, time, service Use S.O.A.P. format or short narrative, when appropriate Use measuable objectives

Frequency - when change takes place, or at minimum of once every 2 weeks

B. Outpatients Use ambulatory care sheets Include date, "O.T. Dept" (at the bottom), "O.T. progress note" (at top) Use S.O.A.P. format (or short narrative, when appropriate)

Frequency -when change takes place, or at a minimum of once every 4 weeks

2. Signing sheets must include: Patient's namelunit number Room number if hospitalized Initialled by O.T. for each attendance Date of discharge from O.T.

Signing sheets are kept in the following locations: lnpatients - in medical chart under "consultation''

a Outpatients - in O.T. department charts until discharged from active treatment, then forwarded to medical chart

IV. DISCHARGE I TERMINATION OF INTERVENTION

Discharge Note

a Use S.O.A.P. format (or short narrative when appropriate) a Include - summary of treatment, status of patient on dischargeltermination of O.T. intervention and follow-up

plan (i.e. refer to other service centre as needed) Note signed by O.T. I countersign student note

A. Inpatient Written in "progress record section Write date, time, service, "DIC note"

B. Outpatient Written on ambulatory care sheets - Write date, service (at the bottom) and "O.T. discharge note" (at the top)

Centre universitaire de santC McGill McGill University Health Centre

POLICY AND PROCEDURE I OCCUPATIONAL THERAPY SERVICES - MUHC

PAGE: 1 OF: 1

TITLE: PATIENT DISCHARGE1 DISCONTINUATION OF TREATMENT1 REFERRAL TO OTHER SERVICE

POLICY 1 PROCEDURE #: 6.14

POLICY IN-PATIENTS

In-patients wil l be discharged when one of the following occurs: a) Client discharged from MUHC. b) Status unchanged despite continuous treatment x 1 month. C) Client has been on inactive list x 1 month (inactive = monitor status, no treatment given) and

is medically stable. d) C.T.M.S.P. on an active floor - unless time permits.

Should an in-patient be discharged and require an O.P. treatment, a new requisition must be obtained. In-patients referred to another facility should have a discharge summary written in duplicate.


Patients who require further rehabilitation/convalescence, either centre-based or home-based, will be referred to the appropriate institution by the Social Worker or Case Manager of the team responsible for the case.

SECTION:

6 PATIENT CARE

REVISED DATE

PROCEDURE

DATE

2 0

YEAR

2000

YEAR

The occupational therapist will be required to provide a discharge summary on the patient's functional status, i f requested.

MONTH

0 3

For discharge summaries sent to other institutions, the department form is prepared in duplicate: 1. Original placed in client's chart. 2. Copy attached to Department file (OT dossier).

MONTH

POLICY OUT-PATIENTS AND CSST

DATE

All O.P. department patients are to be discharged from treatment when no further benefit may be obtained. Notification of discharge is made to the referring doctor.

Centre universitaire de santk McGill McGill University Health Centre


EFFECTIVE DATE REVISION # REVISED DATE SECTION: 6

PATIENT CARE

TITLE: PRIORITY OF TREATMENT - MEDICAL, SURGICAL AND NEUROLOGICAL INPATIENTS (INTERNAL OT USE ONLY)

I

POLICY:

The following list is a guideline for the daily prioritizations of interventions by OT staff. Our goal is to prevent complications, facilitate discharges and maximize the patients' rehabilitation potential whenever possible.

POLICY1 PROCEDURE #: 6.1 5

1. Dysphagia evaluation and recommendations with patients that are NPO pending results, including long term care patients that are deteriorating.

2. A: Splinting after cast removal or with acute plastic conditions for example: skin graft, cellulitis, bum ... B: Any conditions that will result in eminent contracture and skin breakdown.

PAGE: 1 OF: 1

3. Intervention regarding discharge planning for a patient going home including ADL, IADL evaluations, and screening for driving abilities and application for outpatient services.

4. Dysphagia Re-evaluaiton of patients already followed by OT service, or initial dysphagia evaluation for patients fed by an alternative method of feeding.

5. Intervention regarding discharge planning for patients going to in-patient rehabilitation including ADL assessment, rehabilitation potential evaluation and writing of discharge summary. NOTE: any impairments caused by purely ambulation deficits will not be assessed.

6 . Positioning for patients that are at non-eminent risk of physical deterioration (foot drop splint, cushion, wlc ...).

7. Intervention regarding discharge planning for patients going to / admitted from a nursing home and if there is a question on their ability to go back to their nursing home including ADL evaluation.

8. A: Dysphasia reevaluation / monitoring of long term care patients off 7 West if diet needs to be upgraded. B: Wheelchair evaluation of long term care patients off 7 West.

1 9. Ongoing reevaluation / interventions.



PATIENT CARE

The department of Occupational Therapy has a waiting list for outpatients. When the referral is brought to the department, it is screened to assess if the client requires immediate attention. Those not requiring immediate attention will be seen as per the priority list.

PROCEDURE FOR INITIAL APPOINTMENT

When the client is put on the waiting list, the date the referrals was received in the department is recorded, telephone number is verified and if it requires a pre-op assessment or if client is CSST or staff it is noted.

If 3 unsuccessful attempts are made to contact a client by phone for an appointment, a letter is then sent to the client with a specific appointment date and time. When contacted, clients are also informed that if they do not come to their scheduled appointment and do not call to cancel, their file will automatically be closed. If message left on machine and they do not show they will be contacted again.

MNH OUTPATIENTS

Clients who do not come to their scheduled appointment and do not call to cancel are sent a letter with a specific appointment date and time and are informed that their file will be closed if they do not come to their appointment.

Client's MRN must appear on a therapist's statistical sheet before being discharged.

PROCEDURE FOLLOW UP APPOINTMENTS

Follow up appointment scheduling is the responsibility of each therapist. If a patient does not attend a follow-up appointment, the file is kept open for one month at which point it is closed if the patient has not contacted the therapist.

CODE OF ETHICS OF OCCUPATIONAL THERAPISTS Professional Code

(R.S.Q., c. C-26, s. 87)

DMSION l

GENERAL PROVlSDNS

1.01. In this Regulation, unless the context indicates otherwise, the following words mean :

(a) "Order": the Ordre des ergotherapeutes du Quebec ;

(b) "occupational therapist" : every person who is entered on the roll of the Order.

1.02. The Interpretation Act (R.S.Q., c. 1-16), with present and future amendments, applies to this Regulation.

DMSION II

DUTIES AND OBUGATIONS TOWARDS THE PUBLIC

2.01. An occupational therapist must, unless he has sound reasons to the contrary, support every measure likely to improve the quality and availability of professional services in the field in which he practises.

2.02. In the practice of his profession, an occupational therapist must take into account the general effect which his research and work may have on society. .

2.03. An occupational therapist must promote measures of education and information in the field in which he practises. Unless he has sound reasons to the contrary, he must also, in the practice of his profession, perform the necessary acts to ensure such education and information.

2.04. An occupational therapist must be well informed on new developments in the field of occupational therapy practice so as to offer professional services of the highest q~ality.

DMSION Ill

DUTIES AND OBUGATlONS TOWARDS CUEKTS

3.01.01. An occupational therapist must refuse any request for service which lies beyond his professional competence or in respect of which all the essential data is not supplied to him.

3.01.02. An occupational therapist must at all times recognize his client's right to consult a colleague, a member of another order or any other competent person.

3.01.03. An occupational therapist must refrain from practising in conditions or situations which could impair the quality of his services.

3.01.04. An occupational therapist must endeavour to establish a relationship of mutual trust between the client and himself. To this end, he must in particular :

(a) refrain from practising his profession in an impersonal manner ;

(b) conduct his interviews in such a way as to respect his client's scale of values and personal convictions, when the latter informs him thereof.

3.02.01. An occupational therapist must accomplish his professional tasks with integrity.

3.02.02. An occupational therapist must ;void any false representation with respect to his level of competence or the efficiency of his own services and of those generally provided by the members of his profession. If the good of the client so requires, he must, with the latter's authorization, consult a colleague, a member of another order rJr another competent person, or refer him to one of these persons.

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3.06.03. An occupational therapist must avoid indiscreet conversations concerning a client or the services rendered to him.

3.06.04. An occupational therapist shall not make use of confidential information which may be prejudicial to a client or with a view to obtaining a direct or indirect benefit for himself or for another person.

3.06.05. Clinical data obtained in the practice of the profession or in the course of research may be used for publication or teaching purposes only if the identity of the persons.concemed is kept confidential.

3.06.06. An occupational therapist must obtain the written permission of the client concerned when using audiovisual techniques for purposes of therapy, teaching or research.

$7. T m s a d condtions f the exenrke qf the rights c j

access and comcaon pmuidedjbr in section 6O.j and 60.6 qf the PmfissionaL Cod and obhgation jbr an ocqatr'onal thenpist to@e hnlments to his cdent

3.07.01. An occupational therapist may require that an ,-. application referred to in sections 3.07.02, 3.07.05 or

3.07.08 be made at his place of business, during his regular working hours.

3.07.02. In addition to the particular rules prescribed by law, an occupational therapist shall promptly follow up, at the latest within 30 days of its receipt, on any request made by his client whose purpose is :

(1) to consult documents that concem him. in any record made in his regard ;

(2) to obtain a copy of the documents that concem him in any record made in his regard.

3.07.03. An occupational therapist who grants an application referred to in section 3.07.02 shall give free access to documents to his client. However, an occupational therapist may request reasonable fees not exceeding the cost for reproducing or transcribing documents or the cost for forwarding a copy, in respect of an application to which paragraph 2 of section 3.07.02 applies.

An occupational therapist requesting such fees shall, before procaeding with the copying, transcribing or sending of the information, inform his client of the approximate amount he will have to pay.

3.07.04. An occupational therapist who, pursuant to the second paragraph of section 60.5 of the Professional Code, denies his client access to the information contained in a record made in his regard shall inform his client in writing that the disclosure would be likely to cause serious harm to his client or to a-third party.

3.07.05. In addition to the particular rules prescribed by law, an occupational therapist shall promptly follow up, at the latest within 30 days of its receipt, on any request made by his client whose purpose is :

(1) to cause to be corrected any information that is inaccurate, incomplete or ambiguous with regard to the purpose for which it was collected, contained in a document concerning him in any record made in his regard ;

(2) to cause to be deleted any information that is outdated or not justified by the object of the record made in his regard ;

(3) to file in the record made in his regard the written comments that he prepared.

3.07.06. An occupational therapist who grants an application referred to in section 3.07.05 shall issue to his client, free of charge, a copy of the document or part of the document to allow his client to see for himself that the information was corrected or deleted or, as the case may be, an attestation that the written comments prepared by his client were filed in the record.

3.07.07.. Upon written request from his client, an occupational therapist shall forward a copy, free of charge for his client, of corrected information or an attestation that the information was deleted or, as the case may be, that written comments were filed in the record to any person from whom the occupational therapist received the information that was subject to the correction, deletion or comments and to any person to whom the information was provided.

3.07.08.. An occupational therapist must promptly follow up on any written request made by his client, whose purpose is to take back a document e~tnisted to him by his client.

An occupational therapist shall indicate in his clients record, where applicable, !he reasons to support his clients application.

$8. Detenm'mon andpqment offees

3.08.01. An occupational therapist must charge and accept fees which are justified by the circumstances and in proportion to the services rendered. In determining his fees, he must, in particular, take into account the following factors :

(a) the time given for carrying out the professional service ;

(b) the complexity and importance of the service ; (c) the performance of unusual services or services

requiring exceptional competence or celerity.

3.08.02. An occupational therapist must provide his client with all the explanations required for the understanding of his statement of fees and the terms and conditions of payment.

3.08.03. An occupational therapist must refrain from demanding advance payment of his services ; he must, on the other hand, notify his client of the approximate cost of his services.

3.08.04. An occupational therapist may collect interest on outstanding accounts only after having duly notified his client. The interest thus charged must be at a reasonable rate.

3.08.05. Before having recourse to legal proceedings, an occupational therapist must have exhausted all the other means at his disposal to obtain payment of his fees.

3.08.06. An occupational therapist must refrain from selling his accounts, except to a colleague.

3.08.07. When an occupational therapist appoints another person to collect his fees, he must ensure that the latter will act with tact and moderation.

DMSION lV

DUTlES AND OBUGAllONS TOWARDS 'ME PROFESSION

4.01.01. In addition to those referred to in sections 59 and 59.1 of the Professional Code and what may be determined pursuant to subparagraph 1 of the second paragraph of section 152 of the Code, the following acts are derogatory to the dignity of the profession :

(a) prompting a person in pressing or repeated terms to resort to his professional services ;

@) communicating with the plaintiff without the prior written permission of the syndic or his assistant when he is informed that an inquiry into his professional conduct or competence is to be held or when a complaint has been served against him ;

(c) producing or causing to be produced for any person unjustified or illicit benefits, in particular by falsifying a declaration, report or any document respecting a client or by having an interest in the sale or rental of therapeutic equipment ;

(d) failing to inform the secretary of the Order in due time where he knows that a candidate does not meet the conditions of admission to the Order, and where he believes that an occupational therapist is practising the profession in a manner likely to harm the public ;

(e) allowing a person who is not a member of the Order to use the title (( occupational therapist )), or a title or abbreviation which may lead people to believe that he is a member, the abbreviation "erg.", or initials which may lead people to believe that he is a member, or the initials "O.T." or "O.T.R.", or not immediately informing the secretary of the Order where he knows that a person who is not entered on the roll of the Order uses those titles, abbreviations or initials.

$2. Rehbons uitb the Or& and colleagues

4.02.01. An occupational therapist whose participation in a council for the arbitration of accounts, a committee on discipline or a professional inspection committee is requested by the Order must accept that duty unless he has exceptional grounds for refusing.

4.0202. An occupational therapist must promptly answer all correspondence addressed to him by the syndic of the Order, investigators or the members of the professional inspection committee.

4.02.03. An occupational therapist shall not abuse a colleague's good faith or be guilty of breach of trust or disloyal practises towards him. He must not, in particular, take credit for work done by a colleague.

4.02.04. An occupational therapist must, in his field of work, cooperate with his colleagues and members of other

. - professions and seek to maintain harmonious relations with them.

$3. Contribution to the advancement oftbepmfRFsion

4.03.01. An occupational therapist must, as far as he is able, contribute to the development of his profession through the exchange of his knowledge and experience with his colleagues and students, and his participation in courses and continuing training periods.

CONDITIONS, OBLIGATIONS AND PROHIBITIONS IN RESPECT OF ADVERTISING

5.01. An occupational therapist may mention in his advertising any information likely to help the public make an enlightened choice and to promote access to useful or necessary services.

An occupational therapist must promote the preservation and development of professionalism in his advertising.

5.02. An occupational therapist may not, by any means whatsoever, engage in or allow the use of advertising that is false, incomplete, deceptive or liable to mislead.

5.03. An occupational therapist who, in his advertising, claims to possess specific qualities or skills, particularly in respect of his level of competence or the scope or efficacy of his services. shall be able to substantiate such claim.

5.04. An occupational therapist may not use an endorsement or testimonial concerning himself in his advertising.

5.05. An occupational therapist shall indicate his name and professional title in his advertising.

5.06. An occupational therapist may not engage in advertising intended for a clientele that is vulnerable by reason of the occurrence of a specific event.

5.07. An occupational therapist must avoid, in his advertising, all methods and altitudes tending to impute a mercenary or commercialistic nature to the profession.

5.08. An occupational therapist may not resort to advertising practices likely to discredit or denigrate anyone, including another professional.

5.09. An occupational therapist mus! keep a complete copy of every advertisement for at least 5 years following the dale on which it was last authorized to be published or broadcast. That copy must be given to the secretary of the Order upon request.

5.10. An occupational therapist who advertises professional fees or prices must do so in a manner easily understandable by persons without special knowledge of occupational therapy or the professional services covered by the advertisement and must :

(1) maintain them in force for the period mentioned in the advertisement, which may-not be less than 90 days after the last authorized broadcast or publication ;

(2) specify the services included in those fees or prices ;

(3) indicate whether expenses are included or not ; (4) indicate whether additional services not included

in those fees might be required.

However, an occupational therapist may agree with his client on an amount lower than the one advertised.

5.11. In the case of an advertisement relating to a special price or a rebate, an occupational therapist must mention the period of validity, if any, of the special price or rebate. That period may be less than 90 days.

5.12. In a statement or advertisement, an occupational therapist may not, by any means whatsoever, emphasize a price or rebate more than the service offered.

5.13. An occupational therapist who reproduces the graphic symbol of the Order for advertising purposes must make sure that it is an accurate copy of the original held by the secretary of the Order.

An occupational therapist who reproduces the name of the Order in his advertising must use the following formulation : member of the Ordre des ergotherapsutes du Qukbec.

September 1998

McGill University Health Centre Corporate Organizational Structure

Council for Services to Children and Adolescents

i

Assodale Executive Child and Adolescent Services

Senior Admln. Mncer MCH P. Sheppard

Director Informalion Servlws

J. Huot

Executive ~irector and Chief Executive Officer

H. Scott

I Corporate Seuelery and Legal Counsel

B. Cappel t OfRw of the CEO and

C. Maquls

Director of Quality and . f h k Management

M. Kaplow

Dlredor Professional and Hospllal Servicas

Senior Admin. Ofiicer RVH

Asot5ate Executive Dlmctor Planning and Strategic lnltiathres

N. Stelmnetz

President MUHC Fwndatlon

D. Taddeo

Director Human Resources N. Rinfret

- SdenUflc Dlrector Research lnsUtute

E. Skamene

Dlreclor Nursing Senior Admin. Officer MGH

V. Shannon

AssodaleExearthre~01 N e u m l o g l c a l ~

Senla Admln. ORlcer MNH J. Gates

Associate Medical

Dr. F. Chagnon

-Pharmacy (MUHC) -Rehabilitation Program (A) -Trauma Program (A) -SAAQ - Brain Injury Program -Clinical Depattmentr (MGH)

'Under nwiew (A)Adult

Designated MUHC I Transfusion Centre MNH Clinical I I 1 ( Departments 1

Associate Medical

RVH Dr. M. Marcil

-Montreal Cheat Institute -Clinical Dcpts. (RVH) -Allied Professionals(A) vPhyeiotherapy + Oocupationel Therapy + Clinical Nutrition + Social Services - Psychology * AudiologyBpeach

Pathology

Associate Hospital Associate Hospital Services

Director (1) Director (2) Ms; R Gmais M. R LegauY

-Laboratories (MUHC) -Diagnodic Radiology (MlJHC) -Cardiorespiratory Tech (A) -Radiotherapy (MUHC) -EIectrophysiology (A) -Nuclear Medicine (MUHC) *Pastoral -Radiation Safeiy (MUHC) 'Libraries -Biomedical Engineering (MUHC) -Food Services (MUHC) -Clinics (Adult) -Cardiology -MUHC Equipment Review Cmtc * Cath Lab -Medical Physics (MUHC) u Pacemakers u Echocardiology - ECO

Council

Associate Medical

Dr. C. Dupont -Infection Control ( U C ) -Clinical Pediatric Dcpts. -Pediatric Clinical Ethics -Pediatric Clinical Investigation Unit - MCH Clinical Labs -Pediatric Pharmacy -MCH Complaints Mgmt -MCH CPDP Cmtc's -MCH Residents' Office

Associate Director Hospital Services

Ms S. lkemblay

-Medical Records (MUHC) -Admitting & Discharge

(MUHC) -Clinical Perfusion (MOIUhfCli) Child & Adolesc. Amb. S m . -Audio-visual (MCWMOH) Child & Adolcsc. Biobchaviod Sciences Unit -Child Life Dcpt. -Pediatric Clinical Nuttition -Pediatric Diagnostic Scw. -MCH Pastoral Serv. -Pediatric Anesthesia Tcchs. -Pediatric Respintoly Thcnpy -MCH Social Work Dept. -Pc-clintric. Trrlltlnn Proprntn

O R G A N I G R A M M E

OCCUPATIONAL THERAPY SERVICES M. U. H. C. - ~ d u ~ t ~kwices

Dr. D. Roy, DPS v I Dr. M. Marcil, DPS Pdj. I

I

Madeleine Shaw, Dir. O.T. I

Montreal General I In-Patied SeTViOB8 3 FTE

Od-Patienls .5 FlE -

1 Tramtic Brain lrCy 1.4 FIE In-Patie* .6 FE

Geriatrics 1 FIE t MO~SXM a- I m ~ u g e y 1 FIE t t D S ~ mpital 1 FTE t MedicindSurgery .5 FTE

Crisis Intervention .4 FIE NeurdSlrgery 1.6 FIE L Vocational P.C.U. .5 FE Rehabiliation 1.3 FTE

General Psych Clinic .4 FTE MedicinelSurgary 1 FTE Geriatrics 1 FTE

Transitiin (L.T. PPs) .5 FE

t Geriatric Day Hospital 1 FIE

L ln-patient ~ e ~ i c e s 1 FIX f Respiratory (MCI) 1 FIE

L 0 . P . D . Hand Centre 1.5 FTE

POSITION DESCRIPTION

1. MANAGER OCCUPATIONAL THERAPY JOB TITLE NUMBER

sub-service: sub-service number:

division: Professional Services position number: RVH Budget 6880

2. JOB SUMMARY

Under the general direction of the Associate Director of Professional Services, the manager of Occupational Therapy is responsible for the development, facilitation, coordination, implementation and delivery of comprehensive Occupational Therapy services designed to meet the needs of the adult population and in line with the vision of the McGill University Health Centre. Also fosters an environment that encourages the development of staff, promotes clinical research and teaching but always putting the needs of our patients first.

3. MAJOR RESPONSIBILITIES

20% Responsible for ensuring excellence of patient care, teaching and fostering of clinical research by leadership in development, implementation and evaluation of Occupational Therapy services for the adult population of the MUHC through consultation and collaboration with others.

20% Ensures the best possible utilization of resources through effective organization planning and collaboration with other managers and staff.

20% Ensures by working in an equitable and transparent manner the ongoing integration of the different services across sites and sections (10) to harmonize the various practices to ensure consistency.

20% Ensures the provision of a program of clinical education for students and others as well as opportunities for staff growth and development.

20% Establishes and maintains effective lines of communication internally and externally in order to promote the services provided and the role of the MUHC to the community.

4 . & 5. GENERAL & SPECIFIC DUTIES

4.1.0 CLINICAL SERVICES

4.1.1 Creates in conjunction with staff a vision for Occupational Therapy Services. Consistent with the vision of the MUHC, provincial and national .

professional bodies, ensures that the MUHC OT Services assume a leadership role.

Formulates, in collaboration with staff, .the mission, philosophy and annual objectives for the service, consistent with those of the MUHC.

Defines, in collaboration with OT staff and other health care professionals, treatment priorities for the section in line with limited resources.

Consults with staff to ensure that OT treatment is appropriately integrated within the patients total care program and services

Collaborates with staff in developing standards of care to ensure quality and consistency across sites.

Promotes the development, implementation and evaluation of outcomes of Occupational Therapy.

Facilitates and encourages staff participation in research.

Receives and analyzes complaints and ensures corrective measures as necessary.

STAFF DEVELOPMENT/EDUCATION AND TRAINING

In collaboration with staff and/or student coordinator, approves the number of student placements to be offered.

Collaborates with the McGill School of occupational Therapy - clinical days, curriculum review committees, etc., to ensure the quality of clinical placements.

Collaborates with staff to ensure an effective learning environment for students.

Applies accreditation standards as appropriate and ensures they are met.

Plans and supports orientation of new staff and in- service education for all staff to ensure levels of competence within the various sections.

Promotes, encourages and supports as far as is possible within the resources available ongoing professional development for all staff.

Ensures that all staff receive supervision and coaching in order that standards of clinical performance are maintained and/or ensures their competency as the demands of the position evolve.

Develops and implements an effective performance management program.

Contributes to the education of other MUHC health care disciplines and their students.

RESOURCES

Determines the organizational structure of O.T. Services and analyzes staff utilization, staffing needs and allocation using workload data, staff input and budget reports.

Prepares, submits and controls the department budget; authorizes expenses and is accountable for resources allocated. Submits variance reports.

Submits requests for equipment - replacement or developmental.

Approves staff schedules and payroll.

In collaboration with Human Resources, ensures that all new staff meet department hiring criteria and have the qualifications to match job requirements; promotes and disciplines as appropriate.

Formulates, as appropriate, job descriptions and job standards.

Ensures that all staff , are members in good standing with the Ordre des ergoth4rapeutes.

Creates a mechanism of compiling and reporting in£ ormat ion (education, workload, student volume ) . Creates policy and procedures for the service so that they are current, relevant and accessible to all staff. Ensures their compliance.

Establishes effective internal and external communication channels.

Participates in committees and task forces of the MUHC which impact the various services and sections of Occupational Therapy.

Represents and responds to requests from professional organization on OT issues.

Participates in provincial and national associations to represent the MUHC, provide direction and/or enhance growth of the profess'ion.

QUALITY IMPROVEMENT AND RISK MANAGEMENT

Ensures a safe working environment for staff and patients.

Develops, maintains and evaluates ongoing quality improvement and risk management activities in keeping with the MUHC quality management program.

6. STANDARDS OF PERFORMANCE

Attainment of departmental annual and personal objectives.

Operates within the confines of the resources allocated.

Quality of patient care meets accepted standards and compares favorably with that of other institutions.

Monitors and provides feedback to staff.

Ensures a safe working environment.

Responds appropriately and in a timely fashion to directives and requests.

Maintains accreditation - national, provincial and successfully participates in hospital CCHSA accreditation.

7. SCOPE OF RESPONSIBILITIES

7.1 & 7.2 DECISION MAKING & COMMUNICATION

Accountable for all decisions related to the organization and provision of occupational therapy clinical services, policies & procedures and staffing of the various departments and sections of the MUHC.

Accountable for establishing and maintaining effective lines of communication within the various occupational therapy sections of the MUHC hospitals and the community, so that appropriate links are established.

Accountable for the provision of a comprehensive program of clinical education and for promoting research.

Accountable for all resources allocated to the services on all sites.

Represents the various sections (physical medicine, psychiatry, geriatrics, therapeutic recreation, etc.) on the various sites, by participating in committees, task forces, etc. - both in and outside the hospital.

7.3 INFORMATION AND DATA ON THE ADMINISTRATIVE UNIT 1998-1999

Total operating budget:

Occupational Therapy

Therapeutic Recreation

Occupational Therapy:

Total # of users

Total # of attendances

Total # of HPS

Total # Referrals

Therapeutic Recreation (RVH only)

Total # of Presence 3,698

* Excludes 1 F.T.E. - budgeted to G.D.H. (RVH)

. 5 F.T.E. - budgeted to P.C.U. (RVH)

7.4 SUPERVISION RECEIVED:

1 of 9 managers of Allied Health Professionals

Works autonomously, uses initiative, prioritizes .own work but seeks input and reports to the Associate Director on relevant matters through written and/or verbal reports on issues under his jurisdiction or as requested.

7.5 SUPERVISION EXERCISED:

Directly supervises all staff.

7.6 NUMBER OF EMPLOYEES SUPERVISED (FTE):

OCCUPATIONAL THERAPY NUMBER AND LOCATION OF EMPLOYEES M.G.H.

Main Department C2 In-patients 4.6 F.T.E. O.T. Out-patients 2 F.T.E. O.T. Support staff .8 F.T.E. Clerk TBI In-patients 1.4 F.T.E. O.T.

Psychiatry B4 & 5 In-pat ients 1 F.T.E. O.T. Out-patients 1.6 F.T.E. O.T.

Rehab Day Centre & Community Link Service Out -patients 2.8 F.T.E. O.T.

Griffith Edwards House Out-Patients 1.8 F.T.E. O.T.

Number of Employees

On Leave 1

15.2 F.T.E. O.T. 19 OTIS .8 F.T.E. Clerk 1 Clerk

TOTAL16.0 F.T.E. Total Employees 20

OCCUPATIONAL THERAPY NUMBER AND LOCATION OF EMPLOYEES R.V.H. Number of Employees

Main Department A3.20 In-patients 3.5 F.T.E. O.T. 4 Out-patients 2.5 F.T.E. O.T. 3 Support staff 1.5 F.T.E. Senior Clerk 3

Geriatrics M8.38 1.0 F.T.E. O.T. 2.2 F.T.E. T.R.S.

Geriatric Day Hospital Ross 4 1.0 F.T.E. O.T. 1

Montreal Chest Hospital 1.0 F.T.E. O.T.

Montreal Neurological Hospital 3.3 F.T.E. O.T.

Allan ~emorial Institute 3.3 F.T.E. O.T.

On Leave 3

15.6 F.T.E. O.T. 21 OTrs 2.2 F.T.E. T.R.S. 3 TRSr 1.5 F.T.E. Senior Clerk 2 Clerks

7.7 WORKING CONDITIONS:

The position is permanent full-time 35 hours per week.

The incumbent must be extremely flexible in order to respond to the needs and supervision of staff, deal with complex organizational issues within each of the 10 sections, effectively manage the overall resources, report as required, maintain effective communication links and represent the department both internally and externally.

QUALIFICATIONS

8.1 EDUCATIONAL: Qualified occupational therapist who is an active member of the national and provincial regulatory body.

Degree/Diploma in hospital administration.

8.2 WORK EXPERIENCE:

Minimum of five years clinical experience and two years in an administrative supervisory capacity.

Participation on professional committees, organizations.

8 . 3 OTHER:

Spoken and written English and French.

Excellent communication and interpersonal skills, multidisciplinary team player.

Proven leadership ability.

Excellent organizational and time management skills.

Innovative problem solver.

~nowledge/Understanding of budgeting process.

Knowledge of collective agreements and working conditions of unionized staff.

Excellent negotiating skills.

Extremely flexible.

9 , SIGNATURES

PREPARED BY:

AUTHORIZED BY:

REVIEWED BY:

Word/des.an

DATE :

DATE :

DATE :

POSITION DESCRIPTION

1. OCCUPATIONAL THERAPIST JOB TITLE NUMBER 1231

sub-service: Occupational Therapy

division: Professional Services

sub-service number: 0692

position number: Generic

2. JOB SUMMARY

Under the direction of the Manager of Occupational Therapy, the incumbent will provide a full range of occupational therapy services to adult clients of the MUHC, as well as delegated tasks in teaching and leadership within clinical programmes.

2.1 JOB OUTLINE

Person who conceives, defines and applies programmes of rehabilitation through therapeutic activity evaluates the progress of the beneficiaries, drafts observation reports and records the treatment given in the beneficiary's file. (Translated from collective agreement).


*80% Develops and provides patient evaluation and direct care. Plans, liaises and consults with client, family and team.

10% Provides training of students and consults with colleagues.

10% Performs other related duties including non patient care activities and delegated tasks.

GENERAL DUTIES

Evaluates patients referred for Occupational Therapy.

Develops a treatment plan with the client and outlines specific interventions.

Involves the client,family in the plan when appropriate.

Collaborates with team members to formulate and facilitate the treatment and/or discharge process.

* % Negotiated pending on the position

Ensures (as far as possible) that patientts safety upon discharge is not compromised.

Documents relevant findings and OT interventions in the medical dossier, based on charting policies, standards and guidelines of occupational therapy practice. Maintains and submits accurate daily statistics reflecting patient and non patient care activities.

participates in ongoing departmental activities mandated to promote the wellbeing of patients and their families, the staff and the MUHC.

Responsible to provide supervision of OT students (clinical training) and to other allied health care professionals.

Responsible to maintain professional competence through participation and active involvement in continuing education.

Provides coverage as needed.

Responsible to work and treat patients in a safe environment free from hazards.

Develops effective relationships as a member of a multidisciplinary team (clinical and departmental).

Assumes special responsibilities as delegated that promote and enhance the professional role within the institution and/or specific patient population.

SPECIFIC DUTIES

Develop a treatment plan in collaboration with interdisciplinary team.

Provide a leadership role in the innovation of OT treatment for patients.

Provide specialized expertise for OT staff requiring consultation, teaching or training.

6. STANDARDS OF PERFORMANCE

1. Ability to articulate the role of the OT and findings within the context of a multidisciplinary team in a large tertiary care facility.

2. Attainment of annual objectives.

3. Quality and quantity of patient care meets standards expected (chart and statistic audits).

4. Responds appropriately and in a timely fashion to directives and requests.

5. Demonstrates interest and ability (within the context of clinical expertise) to participate in research, publication,

. . presentations and teaching.

6. Responds to peer review.

7. Works autonomously, but acknowledges limitations, and acts appropriately.

7. SCOPE OF RESPONSIBILITIES

7.1 DECISION MAKING

Initiates and prioritizes own work.

Operates within professional scope autonomously, while consulting a Senior Therapist and/or OT Manager.

Makes decisions which impact on OT services to patients, families and on the MUHC.

7.2 COMMUNICATION/CONTACTS

INTERNAL: Physicians, multidisciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources

7.3 INFORMATION AND DATA ON THE ADMINISTRATIVE UNIT

Reflects area of work - to be determined for each job.

7.4 SUPERVISION RECEIVED

Reports directly to the Manager of Occupational Therapy.

New staff or staff new to a service will be monitored by another therapist.

7.5 SUPERIVSION EXERCISED

Direct: As delegated by the Manager of Occupational Therapy

7.6 NUMBER OF EMPLOYEES SUPERVISED (FTE)

N/A

7.7 WORKING CONDITIONS

8.0 QUALIFICATIONS

8.1 EDUCATIONAL

Bache lo r o f S c i e n c e i n Occupa t iona l Therapy o r e q u i v a l e n t Member i n good s t a n d i n g w i t h l f O r d r e d e s Ergothe-rapeutes du Quebec

8.2 WORK EXPERIENCE

To be d e t e r m i n e d .

8.3 OTHER

F l u e n t i n b o t h spoken and w r i t t e n French and E n g l i s h .

Ref\a\jobdescriptions.ot

April 13, 2000

2 . STUDENT COORDINATOR - JOB SUMMARY (cont . )

In addition to the above, the incumbent is responsible for the coordination of the clinical education programme of the

section at the This includes the orientation to Occupational Therapy, hospital clinical experience and/or academic training of the : 1) Occupational Therapy students enrolled at McGill

University. 2) Occupational Therapy students from outside the

province (including foreign students) - the placement being approved by the McGill Clinical Coordinator.

3) High School/CEGEP/career day activities. 4) Volunteer placements.


8 5% (1.5 hours per week of clinical responsibilities) 0 Clinical Education Program: Identifies and analyzes the needs of students and staff, develo6ing a comprehensive clinical education program.

5. SPECIFIC DUTIES

1. To collaborate with staff in developing a student contract for each level of student.

2. To develop and review policies and procedures pertaining to the clinical education program.

3. To orient students, volunteers, visitors to the department and hospital.

4. To collaborate with staff in planning of placements. 5. To organize treatment evaluations/demonstrations if

necessary and when possible. 6. To mediate any conflicts which may arise with students

during placements. 7. To assist staff as requested in the evaluation of a

student and in documentation of reports. 8. To evaluate the feedback from staff and students,

develop and implement remedial action as required. 9. To participate in all meetings at McGill pertaining to

the clinical education program and to act as a liaison between McGill and the Department.

10. To review and revise as appropriate the student handbook and ensure compliance with FESAP requirements.

11. To meet as required with Department Head to discus's the clinical program, review activities and problem areas.

6.STANDARDS OF PERFORMANCE

Submission of student evaluations to the University within 5 days of the end of placement. ~evision/review of student handbook and Policies and Procedures pertaining to the clinical education program. Submission of annual report and/or other reports requested by Department Head. To include: a) List of students, level, therapist, area of

placement, dates, total number of hours of placement, total number of hours completed by the student.

b) Analysis of student and staff feedback. C) Recommendations.



TITLE: PROFESSIONAL DEVELOPMENT

POLICY:

The MUHC is committed t o improving the skills and knowledge of employees, to enhance their contribution to patient care, as well as t o increase employee job satisfaction and development. The employee is equally responsible (see code of ethics and job description) for self-continuing education to ensure competence and develop proficiency in the therapeutic areas of their profession. It is therefore, expected that all staff will attend and participate in the educational inservice program within the department as well as attend continuing education programmes offered to professional groups internal and external t o the institution.

When possible, each FTE is allowed five days paid study leave per annum. This is not a union policy and may be rescinded. Approval t o attend a course must be granted by Department Head. Limited funds are sometimes available t o assist staff, but usually the "time off" will be paid.

Focus for staff development and allocation of resources (pending availability) is dependent onlidentified through QA activities, performance appraisals and hospital and department needs.

PROCEDURE:

1. Each section of the department will maintain a list of ward rounds and meetings. Participation is encouraged when time away from patient treatment permits. Time spent attending ward rounds will be documented daily according to the Stats policy of the department.

2. All staff attending staff training, seminars, lectures (informal internal t o the institution) will record time in stats and if required complete the necessary forms for Bill 90.

3. All staff wishing to attend formal courses (usually with cost and time implication) should be prepared t o present the material at an in-service education session or arrange a series of lectures. Time off t o attend a course must be submitted in writing.

4. The Department Head is responsible for the compilation and reporting of educational activities.

PAGE: 1 OF: 1

SECTION: 8

TEACHING1

EDUCATION1

PROF. DEVELOPMENT


POLICY 1 PROCEDURE #: 8.3

REVISED DATE

YEAR DATE

20

YEAR

2000

MONTH

01 MONTH DATE



PAGE: 1 OF: 1

TITLE: SUMMARY OF CLINICAL ACTIVITIES - ACTIVITY REPORT

EFFECTIVE DATE REVISION # REVISED DATE SECTION: 1 ADMINISTRATION1

ORGANIZATION

POLICY I PROCEDURE #: 1 . I 1

!

I

POLICY:

Occupational Therapists are expected to complete an annual activity report, reflecting their professional growth and development in the past year. This will become part of the employee's file and can be accessed by staff at any time.

Centre universitaire de sante McGill McGili University Health Centre


TITLE: PROFESSlONAL lNSPECTlON

POLICY:

The OEQ is responsible t o ensure the competence of its members, which is undertaken through professional inspection.

PAGE: 1 OF: 1

SECTION: 9 QUALITY

ASSURANCE


POLICY / PROCEDURE #: 9.1

REVISED DATE

YEAR

2000

YEAR MONTH

03

MONTH DATE

20

DATE

The Montreal General Hospital Physical Medicine Section

External Courses Attended by Staff

Champoux Traumatologie : Defis Qc City

Champoux, Colloque : La prise en charge des Montreal Christopher personnes blessees medullaires

traumatique

Couturier Multiple Sclerosis - Focus on Rehab

Montreal

Newman Assurance de la Qualite et Montreal Credibilite Professionnelle

Newman

Newman

Krug, Couturier

Christopher

Newman, Krug, Couturier

Assessment of Motor and Process Skills (AMPS)

Canadian Assoc. of Geriontology Conference

Stroke Management : Ethical Considerations and Issues for the New Millenium

3rd World Congress on Brain Injury

McGill Clinical Research Day

Montreal

Ottawa

Montreal

Montreal

Montreal

Internal Courses Attended by Staff - MGH 1999-2000

All Staff (Physical Medicine and Psychiatry) participated in :

1. Cardiopulmonary Resuscitation Course Half day course

2. Tournee de la Presidente L'Ordre des ergotherapeutes du Quebec 3-hour Presentation by Fran~oise Rollin-Gagnon, Presidente Organized by Madeleine Shaw

Membership of Staff in Special Interest Groups

Dysphagia - RVWMNHIMGH Group Cancer in Rehab Group OT working with TBI (regroupement des ergotherapeutes) Hand lnterest Group (with other hospitals) Monthly hand meetings MGHIRVH

Occupational Therapy i n , s e ~ i ces April 111999 - March 3112000 -

May 1811 999

June 111999

ICU Monitors - Part I by Sylvain Richard, RN 1 hour

ICU Monitors - Part II by Sylvain Richard, RN 1 hour

1 hour June 1511 999 OT Journal Club

July 611 999 Charting Guideline Presentation by Janie Rosen 1 hour

Oct 1211999 Leika LtdlTherapeutic Surfaces by Danielle L'Ecuyer 1 hour

Nov 911 999 (MGHIRVH)

Trail Making B by Elaine Deguise

Driving Evaluation by Celine Couturier and Marie-Claude Champoux 1 hour

1 hour Nov 2311 999 I.V. Pumps, Feeding Pumps & Mini-Infuser

by Nancy Tze, RN

Nov 3011 999 (MGHIRVH)

Dysphagia at lnstitut universitaire de geriatric de I'U de Mtl by Marie-France Jobin 1 hour

1 hour

1 hour

AMPS Course by Julia Newman

Dec 2111 999

Jan 1912000 (OTIPT)

CSST Information by Denis Gravel

Feb 1812000 New Student Evaluation Fonn by Julia Newman 1 hour

1 hour March 912000

March 2112000

2nd Part of Student Evaluation Form by Julia Newman

Box & Block Manual Dexterity Test by Celine Couturier

Supewision of Students by Marie-Claude Champoux 1 hour