montreal general hospital - mental health - (part1)

Fieldwork Site Profile (FS-PRO): Learning Opportunities and Resources 1

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

Site and Contact Information I

1 Name of site: Montreal General Hospital

I I I Name of programhector: Adult Psychiatry

f l

Name of contact person: Hiba Zafran

Title of contact person: Staff Occupational Therapy, Clinical Coordinator of Education

( Address: 1650 Cedar Ave. -0T dept. C2-150 I I Montreal. Quebec I I

Phone': ((514) 934-1934 ex.34168 Fax*: (514)934-8371

E-mail address': [email protected]

I Web site: nla I 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 MlJHC 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

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

University Fieldwork Committee (UFCC) ,

the Association of (2005 revised edition)

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

Copy and complete for individual location or program as appropriate.

Name of program / site: MGH-PSYCHIATRY (if different from page 1):

Characteristics of Occupational Therapy Services:

1. Occupational therapy services are organized on: an O.T. department basis IXJ a program basis

IXJ No O.T. on site other:

Contact infonnation if different from page one:

Description (e.g. the mission and vision of your organization, occupational therapy philosophy and role of occupational therapy within your organization): The MlJHC represents the first and largest voluntary merger of university teaching hospitals in

Canada. The partners include the McGill University Faculty of medicine, four institutions servicing adult patients (Montreal General Hospital, Royal Victoria Hospital, Montreal Chest lnstitue and the Montreal Neurological Hospital) and the Montreal Children's Hospital. The vision of the MUHC consists of a facility offering care of the highest quality to patients of all ages and offering ontinuity of care across setting in the health network. The patient and family are central to the way care is organized. They are encouraged to participate actively in the healing process. Patient care is coordinated by multidisciplinary teams working to treat patients with increasingly complx problems.

Location of occupational therapy services in the building:

Main Building- A4. 188 Inpatient

Rehab Day Center- Community Link Service

-McConnel Building

Addictions Unit- Grifith Edward House

Transition Day Program A2 MGH

Community Link Service. Birks House.

Crisis Service and Anxiety Disorders. AM1 P2

Occupational Therapy Philosophy OT services are offered in a person centred model, with an emphasis on collaborative decision-

making within interdisciplinary teams. Service values include hope for recovery and empowerment.

Program Description The McGill University Health Centre is a tertiary, acute facility, which employs over 40

Occupational Therapists in the adult sites. While the majority of positions are permanent full- time, some staff are part-time and temporary. OT's are members of a variety of multidisciplinary teams and they work closely with other health care professionals to facilitate prompt and appropriate discharge of patients, back to their homes and/or to other health care institutions in the community, depending on their needs/level of independence.

A large portion of treatments are evidence based and a large variety of standardized evaluations are utilized as part of objective evaluations completed on patients referred.

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

I 2. System(s) I services in which you practice: IXI Public sector [7 Private practice

[7 Rehabilitation centre (XI Outpatient clinic IXI Hospital [7 Long term care centre (XI Home care Day hospital [7 Insurance industry (XI Community setting [7 School

[7 Other:

I 3. Occupational therapy roles: IXI Direct care (XI Indirect care IXI Consultation [XI Research

IXI Administration (XI Other: Teaching

4. Client life span: [7 Children Adolescents (XI Adults (XI 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 . Mood, emotional and behavioral regulation

2. Stress management

3. Social functioning (interpersonal, public transport, leisure)

4. Community functionning (budgeting, public transport, leisure)

5. Academic and vocational rehabilitation

6. Basic ADL

7. Substance abuse and dual diagnosis

8. Illness management

9. Substance abuse

Most frequently seen disgnostic illnesses

-Psychotic disorders

-Mood disorders

-Anxiety

-Spectrum of DSM IV Psychiartric Illness

6. Occupational therapy focus:

Please describe common areas of practice, interventions and programs :

PRACTICE (Frame of Reference)

- Psychodynamic

- Developmental

- PEO

- Boston University Psychiatry Rehabilitation Model

- Psycho-education

- MOHO

INTERVENTIONS

-Verbal and Activity Group Therapy

-Individual evaluations and assessments

-Community Re-integration

I -Social and Assertiveness training I I -Case management I I -Cognitive behavioral therapy I I -Motivational interviewing I I -Addictions counseling I I I I -Cr~s~s management

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

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Two full-time Occupational Therapists work as members of a multidisciplinary team to provide assertive community treatment for those patients suffering from severe and persistent mental illness. The Therapists use a case management approach with the goal of stabilizing symptoms, improving functioning, enhancing integration within living environment and broadening access to services while concurrently working with families, landlords, police and legal system where indicated, and with a variety of community resources and support services.

BORDERLINE PERSONALITY DISORDER CLINIC (MGH)

The occupational Therapist works part-time within a multidisciplinary team. Shelhe assesses cognitive, functional and interpersonal skills and assists clients managing their stress and emotional intensity, balancing their lifestyle and setting realistic goals both in the groups and individuality. The OT also serves as a primary care therapist offering a case management approach for apart of the clients census.

Site

7. Hours of operations: 8 - 5 Mondav - Fridav

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

Full Time: 3 Part Time: 7

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


Learnir~a O~~ortuni t ies and Resources for Students:

1. Access to a library (either on or off-site) : 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): -Hospital medical library 6th floor, Psychiatry library 4 east -Ward rounds, inservice education, grand rounds -Community and government services -Home visits -Psychodynamic interviews -Regroupement des Ergothdrapeutes en Santd Mental de la Grands Rdgion Mdtropolitaine -Visits to other services in psychiatry -Videos and discussions -Meeting with other health care professionals

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.

Please see attached CONTRACTS2 Services- Addictions and Community Link require students with a high level of maturity and autonomy due to the populations severity of illness and nature of interventions.


Site:

Administrative Resources:

1. Orientation session offered upon students arrival:

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

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

- Desk and chair in supervisor's office

- Access to computers, secretarial assistance and any other department resources

3. Policies and procedures information available:

(XI yes, location: MGH C2-150

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

4. Health and safety policy in place:

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

5. Emergency procedures information available:

(XI yes, location: MGH C2-150


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


yes. Please outline its major characteristics:

Supervisory Contingency Plan

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 long term absence from the supervising therapist (longer than 5 days) the student's supervision and evaluation will be reassigned to one of the other occupational therapists.

I


I Site:

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


(XI yes. Please outline its major characteristics:

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 Department Policy and Procedure on Professional Development.

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

3. In addition to the above, on a personal basis one staff is pursuing an MBA.

4. In-services in OT dept.

5. Financial support is available through bursaries awarded by MIJHG-M.D.C (multidisciplinary council, OT Dept., Education Budget ect.)

6. Attendance at rounds

7. Ongoing critical review of all programs in interdisciplinary committees

8. New Programs and Changes to current practices within the MUHC, psychiatric program must be E.B.P. based

- Standardized assessments

- Case management

- Assertive community interventions

- Recovery and illness management model

- Cognitive behavioral therapy

- lntergrated dual diagnosis

- Cognitive rehablitation

Administrative Resources (continued):

I

I

6

I

I

I

I I I I

I I

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I Site:

Amenities Available to Students:

1. Cafeteria: (XI yes no

2. Kitchen facilities: IXI microwave oven €3 refrigerator (XI other: stove

3. Locker: yes IXI no

4. Bicycle rack: (XI yes no

5. Parking: yes, cost: $1 5 a day

6. Public transportation available: (XI yes no

7. Other (please list):

(e.g. accommodation for students)


Site: I

Site Requirements for Students:

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

2. Criminal I police record check: yes [XI 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 [XI no

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

Please specify additional information andlor requirements (e.g. mask fit testing):

No jeans, no bellies!

Professional attire (e.g. no cleavage, no see throughs, no flipflops, no shorts, no halter tanks,

minimal jewllery)

Immunization as per University Policy

Message to Students: I

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

1. Reports: At mid term you will be expected to give verbal feedback to your supervisor. For the final report you will EXCHANGE reports with your supervisor. You will, PRIOR TO THIS MEETING, have completed and printed a copy of the McGill evaluation as well as the department evaluation. The department appreciates receiving honest feedback so we can improve the learning opportunity and your honesty cannot inlfuence your report, as it has already been written.

1 2 Review of all psycho-social and course material (including group dynamics)

1 3. -Hours: 8:30 - 4:30 Mon-Fri

1 -Metro: Guy-Concordia. Bus 165

I Atwaterl Sherbrooke. Bus 144

PLEASE CALL OR E-MAIL CLINICAL CO-ORDINATOR OF FIELDWORK AT LEAST ONE WEEK PRIOR TO START OF STAGE TO ENSURE YOU ARE EXPECTED.

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


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:

Profile completed by: date: (Name and title)

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

IXI my affiliated University IXI 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:


STUDENT CONTRACTS

1. In-patients 4 east- U1,2,3

2. Rehab Day Centre- U1,2,3 .

3. Transition Day Unit- B.5- U 1,2,3

4. Community Link- U2,3

5. Addictions- U2,3

Refld:st/mgh/fesap/studcnt contracts

MONTREAL GENERAL HOSPITAL Occupational Therapy Department

In-Patient Psychiatry-4E Student Contract

U-1 level

The first week of the placement consists of an orientation to the hospital and to the department, as well as an observation period.

The student is expected to meet the following requirements during her/his placement on 4-E.

The student will familiarize with the department and the clinical setting. The student will project a professional image in the manner of dress and behaviour. The student will formulate personal objectives that shehe would like to achieve during herhis placement. The student will begin to experience and participate in self-evaluation, providing and receiving feedback with supervisor. The student through observation and participation, will begin to speak effectively with the team members, clients, and family members under the close supervision. The student will begin to familiarize herselYhimself with various psychiatric conditions and diagnoses. The student win read educational material. The student will observe different evaluations and assessments such as HTP, KELS, ACLST, etc. The student will observe groups and may assume a co-therapist role under the close supervision in group therapy. The student will analyze and select appropriate activities for 2-3 clients. The student will be able to write initial and progress notes with assistancelsupervision. The student will share the responsibility fot a partial client case load under the close supervision of tbe therapist (2-3 clients). The student will attend team meetings. The student will participate in various psychiatry department educational oppotunities such as Grand Rounds. The student will visit various psycbiatry clinics (in-pt/out-pt) to learn more about role of OT.

I agree with this contract and any questions I bad have now been clarified.

Student: Date :

Supen-isor: Date



U-2 level

The student is expected to meet the following requirements during her/his placement on 4-E.

The student will familiarize with the department and get a feel of daily OT routine. The student will formulate personal objectives that shelhe would like to achieve during placement. The student will attend team meetings. The student will observe supervisor's clients (emphasis: therapist's interventions and Rx. plans). The student will read educational material. The student will receive and respond to constructive questiondfeedback The student will complete statistic sheets with minimal assistance. The student will exchange with other disciplines. The student will give verbal report at team meetings. The student will participate in various psychiatry department educational opportunities such as Grand Rounds. The student will participate and co-leadoead OT groups. The student will conduct specific OT evaluations such as HTP, and KELS. The student will write initial assessment notes, maintain regular progress notes, and discharge notes with assistance/supervision. The student will record statistics with minimal supervision. The student will complete a project. The student will be able to present one case shehe has followed in treatment.

I agree with this contract and any questions I had have now been clarified.

Student: Date :

Supemisor: Date


In-Patient Psyc hiatry-4E Student Contract

U-3 Level

The student is expected to meet the following requirements during herlhis placement on 4-E.

The student will familiarize with the department and get a feel of daily OT routine in the shortest time possible. (Different opportunities to observe assessment procedures and treatments will be provided.) The student will practice in a professional manner. The student will formulate personal objectives that shehe would like to achieve during herlbis placement. The student will make observation notes on supervisor's clients during the first week. The student will read educational material. The student will independently perform client assessment and review results with supervising therapist. The student will independently plan and set client treatment goals, and reviewing them with supervisor. the student will independently carry out treatment, incorporating a variety of treatment techniques. The student will participate and co-leadllead OT groups. The student will attend and participate in team meetings and report on herhis clients. The student will make and maintain initial, progress, and discharge notes. The student will participate in various psychiatry department educational opportunities and visit various psychiatry clinics. The student will independently record statistics. The student will complete a project. The student will present one case shehe has followed in treatment.

1 : I agree with this contract and any questions I had have now been clarified.

I I Student:

Date :

Supervisor: Date . .

THE STUDENT 1s EXPECTED T O MEET THE FOLLOWING REQUIREMENTS DURING HISMER PLACEMENT AT THE MONTREAL GENERAL HOSPITAL'S PSYCHIATRY REHABILITATION DAY CENTER

The first week of the placement consists of an orientation to the hospital and to the department, as well as an observation period. The length of time attributed to the observation period and progression of the clinical placement depends on the student's previous clinical experience, therefore the time frame may vary for each individual.

1 By mid-term the student will develop an effective communication with therapists, team members, and will interact with patients. By the end of the placement students should begin to display a sense of identity as future O.T.'s.

2. The student will project a professional image in the manner of dress and behaviour.

3. The student will develop and utilize observation skills.

4. The student will show initiative in learning about the different client's diagnosis.

5. The student will show initiative in trying different evaluations and tests such as COPM, 'YaFPE , Pre-vocational Rehabilitation Potential, Dimock groups evaluations.

6. The student will be aware that standardized norms exist for particular assessments.

7. The student will analyze and select appropriate activities for at least one patient considering the value and meaning of client's interests and activities.

8. The student will be able to write one initial note and one progress note with assistance or supervision.

9. The student will help to maintain the O.T. activity areas in an orderly manner.

10. The student will attend staff meetings in-services and multi-dbciplinary meetings when indicated.

1 I . Students should begin to recognize their future professional responsibility for training students.

12. The student will be evaluated only at the end of the placement by the supervising therapist but will meet regularly with the supervisor for feedback.

I AGREE WITH THIS CONTRACT AND ANY QUESTIONS I HAD HAVE NOW BEEN CLARIFIED:

STUDENT: ............................................ " ................. DATE:

SUPERVISOR: ........... . .................................... -.......DAm

Student Contract U-2 Level & U-3 Level

The student is expected to meet the following requirements during hisher placement at the Montreal General Hospital's Psychiatry Rehabilitation Day Centre. . .

1. will meet the requirements of a year O.T. student as stated in the evaluation guide From McGill University. The criteria will be reviewed by , hisher supervisor. to clarifj. the requirements.

2. By mid-term, the student is expected to have prepared one initial note with minimal supervision. By the end of the '

placement. helshe will have written 1-2 progress notes on two patients (followed by himher under supervision).

3. By mid-term, the student will have written 1-2 STRAP notes with supervision, and by final evaluation independently.

4. By mid-term, the student will have started a COPM evaluation and by final, will have completed one assessment report with problems and will plan independently. .

5. The student will participate in team meetings (both at the Day Centre and with the Continuing Care team*) and goal planning when patients helshe follows are being discussed. i:

6. The student will participate in patient groups - co-leading by mid-term (with minimal supervision) and by fml, leading at ; least one group independently.

7. The student will accompany the O.T. on h&t visits. By mid-term hdshe will make observations about home visits and by i tinal identify needs and make appropriate refeds, if applicable.

8. The student will attcnd Grand Rounds, OPD Rounds, as well as one meeting of Regroupement Des Ergs m Santd Mentale. .

9. Additional evaluations:

By the end of the placement, the student will have been exposed to one of each of these evaluations with minimal supervision: +

Meal Preparation course evaluation, Pre-vocational rehabilitation potential, and Dimock group interaction. As well. he/she will be using projective and creative media in OT workshop as a basis for evaluation and treatment planning, and as a way to identij. the patients needs to then modifL activities to create functional and behavioural changes. . .

10. Final: The student will be able to present one case heishe has followed in treatment. The presentation will include a case i. histcwy, problems and plan as well as treatment modalities.


Student: Date

Supervisor: Date

*Note: The opportunity to complete all of these aspects may vary due to patient population and individual need. The same contract will be utilized for U-2 and U-3 students. One would expect a qualitative difference in ability.

file: C:~sara\connact.wpd

MONTREAL C E N E W HOSPITAL

TRANSITIONAL DAY PROGRAM (TDP) STUDENT CONTRACT

U - 1 Level

The student is expected to meet the following requirements during hisher placement at the TDP.

1. The student will begin to speak effectively with team members. Will also interact with patients and learn about maintaining boundaries and limit setting.

2. The student should feel fairly comfortable by the end of placement with TDP routine. This includes their role as OT students/future helping professionals.

3. The student will project a professional image in terms of dress and behavior, including punctuality and responsibility. -

4. The student will begin to develop observation skills. By end of placement will be able to write observation notes (with &istance) on slipemsor's pati&.

*

5. The student will be able to write 2-3 progress notes with assistance (wk. 5-6).

6. The student will observe groups led by all disciplines on TDP and practice group observation skills in discussion with supervisor.

7. Thestudent will begin to familiarize self with various psychiatric Eonditions/medications/siW and symptoms.'

8. The student will visit one community resource.

9. The student will participate in various psychiat~~ department educational opportunities. Will visit various psychiatry clinics (in-ptlout-pt.) to learn about role of O.T.

I I agree with this contract and all questions I had have been clarified.

1

i Student: Date:

Supervisor: Date: I I

MONTREAL'GENERAL HOSPITAL


U - 2 Level

The student is expected to meet the following requirements during hidher placement at the TDP.

1. The student will get a feel of daily TDP routine.

2. The student will participate in team meetings making observations on supervisor's patients (wk. 1-2) then proceeding to hidher own.

3. The student will write observations notes on supervisor's patients (wk 1-3) then proceed to progress notes.

4. The student will prepare data gathering with supervisor prior to a team assessment (wk. 1- 3) then proceed for any new patients (not

5. The student will observe team assessments and participate under supervision.

6. The student will plan patient treatment and set goals (weekly + longer tenn) with supewisor.

7. The student will follow 1-2 of supervisor's patients with supervision including regular individual sessions indepently (wk. 4-6)

8. The student will assume a co-therapist role in O.T. run groups, including planning and leading (wk 4 +)

9. The student will lead 1-2 groupsiwk independently by wk. 5-6. Groups being physical activity andlor leisure group.

10. The student will visit 1 or more community resources.

1 1. The student will participate in various psychiatry department educational opportunities and clinics.

12. The student will be more familiar with various psychiatric conditions and medications.

13. The student will formulate personal objectives that he/she would like to achieve during placement.

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:. MONTREAL GENERAL HOSPITAL


U -3 Level

. .. . . The student is expecting to meet the following requirements during his/her placement at the TDP.

Weeks 1 to 3; The student will: . .?

1. Get a feel of daily TDP routine (wk. 1).

. . 2. Attend and participate in team meetings and report,observations on supervisor's patients

(wk. 1-2) and patients helshe follows (wk. 2 +). .. .

3. Make regular obsewation notes on supervisor's patients (wk. 1) then proceed to progress notes on hidher patients.

4. Data gathering prior to a team assessment (wk. 1 +) then write up of initial assessment (wk. 2-3).

_ .. : . . . ~ .. I .

5. Participate in a team assessment. . .

6. Participate and co-lead O.T. nm groups

. ,. 7. Participate , in all groups run by the various TDP professionals. (wk. 1).

. .. .. , , , . ';. ' .... . . . .... -. ..

.,. . . , . ... . 8. Participate in various psychiatry'depamnent educational opportunities and visit various . ,,

psychiatry clinics (in-ptJout-pt.)

9. Visit one or more community resources

10. Learn to deal with "daily crisis".

1 1. Formulate personal objectives that he/she would like to attain during placement.

eeks 4 to 6; The student will:

1. Follow 1 to 3 patients (evaluation and treatment including individual sessions at least 2 2dweek).

2. Co-lead'a team assessment of a new patient.

3. ~rep&e and lead O.T. run groups (2dweek).

4. Maintain regular progress notes. write initial assessment notes and transfer notes.

5 . Conduct specific O.T. evaluation (BaFPE, community living skills, etc..).

6, Liaiw with case managen, community workers, family members and significant others.

7. Complete a project to benefit TDP.

1 agree with this contract and all questions I had have been clarified.

Student: Date:

Supervisor: Date:

U-2 AND U-3 LEVEL

The student is expected to meet the following requirements during hisfher placement at the Montreal General Hospital's Community Link Service.

1. will meet the requirements of a year O.T. student as stated in the evaluation guide from McGill University. The criteria will be reviewed by hisher supervisor, to clarifL the requirements. 2. The student will participate in team meetings, case reviews and family meetings. 3. The student will participate in group therapy and will co-lead by end of placement. 4. The student will accompany supervisor on home visits. By mid-term, the student will

do home visits independently. 5. The student will attend Grand Rounds, O.P.D. Rounds, as well as at least one external

meeting (RESMM, AM1 Quebec, "Comite itin&anceW, etc.. .) 6. The student will identify patient's needs and set treatment goals. 7. The student will write regularly progress notes as well as fill in statistic sheets. 8. The student will visit community resources. 9. The student will have contacts with governmental agencies (e.g.: welfare office,

RAMQ, RRQ, CSST, IVAC etc.. .) 10.The student will work in collaboration with members of the team as well as with staff

of other discipline (e.g.: pharmacist, dentist, G.P, optometrist, police, etc.. .) 1 1 .The student will learn about psychiatric medication (name, indication, side effects,

dosage) 12.The student will take initiative, set priorities, manage time autonomously and fulfill

responsibilities. 13.The student will administer one of these evaluations by end of placement: BAFPE,

PECCA, and Pre-vocational rehabilitation potential. As well he/she will analyze results and write assessment reports.


Student: Date:

Supervisor: Date:

*Note: The opportunity to complete all of these may vary due to patient population and individual needs. The same contract will be used for U2 & -U3 students. One would expect a qualitative difference in ability. In return, the student can expect the following fiom hisher supervisor.

1) Will orient student to working environment and team members.

2) Will have educational material available (articles, videos) and will inform student of upcoming presentations, teaching sessions (Grand Rounds, O.P.D. Rounds, etc.. .)

3) Will orient student to the policies and procedures of the department in relation to charting, confidentiality, ethics, etc.. .)

4) Will clarifL objectives of placement

5) Will model professional behaviors and skills

6) Will provide direct, concrete and frequent feedback

7) Will provide access to people and information

8) Will give space and support to allow student to develop professional knowledge, skills, identity and attitudes

9) Will read, correct if need be, and countersign all written material . .

10) Will encourage student to progress from comfortable situation to challenging areas

11) Will allow student to work independently as much as possible

12) Will be available to answer questions and explain clinical interventions

13) Will provide student with as much opportunities as possible for h i d e r to achieve objectives of placement

Student Contract

U-2 Level or U-3 Level

he stbdent is expected to meet the following requirements during his/her placement at the Montreal General Hospital's Addictions Unit:

1. will meet the requirements of a - year O.T. student as stated in the evaluation guide from McGill University, the criteria will be reviewed by

, hislher supervisor, to clarify the requirements.

2 . By mid-term, the student is expected to have prepared observation notes on the patients assigned to him/her; he/she will have written 1-2 progress notes on four-five patients (followed by him/her under supervision).

3 . By mid-term the student is expected to complete an Initial Assessment on a new patient to the Unit, and to present the case history to the supervising Psychiatrist.

4. By mid-term the student is expected to have covered the assigned reading material and presented his/her knowledge of these subjects to hisjher supervisor (s) in the weekly sessions scheduled.

5. The student will participate in patient groups - co-leading after midterm in respect to group therapy and by midterm in respect to task oriented groups.

6. The student will participate in team meetings (Monday and Thursdays) to discuss patient progress and goal planning.

7 . . Student is expected to attend Grand Rounds on Friday mornings, and when available attend sessions run by therapistsother than o.T.,s in the Unit.

3 8. By end of placement, student will have been exposed to each of the above procedures and expected to perform with minimal supervision.

9. Student will be expected to present a case history with goals of treatment, and recommendations or a short paper on a subject relevant to hisjher placement by the end of the stage.

I agree with this contract and any questions I may have had, have now been clarified.

Student : Date:

Supervisor (s) : Date:

Centre universitaire de santt McGill McGill University Health Centre

*', .

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MUHC

EFFECTIVE DATE REVISION # REVISED DATE SECTION: 8 TEACHING EDUC. & PROFESSIONAL

06 DEVELOPMENT

I TITLE: PROFESSIONAL DEVELOPMENT POLlcyl #: 8.3 I

POLICY: The MUHC is committed to irnproving the skills and knowledge of employees, to enhance their contribution to patient care, as well as to increase employee job satisfaction and development. The ernployee 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 prograrnrnes offered to professional groups internal and external to the institution.

PAGE: 1 OF: 2 I

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).

. .

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".

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.

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.

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

Staff are encouraged to apply for Grants and Bursaries.

1) Gustav Levinschi Foundation Award: Aim -to provide funds for staffing, equipment or other materials

( /- 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 . .

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.

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

. .

*Laidley - if requesting geriatric or ophthalmology

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 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.

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.

OCCUPATIONAL THERAPY PROFESSIONAL DEVELOPMENT

2005 - 2006

GRAVEL, S. ANNUAL MEETING DY SPHAGIA 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 1 TH 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

MCGlLL

MNI

MONTREAL

HUI, Y.


2005 - 2006

PECPA 2R LEVEL I11 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

DAY (S)

MONTREAL 1

MONTREAL 2

MONTREAL 0.5

OTTAWA 3

MUHC 5

MONTREAL 1

MONTREAL 1

MONTREAL 1.5

MONTREAL 1

MONTREAL 1

LAVAL 1

MONTREAL 1


2005 - 2006

DESKOSIERS, F. JOINT MOBILIZATION OF THE STIFF HAND AND WRIST

MALO, V. DEPRESSION AND REMOTIVATION

POULIN, C. ATELIER SUR LES TECHNIQUES DE CONFECTION D'ORTHESES STATIQUE

NEWMAN, J. GERIACTRIC IN-PATIENT RETREAT

MENTAL HEALTH & GERIACTRICS BRIDGING THE GAP

GERIACTRICS AND RESTRAINTS

GINGRAS, B. NON VIOLENT CRISIS INTERVENTION

MEHRZAD, M. SANTE MENTALE ET CULTURE ARABE MIEUX COMPRENDRE POUR MIEUX INTERVENIR

LEMOIGNAN, J. CANADIAN BIOETHICS CONVENTION

NCEHR

STROKE CONFERENCE LES SEQUELES D'UN ACCIDENT VASCULAIRE CEREBRAL

LAVAL

QUEBEC

MONTREAL

MONTREAL

MONTREAL

MUHC

MUHC

MONTREAL

HALIFAX

OTTAWA

MONTREAL


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

GATINEAU

MUHC

MUHC

MONTREAL

DAY (S)

2

1

5

2

MCGILL 1

UNIVERSITY DE 1 MONTREAL

MONTREAL

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

OCCUPARONAL THERAPY PROFESSIONAL DEVELOPMENT

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

McGill Universitv Health Centre

OCCUPATIONAL THERAPY SERVICE

Psychiatry

Several Hospitals recently merged to form the McGill University Health Centre. Madeleine Shaw was appointed Director of Occupational Therapy for the adult sites of the MUHC. There are four clinical co-ordinators.

Julia Newman- Physical Medicine, Montreal General Hospital Sonia Geller- Psychiatry Montreal ~ene ra l Hospital

JosCe Lemoignan- Physical Medicine Royal Victoria & Montreal Neurological Hospital Madeleine Shaw- Psychiatry Royal Victoria Hospital

The Physical Medicine sections were invited to apply for F.E.S.A.P. in April 2000. The process of responding to the F.E.S.A.P. questions helped us clarify similarities and differences between the sites and in fact P.E.S.A.P. became a tool which facilitated the consolidation of the student program in the different hospitals. The same applies in psychiatry- two manuals are submitted, one specific to the MGH, the other to the RVH.

The F.E.S.A.P. manuals from the MUHC are thus organized, using colored paper.

WHITE= MUHC and applicable to all sites. PINK= Specific to MGH. BLUE= Specific to RVH. .

YELLOW= Section separators.

At the Royal Victoria Hospital Site, all Psychiatric in and out patient services are located at the Allen Memorial Institute, where there is an O.T. central office and department.

At the Montreal General Hospital, O.T. Services for psychiatric clients are provided in a variety of different programmes, each with its own geographic location and staff. Students coming for a clinical rotation in O.T. will therefore go directly to the location of the programme to which they have been assigned. While O.T. clinical services are coordinated by Sonia Geller, each area - or programme functions independently of each other. Each programme therefore has its own student manual which is specific to that particular section. While the same policy may appear in all manuals, very often the types of clients and their needs, necessitates different policies.

There are 6 major programmes in 6 locations.

- Addiction and drug abuse - Rehabilitation Day Centre and continuing care clinic - Community link - Crisis and general Psychiatric clinics - Transitional Day programme - In-patient services

It is implicit that the information in the manual is generic to all programmes, unless otherwise stated. (by the inclusion of specifics relevant to each programme).

MUHC The Montreal General Hospital

Psychiatric Occupational Therapy Programme

Fieldwork Education Site Approval Program

Application

February 200 1

ReflD\FESAP\application November 13,2000 a.m.

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

PSYCHIATRIC PROGRAMMES TABLE OF CONTENTS

APPLICATION FORM - CAOT AND ACOTUP

CRITERIA A: 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 Psychiatric Services of the MUHC A. 1.3 MAPS & Location of OT Psychiatric Services at the MGH A. 1.4 General orientation to O.T. Services - MUHC A. 1.5 Specific orientations to:

In-patient Services Rehabilitation Day Centre Transitional Day Programme Community Link Service Addictions Unit

A.2.0 Student Contracts In-patient Services Rehabilitation Day Centre Transitional Day Programme Community Link Service Addictions Unit

A.3.0 Learning Opportunities

A.4.0 Safety: Health: Accidents A.4.1 Safety Issues and students within the MUHC-overview A.4.2 Policies and Procedures (from MUHC Dept. Policies & Procedures manual)

Policy & Procedure 10.1 Accidents Policy & Procedure 10.2 Incidents Policy & Procedure 10.8 Occupational Health and Safety Policy & Procedure 10.10 Theft Policy & Procedure 10.3 Emergency procedure Policy & Procedure 10.4 Patient Safety Management

A.5.0 Off Site Supervision not applicable

A.6.0 Supervision - Contingency Plan

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

B.7.1 Mission B.7.2 Philosophy B.7.3 Goals

B.8.1 Scope and Limitations B .8.2 Service Descriptions

C. The sitelprogramme has current guidelines that guide client sewice/programme delivery.

C.9.0 Professional standards and guidelines - Policies & Procedures Policy & Procedure 6.2 Access to Occupational Therapy Policy & Procedure 6.6 Confidentiality Policy & Procedure 7.7 Referraycharting Policy & Procedure 6.14 Patient Discharge/discontinuation of treatment Policy & Procedure 6.1 5 Priority of treatment

C.9.1 OEQ Code of Ethics

D. Siteslprogrammes Employing Occupational Therapist(s) are organized 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 Occupational Therapists

In-patient Services Community Link Rehabilitation Centre Transitional Day Programme Crisis & General Psychiatric Clinics Addictions

D. 1 1.3 Student Occupational Therapy Co-ordinator

D. 12.0 Professional Development D.12.1

Policy & Procedure 8.3 Professional Development Policy & Procedure 1.1 1 Clinical Activity Report Policy & Procedure 9.1 Professional Inspection

D. 12.2 Continuing Education Activities

08/03/01 refld/st/draft(table of contents)

CAOTIACOTUP Occupational Therapy Fieldwork Education Site Approval Programme

Application Form McGill University Health Centre

1. Nameofagency/programme: ~ ~ ~ + ~ ~ ~ l - s ~ j t a l -

Name of agency/programme Contact person: Made leine Shaw A d d r e s s : ~ e ~ t , of Occup. Therapy C2.50, 1650 Cedar Ave., Mtl, H36 1A4 Telephone:( 514 ) 937-6011 loc. 2919Fax:( 514 ) 934-8371 E-mail: madeleine.shaw@M~HC.McGill.Ca

2. Type of Setting: ~ , & , ~ : t i a r y Care - University Teachinq Hospital 3. Name of contact person at the agency regarding issues about occupational therapy andlor fieldwork education (if this is different from the person named above).

Sonia Geller Name: Position: Clinical Coordinator Telephone:( 514 ) 937-6011 loc. 2608 Fax:( 51 4 ) 934-8237 E-mail: n/a

4. Are there occupational therapists employed by the agency/programrne: X& Yes O No

If yes, indicate the number and status (e.g.: employee, self-employed/contract) of: a) full time occupational therapists: 3 x F.T.E. b) p;rt time occu ational thera ists (include dayslhours worked per week/month etc.): .. x .8 F$E, 2 x .f FTE, 1x .4 FTE c) consultant occupational therapy i.e.: contract with private practitioner NO

5. Name of person that completed the application: Name: Madeleine haw and -sonia Geller Position: Dir. of Occupational Therapy and Clinical Coordinator Telenhonerl 514 5 - OC. c - - - - - . - E-mail: [email protected] Name of employer (If other than the agency named above):

6. Name the university OT programme with which site is affiliated: . - McGill

7. Name of university fieldwork coordinator that assisted site personnel to complete this application (if applicable) N/a

This site confirms that all occupational therapists employed by this organization are registered with the appropriate provincial regulatory organization.

The site authorizes CAOT to release the Application and Handbook for fieldwork education purposes when FESAP approval has been granted.

Lzc-l." .,//& . 2, JLJ Name of the DirectorIManager

Date '

1 ,:??

... .. - . , .: CAOT & ACOTUP

.- ..

4 Occupational Therapy Fieldwork Education Site Approval Programme Guidelines

Criteria

Fieldwork Information

Documents Required Completed - A. The sitelprogramme has a student 1. Guidelines to orient students to the goals, structure and procedures

education programme to guide the at the site. cs(

student's learning experience.

2. Student fieldwork learning objectives specific to occupational therapy that identify the siteiprogramrne's expectation for students.

3. Outline of learning, portunities and educational strategies available for stud k ts occupational therapists for example, library, affiliated agenciel, discussion groups, etc.

d

4. Outline of safety procedures appropriate for occupational therapy practice in the fieldwork sitelprogramme. d

5. For those sitesiprogrammes with no occupational therapist on-site, provide guidelines regarding the way in which the student will be guided by fieldwork site personnel in collaboration with a

d consulting occupational therapist.

6. Contingency plan to guide and monitor the student, on-site or off- site in the event that the occupational therapy fieldwork educator is unavailable to monitor student learning.

d B. The s i r e lp rogame identifies whom it 7. Description of the sitelprogramme's function and purpose, i.e.

serves and how it serves this population. pamphlet, brochure, philosophy or mission statement, which is used to inform other professionals, clients and/or public about

w services.

8. Description of the role or potential role of the occupational therapist within the siteiprogramme (Include only if different from #7)

d Service Information

9. Occupational therapy or other relevant professional standards C. The sitelprogramme has current and/or guidelines, for example: referral system, service priorities,

guidelines that guide client documentation standards, ethical parameters, etc. service/programme delivery.

D. Sites/programmes employing occupational 10. Description or line diagram (organizational chart) demonstrating therapist(s) are organized to address how the occupational therapist(s) and/or student(s) are organized occupational therapy professional issues. and to whom they are accountable within the sitelprogramme.

d 11. Job description (if an individual) or terms of reference of the

committee (if a group) of those responsible for establishing and maintaining occupational therapy professional issues; for

w example, occupational therapy scope of practice, programme and staff evaluation, student education etc.

12. Continuing professional education policy or description of how occupational therapists remain current in issues that impact their professional practice.

. ..fpslunivliesaplfirsl packagelapplication (4pages) update dcc90

Orientation to the McGill University

Health Centre

A.1

McGill University Health Centre

Departments of Occupational Therapy

Adult Services (MGH, RVH, MNH, MCI)

Student Manual

February 200 1

The McGill University Health Centre

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

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

University Faculty of Medicine, three institutions serving adult patients- The Montreal 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 M W C 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

environrnent/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, fiom 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 140,000 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 2 1,322 admissions annually. In addition, the RVH receives 444,162

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

DWESAP\STUDENT INFO

November 13,2000 a.m.

DEPARTMENT OF OCCUPATIONAL THERAPY

WELCOME TO THE DEPARTMENT

Both the Montreal General Hospital and the Royal Victoria Hospital offer Occupational Therapy Services in psychiatry. Separate O.T. departments exist on both sites and are not integrated with the Physical Medicine Section.

Both hospitals provide in-patient psychiatric services, the MGH (32 beds) - RVH (45 beds) and a variety of programs and clinics for out-patients. Occupational Therapy Services are provided in the following areas.

MGH #F.T.E.

IN-PATIENTS 1 O.P. TRANSITIONAL DAY PROGRAM 1 DAY HOSPITAL 0 REHAB DAY CENTRE 1.8 REHAB VOCATIONAL 0 COMMUNITY LINK 1 .O CRISIS INTERVENTION .4 GENERAL PSYCHIATRY .4 SUBSTANCE ABUSE 1.8

RVH -

IN-PATIENTS

DAY HOSPITAL REHAB DAY CENTRE REHAB VOCATIONAL

MAPS & LOCATION OF O.T. SERVICES

At the MGH, the in-patient psychiatry section is integrated within the general hospital. Contingent with the in-patient section is the O.T. Department which services the in and transitional day programs. Other O.T. services are offered in a variety of locations, within the hospital.

In-patients 4 east (Main Building) Transitional Day Unit B.5 (Main Building) Rehab Day Centre - McCowell Building Community Link Service - McCowell Building Addiction Unit - Griffiths Edwards General Psychiatric Clinics and Crisis (piease note owning to psychotherapy, this rotation is not available to students).

A-4/ Existing Location L

Comments Lilian Eyre, music therapy Dr Pierre Bleau,(O.P.D.). Brian Bradley,Marlen Vaness Dr K. lgartua psychiatrist Dr.Martin Drapeau psychiatrist (Brian Bradley) 1 secretary, one computer technician 1 resident Dr Myhn Dr M. Jalbert 2 students 1 resident i resident

Room A4.153 A4.157 A4.163 A4.167 A4.169 A4.174 A4.175 A4.256 A4.260 A4.261 A4.266 A4.268

mca 10.51 13.02 1 1.7

12.38 12.07 16.63 8.62

12.96 10.97

15 8.39 8.08

THE MONTREAL GENERAL 808PITA.L ADDICTIONS UNIT

GRIFFITH EDWARDS HOUSE 1604 PINE AVE. WEST MONTREAL, QUEBEC H3G 1B4 (514) 934-8311

FIRE AND EMERGENCY INFORMATION

.

U X A ! ! N

BASEMENT FLOOR

O.T. Room Ksl 120

Group Therapy Room Ksl 101

MAIN FLOOR

Front (Main Door) Pine

Back Door

Door from Dr. Palacios-Boixls

FIRE ALARM BOX EMERGENCY EXIT

X X

X X

X X

X X

Centre univers l ta i re de sant6 McGi l l M c G i 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 Therapy

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: Psychiatric in and out 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

Psychiatric in and out 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 minlday if time permits. This can be taken in the morning or in the afternoon.

Lunch is normally from 12 noon to 1 pm. Lunch may be taken in the cafeteria or the area where you work.

Absences - If you are unable to attend due to illness or other valid reason you must notify your supervisor or clinical co-ordinator as early as possible so they can cancel patients if necessary and/or inform them about any outstanding concerns re. Your patients.

Phone numbers : RVH : 843-1 573 (secretary or voice mail) O.T. AM1 : 842-1231 local 4168 O.T. AM1 : 842-1231 local 4169 (voice mail) M.G.H. : 937-601 1

Local 291 9 (secretary - voicemail physical medicine section C2.150) Local 2608 - S. Geller Local 2370 - M. Boulos Local 2614 - B. Gingras Local 4776 - N. Julien Local 4775 - N. Rolbin Local 2606 - M. Merhzad Local 2392 - H. Pentney Local 2388 - P. Randolph

Bank of Montreal Machine - available in Main Building (RVH) Bank of Montreal Machine - available on 6" floor (MGH)

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 the RVH a locker is made available to each student. At MGH, you will be assigned locker space when available depending on each section.

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.

Library -The medical libraries are open to all students. CJOT and AJOT's are kept in the O.T. Depts.

Keys - The O.T. Dept is locked at the end of each work day. Students are allocated a key at the RVH.

Maintenance - All students are expected to return item 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 notes may be kept on individual patients which are destroyed when patient is discharged or kept for 1 year in the O.T. Dept. These include copy of initial assessment, progress notes, Rx program and various assessment forms. Re : Patient's chart must never be left in O.T. department over night. All students are expected to keep their charting up to date for their individual patients.

Complete chatting information will be found later in the student manual.

CONFIDENTIALITY : Students are reminded of the need to maintain confidentiality at all times. This includes conversations in public places, e.g. elevators and cafeterias as well as when discussing case histories at McGill in or out of class.

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 and/or case presentation (1 5 minutes including questions).

Ref\d\FESAP\ stlotientation March 7th, 2001

STUDENT PACKAGE

Q.A. CHECK LIST

NAME:

ADDRESS:

TELEPHONE NUMBER (during placement):

1 LEVEL: DATES:

I TOTAL NWMBER OF WEEKS: TOTAL NUMBER OF HOURS:

1 SUPERVISOR. AREA: 1

ORIENTATION:

U-B.A.DGE:

KEYS (AMI)

Yes No

BY: TIME:

Returned: Signature of Supervisor:

REPORTS ATTACHED:

1. FINAL CBFE

2. UNIVERSITY EVALUATION OF DEPARTMENT AND DEPARTMENT EVALUATION OF PLACEMENT

4. STUDENT ORTENATION CHECKLIST

5. ORIENTATION MANUAL EVALUATION FORM

6. CONTRACT

The Montreal General Hospital Occupational Therapy Department

Orientation to occupational therapy -4E

The OT setting provides opportunity to pinpoint specifics about a person's functional skills and emotional resources through the use of activity and interpersonal relationships which represent a microcosm of daily life. The OT primary role in 4E is restricted to assessment, evaluation of response to medication and recommendations for rehabilitation. OT is an active and dynamic component of the inpatient services.

Treatment media

Most of the interventions are done in groups such as workshops (arts and crafts), expression groups like discussions,and insight-oriented groups, cognitive groups, and relaxation groups.

Clientele F

Majority of patients are schizophrenic however it is also very common to have clients with mood and personality disorders.

Policies

Hours of work 8:00 to 16:OO Lunch 1200 to 13:OO Coffee Breaks 15 minutes morning and afternoon

Absence

If you cannot attend due to sickness or for other valid reason, kindly noti@ Masoud Mehmd @ 937-601 1 (2606).

Dress

Professional attire is required at all times.

Emergency procedures

Will be explained by supervising therapist.

-. ..

&:.?:> Miscellaneous information

Maintenance: you are welcome to familiarize yourselves with the location of tools and equipment in the department and to keep the department as tidy as possible. Library: medical library located on the 6th floor of the main building.

Placement Objectives . To provide opportunities for student to: I . Develop professional knowledge,skills and attitudes 2. Deve1o.p clinical reasoning and problem-solving skills 3. Develop & integrate independent work skills of a ( eg. time management, setting priorities) 4. Plan, implement and evaluate all aspects of a client's program 5. Integrate constructive feedback into performance 6 . Integrate previous academic and fieldwork experiences with current experiences

The Montreal General Hospital Occupational Therapy Department

The MGH Psychiatry Rehabilitation Day Centre is part of the services offered by the Department of Psychiatry. It is an active and dynamic component of the outpatient services.

I Most of our interventions are done in groups. I Diffeient aspects of daily living are explored through the diirent gmups, including health education, sports activities, meal preparation, bus transportation, and social skills.

Arts and crafts I Clerical activities

Vetbal groups like discussions, music therapy groups, insight-oriented groups I Following receipt of a referral giving diagnosis and pertinent data h m the @tiomr concerned, the team assesses the patient's needs and recommends admission or refers the patient to a more appropriate resource. Upon admission, a program plan is drawn up, implemented, and modified as required to achieve optima1 restoration of hction (as much as possible).

The majority of patients are nferred from :

our ward our outpatient services the Allan Memorial Day Hospital practitioners in our catchment area

Hours of work 8:30 to 16:30 Lunch 12:OO to 1 :OO Coffee Breaks 15 minutes morning and afternoon, between groups

If you cannot attend due to sickness or for other valid reason, kindly notify your supervisor; Phone number: 937-601 1 (4776t4775) or 934-8012.

:Professional attire is required at ail times.

Procedures will be explained by supervising therapist. In case of an accident to a patient or to yourself, advise a supervisor and complete an incident report.

All cupbcrards in the kitchen and in the OT work station are opened before and closed after the workshops. Keys for the rooms are kept in the chart room on the board.

Students are welcome to familiarize themselves with the location of tools and equipment in the department and to keep the department as tidy as possible.

Librarv Students have access to two libraries - the medical library on the 6th floor of the main building and the library located on the 4th floor in the Psychiatry Ihpimmt.

Chartinn SAp method. Will be explained by supnvising therapist.

During your placement, sW would like you to gain as much knowledge sr, you can bout the practice of occupational therapy in Psychiatry, and they are available to assist you towards that g d -

We hope that you will enjoy your placement at the Montreal General Hospital.

file: C:h\occther.wpd

@OVTFtEAL GENERAL HOSPITAL

Orientation Checklist - Transitional Day Program

1. Welcome to the department 2. Introduction to team members 3. Outline of Psychiatric services at MGH 4. Description of TDP (mission statement, clientele, program) 5. Role of O T in TDP 6. Tour of TDP, psychiatry department, other significant places (ER, 4E, Rehab

Day Center, Birks House, Cafeteria, Coffee shop, photocopyffax room, psychology room)

7. Expectations for placement, student contract, special presentationlproject 8. Schedule of TDP, supervisor (M-TH) 9. Student schedule for week 1 10. Keys, safety info, emergency procedures, personal belongings 11. Charting, statistics 12. Handouts for readings related to TDP, psychiatry, OT

Orientation Information - Transitional Day P r o ~ r a m

Mission Statement :

The Transitional Day Program (TDP) is a short term, rapid response, partial hospitalization service for psychiatric patients. I t treats acute and subacute illness to avoid or minimize hospitalizationlin-patient stay. Using a biopsychosocial approach, the program provides an individualized treatment plan within a structured group setting. The goal is community re-integration through health management and education and the promotion of self-awareness in a-person's global functioning.

PROGRAM SPECIFICS AND SCHEDULE :

See TDP description (next page)

OTHER TOPICS T O BE DISCUSSED :

Hours of work : 8 :30 - 4 :30 Coffee Break : 15-30 min./day time permitting Lunch : 12 :30 - 1 :30 Supervisor's work schedule : Monday- Thursday, Friday's schedule will be

discussed and supervision to be available Absences : Call supervisor1 M. Boulos, local 2370 or TDP

Secretary, local 2369 Personal belongings : Supervisor's office, locker

TRANSITIONAL DAY ..... .. . ... . PROGRAM PSYCHIATRY . . ....

Le service situe au 5e Ctage, a Cte conGu pour des personnes ayant des problemes de santC mentale. Le but est de raccourcir ou prkvenir une hospitalisation. I\ s'agit d'un programme de "jour" du lundi au vendredi de !Oh a 15h.

I

La clientele doit etre suffisamment bien pour vivre a I'exterieur de I'hbpital et pour participer aux activites. La duree de sejour du programme est d'environ 2 a 6 semaines et se voit comme une Ctape de transition vers une meilleure sante.

Votre iquipe du Programme de Transition Your Transitional Day Program Team:

Tummy sauvi, sertary (514) 937-601 1 pok/M 2369)

Claude Allard, Educatricel Educator Lillian Eyre, Musicotherapeute/MusicTherapist Marie-France Boudreault, Psychologue/Psychologist Richard Montoro, Psychiatre/Psychiatrist Mireille Boulos, Ergotherapeute/Occupational Therapist Sanda Onesi, Infirmi&re/Nurse Elizabeth De Souza, InfirmiereINurse Wanda Konarski, Travailleuse Sociale/Social Worker

Le succes du programme pour vous et pour les autres participants depend de votre engagement, ponctualite et participation A tous les jours.

Si vous devez vous absenter, veuillez nous aviser par telephone au 937-601 1 poste 2369 ou laisser une message sur la boite vocale.

S.V.P. Presenter votre carte d'assurance maladie i la receptioniste lors de votre premiere semaine au programme.

This service located on 5 East, has been developed for persons with mental health problems with the objective of shortening or preventing hospitalisations. This is a "day" program that runs from Monday to Friday, 10:OO a.m. to 3:00 p.m.

The clientele must be well enough to live outside the hospital and to participate in the activities. Participants may stay in our program from 2 to 6 weeks. It is a transition or link to the next step in your health program.

The success of this program for yourself and for the other participants depends on your commitment. Therefore, you will benefit the most if you attend daily and are on time for the group activities. '1n case of absence, please advise the staff at 937-601 1 local 2369, or leave a message on the voice mail. N.B. Please present your Medicare card to the receptionist during the first week of attendance.

GROUP ACTIVlTY SC#€DUL€

1o:oo - 11:oo

1O:OO - 10:30

COMMUNITY MEETING

10:45 - 11:45 11:OO - 12:30 Physical Activity Health Education

a: Musiart Choir

12:30 - 13:30 LUNCH

13:30 - 14:30 Awareness

13:30 - 14:30 Community Resources

**13:15 - 14:00** Interpersonal

Resources

14:15 - 15:OO Social Skills

13:30 - 14:30 O.T.

Community Living

13:30 - 14:30 Leisure Group

10:OO - 10:30 Communautaire Communautaire

Activitbs physiques

12:30 - 13:30 LUNCH

**13:15 - 14:00** 13:30 - 14:30 13:30 - 11:30 Resources inter Activitk de loisirs

communautaire Ha biletis sociales

HabilCtks Sociales

On the Community Link Service

The MGH Community Link Service is part of the services offered by the outpatient department of psychiatry. It is an intensive outreach program for clients unable ot use traditional services.

Treatment Media

Most of our intervention are done individually

Home visits, visits in the community or at the office

Verbal interviews, accompaniement, phychosocial rehabilitation, advocacy, emotional support, coordination of care

Clientele

The majority of patients suffers from schizophrenia with or without substance abuse

Clients are referred from' : - Inpatient unit - E.R. - O.P.D. - The community

Schedule

8 Hours of work : 8 :00 to 16 :00

Lunch : 12 :00 to 13 :OO *Schedule must be flexible to accommodate special needs of our clients

Absence

If you cannot attend due to sickness or for other valid reasons, kindly notify your supervisor.

Phone number : (5 14) 937-601 1 (local : 26 14 or 4757) / Cel : (5 14) 21 7-5696

Dress Code

Clean, casual attire is recommended

Emergency procedures

Procedures will be explained the supervising therapist. In case of an accident to a patient or to yourself advise a supervisor and complete an incident report.

During your'placement, staff would like you to gain as much knowledge as you can about the practic of OT in psychiatry and they are available to assist you towards that goal.

We hope that you will enjoy your placement at the Montreal General Hospital.

One full time Occupational Therapist works as a member of a multidisciplinary team to provide assertive community treatment for patients suffering from severe and persistent mental illness. The therapist offers a case management approach with the goal of stabilizing symptoms of psychiatric illness, enhancing integration within the living environment, broadening access to services while concurrently working with families, landlord, police, legal system where indicated and a variety of community resources and support services.

Ratio: 1 3 : 1 for case management

Consultant to a 65 patient caseload for assessment of basic needs, assessment of patient's safety.

O.T. needs to be:

A,--. Comfortable working in a less structured setting Able to work as a member of a multidisciplinary team Flexible, autonomous, able to make quick decisions innovative

The Montreal General Hospital

Occupational Therapy Department

The Addictions services resides in the Griffith Edwards House, an out-patient facility at 1604 Pine Avenue West. The Unit is an affiliate of the Department of Psychiatry at the Montreal General Hospital.

The treatment program has an active clinical and research component. For further information, please refer to the information sheets that are available to all new staff/new patients.

Treatment Modality -

Our main modality of treatment is group therapy which provides an opportunity for the patients to achieve abstinence from substances of abuse and allows for an exchange of views, experiences and support in order to make changes in their lives, attitude and behaviors.

#- We offer a number of other groups during both early/advanced stages of therapy such as:

.Occupational Therapy - evaluate cognitive and functional impairment

.Relapse Prevention --- - . -.

.Stress Management

.Prevocational Counselling

.Dual Diagnosis Group

There are two specialized groups organized for specific needs population:

.50+ Group - Elderly substance abusers

.Woman's Group - Group that deals with womensf issues

Patient Referral

Patients are self-referred generally but we also receive referrals from Physicians, other treatment services and the Emergency Room of the Montreal General Hospi.ta1.

Patients make the initial contact, all pertinent information is recorded, reviewed by the Medical Director, for approval, and the patient is assigned an assessment date or referred to appropriate services. There is a Primary Care Therapist (PCT) whom assesses a new patient and will remain, when possible, involved with patient until he/she completes Phase I.

Phase I encompasses attending a support group once or twice a week to achieve sustained abstinence and acquire coping strategies. The patient is followed in individual session once per week by the PCT to ensure a smooth transition into treatment and to clarify issues and goals (approximately 4-6 weeks).

Phase I1 consists of attending a group once or twice weekly for a period of 9 months to secure abstinence and work on specific .issues. During this phase, the patient may be referred to adjunct therapy groups such as Relapse Prevention, etc. in addition to their main group.

Mandatory urine screens are required of all patients and it is the Therapist's responsibility to conduct a periodic check for compliance.

Client Po~ul'ation

As the Addictions Unit has no catchment area, the services receive clients from several sources and may well be work"<ng in collaboration with other treatment programs in the community.

Policies

Working Hours: The Unit is open from 8:00 A.M - 8:00 P.M. Monday - Thursday and 8:00 A.M - 4:00 P.M on Friday Lunch Break - 12:OO - 1:00 P.M.

Coffee Breaks - 15 minutes morning and afternoon

Absence

If you cannot attend due to sickness or for other valid reason, kindly notify your supervisor.

Phone number is 934-8311 ext: 2392/2388.

Dress

~rofessional attire is required at all times.

6;) Emerrency Procedures

Procedure will be explained by supervising therapist. In case of an accident to a patient or to yourself, advise a supervisor and complete an incident report.

Miscellaneous Information

Keys - Therapists in the Unit are supplied with a key to open the FrontIBack doors and a key to their own personal office.

Students should make arrangements with their supervising therapist(s) for availability of appropriate key. Copies of all keys are kept in Ms. McCulloughfs desk and she can be approached, if necessary.

Maintenance

Students are responsible to maintain the location of occupational therapy equipment in O.T. Room (Basement level) and for general tidy-up of any office space utilized.

Library

Students have access to two main libraries - the Medical Library on the 6th floor of the Main Building (M.G.H) and the Library located on the 4th floor in the Psychiatry Department. An informal library is available in the Conference Room at the Griff ith Edwards House - access to pertinent Journals in Addictions, and staff, at times, will make available their own library to review information relevant to treatment. Students are regularly supplied with the necessary reading materials required during their clinical placement.

Charting

1. Formalized Assessment Form - utilized to record patient data and identify treatment goals.

2. Monthly Progress Notes are written with information gathered from the urine screens, patients Rounds and group attendances, indicating progress, problems and plans.

3. Clients that are seen individually at any time, require a progress note to record information of the session.

4. . Telephone and patient Rounds ItStatisticsw are completed regularly, appropriate sheets are available through your supervising therapist (s) .

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STUDENT CONTRACTS

1. In-patients 4 east- U1,2, 3

2. Rehab Day Centre- U1,2, 3 .

3. Transition Day Unit- B.5- U1,2,3

4. Community Link- U2,3

5. Addictions- U2,3

ReBd:st/mgh/fesap/student contracts



U-1 level

The first week of the placement consists of an orientation to the hospital and to the department, as well as an observation period.


The student will familiarize with the department and the clinical setting. The student will project a professional image in the manner of dress and behaviour. The student will formulate personal objectives that shehe would like to achieve during herhis placement. The student will begin to experience and participate in self-evaluation, providing and receiving feedback with supervisor. The student through observation and participation, will begin to speak effectively with the team members, clients, and family members under the close supervision. The student will begin to familiarize herselflhimself with various psychiatric conditions and diagnoses. The student will read educational material. The student will observe different evaluations and assessments such as HTP, KELS, ACLST, etc. The student will observe groups and may assume a co-therapist role under the close supervision in group therapy. The student will analyze and select appropriate activities for 2-3 clients. The student will be able to write initial and progress notes with assistance/supervision. The student will share the responsibility fot a partial client case load under the close supervision of the therapist (2-3 clients). The student will attend team meetings. The student will participate in various psychiatry department educational oppotunities such as Grand Rounds. The student will visit various psychiatry clinics (in-pt/out-pt) to learn more about role of OT.


Student: Date :

Supervisor: Date



U-2 level


The student will familiarize with the department and get a feel of daily OT routine. The student will formulate personal objectives that shehe would like to achieve during placement. The student will attend team meetings. The student will observe supervisor's clients (emphasis: therapist's interventions and Rx. plans). The student will read educational material. The student will receive and respond to constructive questionsJfeedback. The student will complete statistic sheets with minimal assistance. The student will exchange with other disciplines. The student will give verbal report at team meetings. The student will participate in various psychiatry department educational opportunities such as Grand Rounds. The student will participate and co-leadnead OT groups. The student will conduct specific OT evaluations such as HTP, and KELS. The student will write initial assessment notes, maintain regular progress notes, and discharge notes with assistance/supervision. The student will record statistics with minimal supervision. The student will complete a project. The student will be able to present one case shehe has followed in treatment.


Student: Date :

Supervisor: Date



U-3 Level


The student will familiarize with the department and get a feel of daily OT routine in the shortest time possible. (Different opportunities to observe assessment procedures and treatments will be provided.) The student will practice in a professional manner. The student will formulate personal objectives that shehe would like to achieve during herhis placement. The student will make observation notes on supervisor's clients during the first week The student will read educational material. The student will independently perform client assessment and review results with supervising therapist. The student will independently plan and set client treatment goals, and reviewing them with supervisor. the student will independently carry out treatment, incorporating a variety of treatment techniques. The student will participate and co-leadhead OT groups. The student will attend and participate in team meetings and report on herhis clients. The student will make and maintain initial, progress, and discharge notes. The student will participate in various psychiatry department educational opportunities and visit various psychiatry clinics. The student will independently record statistics. The student will complete a project. The student will present one case shehe has followed in treatment.


Student: Date :

Supervisor: Date .

STUDENT CONTRACT

U - 1 LEVEL

THE STUDENT IS EXPECTED TO MEET THE FOLLOWING REQUIREMENTS DURING HIS/HER PLACEMENT AT THE MONTREAL GENERAL HOSPITAL'S PSYCHIATRY REHABILITATION DAY CENTER.

The first week of the placement consists of an orientation to the hospital and to the department, as well as an observation period. The length of time attributed to the observation period and progression of the clinical placement depends on the student's previous clinical experience, therefore the time frame may vary for each individual.

1. By mid-term the student will develop an effective communication with therapists, team members, and will interact with patients. By the end of the placement students should begin to display a sense of identity as future O.T.'s.

2. The student will project a professional image in the manner of dress and behaviour.

3. The student will develop and utilize observation skills.

4. The student will show initiative in learning about the different client's diagnosis.

5. The student will show initiative in trying different evaluations and tests such as COPM, 'JZaFPE Pre-vocational Rehabilitation Potential, Dimock groups evaluations.

6. The student will be aware that standardized norms exist for particular assessments.

7. The student will analyze and select appropriate activities for at least one patient considering the value and meaning of client's interests and activities.

8. The student will be able to write one initial note and one progress note with assistance or supervision.

9. The student will help to maintain the O.T. activity areas in an orderly manner.

10. The student will attend staff meetings in-services and multi-disciplinary meetings when indicated.

11. Students should begin to recognize their future professional responsibility for training students.

12. The student will be evaluated only at the end of the placement by the supervising therapist but will meet regularly with the supervisor for feedback

I AGREE WITH THIS CONTRACT AND ANY QUESTIONS I HAD HAVE NOW BEEN CLARIFIED:

STUDENT: ............................................................... DATE;

SUPERVISOR: ........................................................ DATE:

Student Contract U-2 Level & U-3 Level

The student is expected to meet the following requirements during hisher placement at the Montreal General Hospital's Psychiatry Rehabilitation Day Centre.

1. will meet the requirements of a year O.T. student as stated in the evaluation guide from McGill University. The criteria will be reviewed by , hisher supervisor. to clarify the requirements.

2. By mid-term, the student is expected to have prepared one initial note with minimal supervision. By the end of the placement, heishe will have written 1-2 progress notes on two patients (followed by himher under supervision).

3. By mid-term, the student will have written 1-2 STRAP notes with supervision, and by final evaluation independently.

4. By mid-term, the student will have started a COPM evaluation and by final, will have completed one assessment report with problems and will plan independently.

5. The student will participate in team meetings (both at the Day Centre and with the Continuing Care team*) and goal planning when patients heishe follows are being discussed. *

6. The student will participate in patient groups -- co-leading by mid-term (with minimal supervision) and by fmal, leading at least one group independently.

7. The student will accompany the O.T. on home visits. By mid-term helshe will make observations about home visits and by final identify needs and make appropriate referrals, if applicable.

8. The student will attend Grand Rounds, OPD Rounds, as well as one meeting of Regroupement Des Ergs en Sante Mentale.

9. Additional evaluations:

By the end of the placement, the student will have been exposed to one of each of these evaluations with minimal supervision: Meal Preparation course evaluation, Pre-vocational rehabilitation potential, and Dirnock group interaction. As well, helshe will be using projective and creative media in OT workshop as a basis for evaluation and treatment planning, and as a way to identify the patients needs to then modifj. activities to create functional and behavioural changes.

10. Final: The student will be able to present one case helshe has followed in treatment. The presentation will include a case history, problems and plan as well as treatment modalities.


Student: Date

Supervisor: Date

*Note: The opportunity to complete all of these aspects may vary due to patient population and individual need. The same contract will be utilized for U-2 and U-3 students. One would expect a qualitative difference in ability.

file: C:'~.sara\contract.wpd

MONTREAL GENERAL HOSPITAL

TRANSITIONAL DAY P R O G W (TDP) STUDENT CONTRACT

U - 1 Level

The student is expected to meet the following requirements during his/her placement at the TDP.

1. The student will begin to speak effectively with team members. Will also inieract with patients and learn about maintaining boundaries and limit setting.

2. The student should feel fairly comfortable by the end of placement with TDP routine. This includes their role as OT studentslfuture helping professionals.

3. The student will project a professional image in terms of dress and behavior, including punctuality and responsibility. -

4. The student will begin to develop observation skills. By end of placement will be able to write observation notes (with assistance) on supervisor's patients.

*

t 5. The student will be able to write 2-3 progress notes with assistance (wk. 5-6).

6. The student will observe groups led by all disciplines on TDP and practice group observation skills in discussion with supervisor.

7. The student will begin to familiarize self with various psychiatric ~onditiodmedi~ationslsi~ and symptoms.

8. The student will visit one community resource.

9. The student will participate in various psychiatry department educational opportunities. Will visit various psychiatry clinics (in-ptlout-pt.) to learn about role of O.T.

I agree with this contract and all questions I had have been clarified.

Student: Date:

Supervisor: Date:



U - 2 Level

The student is expected to meet the following requirements during hisher placement at the TDP.

1. The student will get a feel of daily TDP routine.

2. The student will participate in team meetings making observations on supervisor's patients (wk. 1-2) then proceeding to hisher own.

3. The student will write observations notes on supervisor's patients (wk 1-3) then proceed to progress notes.

4. The student will prepare data gathering with supenisor prior to a team assessment (wk. 1 - 3) then proceed for any new patients (not

5 . The student will observe team assessments and participate under supervision.

6. The student will plan patient treatment and set goals (weekly + longer term) with supervisor.

7. The student will follow 1-2 of supervisor's patients with supervision including regular individual sessions indepently (wk. 4-6)

8. The student will assume a co-therapist role in O.T. run groups, including planning and leading (wk. 4 +)

9. The student will lead 1-2 groupshk independently by wk. 5-6. Groups being physical activity andlor leisure group.

10. The student will visit 1 or more community resources.

1 1. The student will participate in various psychiatry department educational opportunities and clinics.

12. The student will be more familiar with various psychiatric conditions and medications.

13. The student will formulate personal objectives that he/she would like to achieve during placement.

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TRANSITIONAL DAY PROGRGM (TDP) STUDENT CONTRGCT

U -3 Level

. .

The student is expecting to meet the following requirements during hisher placement at the TDP.

Weeks 1 to 3; The student will:

1. Get a feel of daily TDP routine (wk. 1).

2. Attend and participate in team meetings and report observations on supervisor's patients (wk. 1-2) and patients helshe follows (wk. 2 +).

3. Make regular observation notes on supervisor's patients (wk. 1) then proceed to progress notes on hisher patients.

4. Data gathering prior to a team assessment (wk. 1 +) then write up of initial assessment (wk. 2-3).

~ 8

5 . Participate in a team assessment.

6. Participate and co-lead O.T. run groups

7. Participate in all groups run by the various TDP professionals (wk. 1). ( 4 > , ,

- "

8. Participate in various psychiatry department educational opportunities and visit various psychiatry clinics (in-pt./out-pt.)

9. Visit one or more community resources

10. Learn to deal with "daily crisis".

-1 1. Formulate personal objectives that he/she would like to attain during placement.

Weeks 4 to 6; The student will:

1. Follow 1 to 3 patients (evaluation and treatment including individual sessions at least 2 2dweek).

2. Co-lead a team assessment of a new patient.

I c q ) 3. Prepare and lead O.T. run groups (2x/week).

.$i' 1 ..I 4 . Maintain regular progress notes, write initial assessment notes and transfer notes.

5 . Conduct specific O.T. evaluation (BaFPE, community living skills, etc..).

6 . Liaise with case managers, community workers, family members and significant others.

7. Complete a project to benefit TDP.

I agree with this contract and all questions I had have been clarified.

Student: Date:

Supervisor: Date:

U-2 AND U-3 LEVEL

The student is expected to meet the following requirements during histher placement at the Montreal General Hospital's Community Link Service.

1. will meet the requirements of a year O.T. student as stated in the evaluation guide from McGill University. The criteria will be reviewed by hisher supervisor, to clarify the requirements. 2. The student will participate in team meetings, case reviews and family meetings. 3. The student will participate in group therapy and will co-lead by end of placement. 4. The student will accompany supervisor on home visits. By mid-term, the student will

do home visits independently. 5. The student will attend Grand Rounds, O.P.D. Rounds, as well as at least one external

meeting (RESMM, AM1 Quebec, "Comite itinerance", etc.. .) 6 . The student will identify patient's needs and set treatment goals. 7. The student will write regularly progress notes as well as fill in statistic sheets. 8. The student. will visit community resources. 9. The student will have contacts with governmental agencies (e.g.: welfare office,

RAMQ, RRQ, CSST, IVAC etc.. .) 10.The student will work in collaboration with members of the team as well as with staff

of other discipline (e.g.: pharmacist, dentist, G.P, optometrist, police, etc.. .) 1 1 .The student will learn about psychiatric medication (name, indication, side effects,

dosage) 12.The student will take initiative, set priorities, manage time autonomously and fulfill

responsibilities. 13.The student will administer one of these evaluations by end of placement: BAFPE,

PECCA, and Pre-vocational rehabilitation potential. As well helshe will analyze results and write assessment reports.


Student: Date:

Supervisor: Date:

*Note: The opportunity to complete all of these may vary due to patient population and individual needs. The same contract will be used for U2 & U3 students. One would expect a qualitative difference in ability. In return, the student can expect the following from hisher supervisor.

1) Will orient student to working environment and team members.

2) Will have educational material available (articles, videos) and will inform student of upcoming presentations, teaching sessions (Grand Rounds, O.P.D. Rounds, etc.. .)

3) Will orient student to the policies and procedures of the department in relation to charting, confidentiality, ethics, etc.. .)

4) Will clarify objectives of placement

5) Will model professional behaviors and skills

6 ) Will provide direct, concrete and frequent feedback

7) Will provide access to people and information

8) Will give space and support to allow student to develop professional knowledge, skills, identity and attitudes

9) Will read, correct if need be, and countersign all written material

10) Will encourage student to progress from comfortable situation to challenging areas

11) Will allow student to work independently as much as possible

12) Will be available to answer questions and explain clinical intewentions

13) Will provide student with as much opportunities as possible for himher to achieve objectives of placement

Student Contract

U-2 Level or U-3 Level

The student is expected to meet the following requirements during his/her placement at the Montreal General Hospital's Addictions Unit:

1. will meet the requirements of a , year O.T. student as stated in the evaluation guide from McGill University, the criteria will be reviewed by

, his/her supervisor, to clarify the requirements.

2. By mid-term, the student is expected to have prepared observation notes on the patients assigned to him/her; he/she will have written 1-2 progress notes on four-five patients (followed by him/her under supervision).

3. By mid-term the student is expected to complete an Initial Assessment on a new patient to the Unit, and to present the case history to the supervising Psychiatrist.

4. By mid-term the student is expected to have covered the assigned reading material and presented his/her knowledge of these subjects to his/her supervisor (s) in the weekly sessions scheduled.

5. The student will participate in patient groups - co-leading after midterm in respect to group therapy and by midterm in respect to task oriented groups.

6. The student will participate in team meetings (Monday and Thursdays) to discuss patient progress and goal planning.

7 . Student is expected to attend Grand Rounds on Friday mornings, and when available attend sessions run by therapistsother than O.T.'s in the Unit.

i 4 8. By end of placement, student will have been exposed to each of

the above procedures and expected to perform with minimal supervision.

9. Student will be expected to present a case history with goals of treatment, and recommendations or a short paper on a subject relevant to his/her placement by the end of the stage.

I agree with this contract and any questions I may have had, have now been clarified.

Student: Date:

Supervisor (s) : Date :

LEARNING OPPORTUNITIES

Listed below are a variety of opportunities and activities in which students may become involved during their stage in psychiatry. Not all these opportunities or experiences may be relevant depending on the learning objectives. Equally they may not be possible given time constraints.

It is suggested students review and discuss these opportunities with their supervisor.

Hospital library - 6th floor, Main Building Psychiatry library - B.5, Main Building Teaching Rounds In-Service Education Grand Rounds Dr. Surkis- Psychodynamic Interview Psycho analytical Interviews Psychiatric Clinics OPD rounds- Birks House Home visits Community Resource Visits (Forward House, Centre dlArtisanales des femmes; Tracon, etc.. .) Regroupement des ergotherapeutes en SantC Mentale de la Grailde RCgion Metropolitaine. Visits1 participation at CLS, RDC, 4E, Addiction Unit/O.T. programmes) Presentations - (drug companies) Videos & discussions: Non-violent intervention, Depression, Schizophrenia Meetings with other health care professionals Articles CLS office Information Center - Birks House Visits- O.T. services, CLS, RDC, In-patients, Addictions

Safety Health

Accidents

A.4

MUHC '

OCCUPATIONAL THERAPY STUDENT MANUAL SAFETY AND HEALTH AND.ACCIDENTS

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 10.71.

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. (Basedon MUHC OTpolicy andprocedure 10.21.

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 to prevent the transmission 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.

I 1 ) Basic Standard Precautions - Handwashing 2) Transmission Based Precautions tMRSA - C - Diff)

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

Section 7-D-30 page 1 of 7 41 Section 3-8-30 page 1 of 3

-- I , . 5. OTHER SAFETY POLICIES

F - , ' , Please review also MUHC: r Policy and Procedure 10.4- Patient Safety

' '- 5 Policy and Procedure 10.8-Occupational Health and Safety ', 1

,.I Policy and Procedure 10.10 - Theft , --!+'

; - 9 ! - "J ' Ref\a\fesap\safetyandhealth ' I

b Centre universitaire de sat4 McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MUHC SITE

POLICY I PROCEDURE #: 1-0.1 PAGE: 1 OF: 1

SECTION: 10

SAFETYfSECURITY, YEAR MONTH DATE DATE HEALTH AND

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.

( Further details are maintained in the staff orientation manial. I 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 t o

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Centre universitaire de santk McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES -MUHC SITE

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 andfor 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 accidentslincidents.

TITLE: OCCUPATIONAL HEALTH AND SAFETY PAGE: 1 OF: 1

SECTION: 10

SAFETY /SECURITY

REVISION # EFFECTIVE DATE

POLICY/ PROCEDURE #:10.8

REVISED DATE

YEAR 2000

YEAR MONTH 0 1

MONTH DATE 20

DATE

Centre universitaire de santd McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - RVH-MNH SITE

I TITLE: THEFT POLICY I PROCEDURE #: 10.10 PAGE: 1 OF: 1

I POLICY:

YEAR

00

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

Locked areas are available for the personal possessions of staff. Any theft must be reported t o the Department Head and t o 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 to the department provided the employee has their ID card.

MONTH

0 2

DATE

15

YEAR MONTH DATE HEALTH AND SAFETY


POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MGH SITE

TITLE: EMERGENCY PROCEDURES POLICY1 PROCEDURE #: 10.3

PAGE: 1 OF: 3

SECTION: 10

SAFETY /SECURITY

POLICY: All staff must be aware of general hospital emergency procedures to ensure quick response to 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 if possible, assign someone to a strategic location to provide direction to 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 ncode 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 to extinguish fire if appropriate

1 EFFECTIVE DATE

YEAR 2000

REVISION REVISED DATE #

MONTH 01

DATE 20

DATE YEAR MONTH

TITLE: EMERGENCY PROCEDURES POLICY/ PROCEDURE #: 10.3

PAGE: 2 OF: 3

SECTION: 1 0

SAFETY /SECURITY

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 of location

+ CO2 extinguisher - Room C2-149 + CO2 extinguisher - Clinic B - next to door to room C2-150.1 + Water extinguisher - next to staff room door (C2-159) + CO2 extinguisher - in hall way opposite clinic A + H20 extinguisher - near Pine elevators + Two (2) 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 nCode Brownn. 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

YEAR 2000

I REVISION REVISED DATE EFFECTNE DATE #

MONTH 0 1

DATE

2 0

YEAR MONTH DATE

TITLE: EMERGENCY PROCEDURES POLICY/ PROCEDURE #: 10.3

PAGE: 3 OF: 3

SECTION: 1 0

SAFETY /SECURITY

10.0 EVACUATION - CODE GREEN

Circulation of traffic to the right hand side of corridors and stairwells. Avoid transferring patients in their beds in order t o 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.

EFFECTIVE DATE REVISION # REV1 SED DATE

DATE

2 0

YEAR YEAR 2000

MONTH 0 1

MONTH DATE

Centre universitaire de santC McGill McGill IJniversity Health Centre


I TITLE: PATIENT SAFETY MANAGEMENT I 1 POLICY 1 PROCEDURE #: 10.4 I

YEAR MONTH DATE

0 1 / 0 2 1 13 1 REVISION #

1

EFFECTNE DATE

PAGE: 1 OF: 4

YEAR

0 0

SECTION: 1 0

SAFETYISECURITY,

HEALTH AND

SAFETY

MONTH

0 2

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


IN-PATIENT SERVICES To increase patient safety, security and provide support for staff providing direct patient care services t o patients w i th mental illness.

1. Camera monitoring. 2. Observation by qualified staff of patients Q60 mins. To Q15 or more often as needed. 3. Designated patients may not leave the unit without authorisation. 4. Patients supplied w i t h a Roam Alert Bracelet. (MGH only) 5. Removal of all sharp objects f rom patient's room. 6. Patient's right t o be visited may be limited or revoked. 7. Staff carry on themselves a buzzer. (MGH only)

OUT-PATIENT SERVICES- OUT BUILDINGS

TITLE: PATIENT SAFETY MANAGEMENT (PSYCHIATRY

- If alone in building- lock the front door. - When in office w i th potentially violent patient - always leave office door open, ensure that other

staff members are aware and have access.

IF PATIENT BECOMES VIOLENT

PAGE: 2 OF: 4

SECTION: 1 0

SAFETYISECURITY,

HEALTH AND

SAFETY

REVISION # 2 EFFECTIVE DATE

POLICY 1 PROCEDURE #. 10 .4

REVISED DATE

- Remove other patients from the area; attempt t o isolate violent person. - Alert other staff on the premises. - Assess degree of violence, i.e.: possibility of escalation or de-escalation. - Press panic button or call 91 1 if necessary. - Code white 5555

YEAR

0 1

YEAR

0 1

EMERGENCY MEASURES

A) Basic safety measures: 1 - Keep personal belongings locked and office door closed when away from the office. 2- Try not to be alone on floor. 3- If alone in office late p.m., keep door closed. 4- Try to meet a potentially acting outlviolent patient with another staff member. 5- If meeting a potentially acting outlviolent patient in your office, ensure that staff are aware of' he

situation and are available. Keep door ajar. 6- Keep portable screamer in easily accessible place. (MGH only) 7- Go on home visits when appropriate with another staff member. 8- Be aware of "Non-Violent Crisis Intervention" techniques, its helpful to complete the 1 -day

workshop.

MONTH

0 2

MONTH

0 3

DATE

1 4

DATE

0 8


TITLE: PATIENT SAFETY MANAGEMENT POLICY 1 PROCEDURE #: 10.4

(PSYCHIATRY) OF: 4

PAGE:

EFFECTIVE DATE REVISION # 2 REVISED DATE SECTION: 10

SAFETYISECURITY, YEAR MONTH DATE YEAR MONTH DATE HEALTH AND

0 1 0 2 14 0 1 03 08 SAFETY

B) Potentially violent situation

1 - Alert staff of potentially violentlacting out situation. 2- Ensure safety of other patientslstaff in immediate area. 3- Quick assessment of situation

a) If containable, use team approach or contact security (8282 MGH ) (4541 RVH) to escort patient of f unit.

b) If non-containable, contact 5555 for code white or 91 1.

MANAGEMENT OF OUT OF CONTROL OR VIOLENT BEHAVIORS (FOCUS ON EARLY IDENTIFICATION OF AGGRESSIVE BEHAVIOR)

There are three steps to this procedure: 1. prevention of aggressive behaviour 2. seclution, and lor 3. physical restraints

Prevention : Measures to prevent the escalation of aggression. They consist of identifying the signs, stressors or imbalanced state as early as possible and to facilitate a resolution. The staff has received adequate training in the prevention and management of the aggressive patients.

Seclution : The state of a patient placed in a secure roomlarea, it is a mechanism that temporarily supports or substitutes the patient's adaptive capacities. The decision t o use isolation is base on the clinical judgement of the staff. A physician's written order is required.

Physical Restraints : A form of physical immobilisation of a person. It is used when a patient is too much out of control jeopardising his o w n safety and that of other patients, the staff or the environment. A physician's order is required. M.D. must assess the patient as soon as possible.

Centre universitaire de santC McGill McGill U~iiversity Health Centre


TITLE: PATIENT SAFETY MANAGEMENT (PSYCHIATRY)

MANAGEMENT OF SELF-DESTRUCTIVE BEHAVIORS (suicidal precautions)

When a patient is on suicidal precaution ( 1 ) A psychiatric assessment of suicidal~ty is done every 2 4 hours and whenever clinically indicated. (2) Camera monitoring is done when possible (MGH only). (3) Patient cannot leave the hospital without authorisation and may be committed. (4) Restraints may be applied PRN when patient is at h ~ g h risk of harming self-imminently. (5) all documentation regarding suicide precaution is part of the permanent record. All assessments must be documented. (6) A psychiatrist writes medical order for the discontinuation of suicidal precautions.

MANAGEMENT OF SELF-DESTRUCTIVE BEHAVIORS (suicidal precautions)

Guidelines for Evaluation of suicide:

1. Does patient have suicidal thoughts? - When did they begin? - What are the reasons for the thoughts? - How frequent are they? - Are they persistent?

2. Does the patient have a suicidal plan? - What is the nature of the plan? - Does the patient have the means to implement this plan?

3. Does the patient have the intent t o carry out the suicide plan? - Has patient written a suicide note? - Has patient said hislher goodbyes? - Has patient dealt wi th financeslaffairs? - Has patient given away hislher belongingslpets?

4. Does the patient have control over hislher suicidal thoughts and urgeslimpulses? - Is patient able t o contract with the treating team and commit to a treatment plan? - Is patient able to resist suicidal urgeslimpulses? - Is patient able t o seek help when in a suicidal crisis?

PAGE: 4 OF: 4

SECTION 10

SAFETYISECURITY,

HEALTH AND

SAFETY

REVISION #2 EFFECTIVE RATE

POLICY 1 PROCEDURE #: 10.4

REVISED DATE

YEAR

01

YEAR

01

MONTH

0 2

MONTH

0 3

DATE

1 4

DATE

0 8

SUPERVISORY CONTINGENCY PLAN

Whenever 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 long tern absence from the supervising therapist (longer than 5 days) the student's supervision and evaluation will be reassigned to one of the other occupational therapists.

Function and Purpose of the Site/Program

8.7

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 in-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

f [, 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 clir~ical research.

February 2000

Re~a\poIicies\mission. I Version2 - March 21,2000

DEPARTMENT OF OCCUPATIONAL THERAPY 1 M.U.H.C.

I 'I I

-I PHILOSOPHY

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

I - ;1 2. We believe that a balanced integration of physical, mental, social, cultural and spiritual

t - elements is essential for restoration of health.

t . 1,. ;:I 3. We believe that engagement in meaningful activities facilitates this integration. . -

1 ,*$ 4. We believe in a client centered approach to care delivery and that the client should be an

_1 . . ,

active participant within the therapeutic relationship, accepting responsibility for themelves I; 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 health care 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 departtnental, hospital, professional association and university levels.

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

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

PHILOSOPHY-I VERSION 2 -APRIL 18,2000

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

1 '[ GOALS 1 I - 1. PATIENT CARE

1 .* To provide quality client centered Occupational Therapy services through the application of evidence based intervention. 1:

li To foster a network of care partners including the client, the family, the multidiciplinary care team and the community. I d, 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 hospital/comrnunity activities which aim to improve quality and/or 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

Scope and Limitations of Occupational Therapy

Services

B.8

CENTRE UNIVERSITAIRE DE SANTE McGILL McGILL UNIVERSITY HEALTH CARE

OCCUPATIONAL THERAPY SERVICES DESCRIPTION SCOPE AND LIMITATIONS

FOR ADULT SERVICES

PATIENT CARE

Occupational therapy services shall be regularly available and readily accessible to meet the needs of patients with physical and psychosocial disabilities within the limitations of physical and human resources. Services offered include assessment and treatment of those patients with physical dysfunction & psychosocial dysfuction to promote functional independence and facilitate prompt and safe discharge of the in-patient population. Utilisation of the service will be authorized 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-patients c> Geriatrics in and out-patient d) Neurological and neurosurgical conditions, including Traumatic Brain Injury

In psychiatry O.T. coverage is extended to :

a) In-patient services b) Out-patient services

Interventions include :

1 . Activities of daily living

A. To assess the patient's capabilities and degree of independence in 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, budgeting, shopping, transport)

B. To train the patient in ADL and, if necessary, suggest modified techniques andlor 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 adaptions to maximize 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. E. To make recommendations related to modifications of job tasks, to facilitate patients return to work.

4. Phvsical status

A. To assess the patient's :

1 . ROM (active and passive), presence of contractures 2. Skin status1 oedema 3. Muscle tone 4. Sensation 5. Strength 6. Co-ordination 7. Balance (sitting, standing) 8. Tolerance1 endurance 9. Pain1 fatigue 10. Shortness of breath

B. To provide therapeutic activities to maintain and 1 or improve physical functioning including :

1. Reduction of oedema 2. Increase joint ROM 3. Strengthening muscles1 encouraging return of appropriate motor control 4. Increasing physical tolerance 5. Sensory retraining 6 . Scar management 7. Reduction of dyspnea and fatigue

C. Splinting to promote healing, maximise function or to prevent the development 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 weak muscles or substituting for lack of muscle power allowing increased function

5. Psvchiatric and psvchosocial status

1. Activity oriented groups, used to assess the patient's ability to interact with others and to perform task-oriented behaviors. Changes in symptomatology, 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. 8. Task oriented groups and individual sessions and standardised evaluations used to assess patient's

functional and cognitive skills and emotional resources and coping mechanisms. Changes in clinical status.

9. Addictions counseling - group and individual. 10. Dual diagnosis groups and individual counseling. 1 1. Cognitive rehabilitation. 12. Crisis interverntion. 13. Psycho-education and support groups for patients families and significant others.

6. Perceutionl cognition

A. Evaluation to determine presence of cognitive1 perceptual deficits resulting from cerebral dysfuntion or trauma or psychiatric illness.

B. Training to compensate for andl or overcome difficulties in order to maximize the patient's functional capabilities.

C. Screening for ability to drive a motor vehicle.

The Occupational Therapy Services provided to the patient shall include :

1. Evaluation upon referral 2. Development and implementation of an 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 (individual and groups) exists for staff, patients and families

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. Psychoeducation and illness management. When appropriate patients and1 or families are provided with written instructions for home-care programmes, and prevention of complications. When appropriate patients and/ or family are provided with written material to facilitate discharge i.e. discharge package. 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. Prior to and after reconstructive surgery, patients are instructed in the procedures, consequences and necessity for compliance in rehabilitation to enhance optimum outcomes. Throughout the hospital, O.T.'s provide in-service lectures for other staff and students. The department receives and trains students for approximately 2-3,000 hours per annum. Staff hold joint faculty positions facilitating the exchange of information and the presentation of relevant, up to date clinical experience for students.

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

11. 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 ErgothBrapeutes du QuBbec. 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, outcomes and client 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.

IV. RESEARCH

Staff are encouraged to engage in research and clinical studies either independently or in collaboration with other services andl or institutions.

Current examples include involvement in :

ALS Western Neurosensory Stimulation Profile (WNSP) McGill Ingestive Skills Assessment Mobilization of Proximal Phalanx Fractures Stroke Outcome Study Nerve Stimulators for patients with PNI (peripheral nerve injury)

LIMITATIONS

The goal of Occupational Therapy in a tertiary care center is to provide specialized

care, facilitate discharge and maximize the patient's rehabilitation potential given

the limited resources available. Policy 6.14 and 6.1 5 (see attached) identify 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, Psychiatric Pact Team, continuing care case managers 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 that require long standing follow-up. These patients

are referred to the appropriate rehabilitation facility.

Ref\d\fesap\scope and limitations November 13,2000 a.m. Rev: March 2,2001 a.m.

MUHC ADULT DEPARTMENTS OF OCCUPATIONAL THERAPY SERVICE DESCRIPTIONS

PSYCHIATRY - IN-PATIENT SERVICES (MGH & RVIQ

1 full time Occupational Therapist on each site is responsible for evaluation and treatment of patient's on the in-patient teaching unit. The therapist is part of a multi-disciplinary team. Helshe assesses functional, cognitive and inter-personal skills both on an individual1 or group basis through selected tasks and assessment batteries. The O.T. also assists with discharge planning. Services are also provided to an adolescent unit (RVH - 8 bed + 5 day care places).

PSYCHlATRY - OUT PATIENT REHABILITATION SERVICE (RVH- AMI)

One Occupational Therapist offers service to the psychiatric outpatient population. The majority of clients are referred from the transition unit, the day hospital and the ambulatory care clinic; some referrals are also received from the mood disorder and schizophrenic clinics. The OT identifies with the client their need for rehabilitation services, helps them to set realistic rehabilitation goals, identify potential barriers to their goal and to help the client build the skills and the support essential to achieve these goals. The focus of this service is primarily vocational and educational but some services are also offered for housing and leisure purposes.

PSYCHIATRY - DAY HOSPITAL IRVH)

The O.T. is a member of a multidisciplinary team that treats approximately 18 adult psychiatric outpatients, in a structured day program. The O.T.'s role involves evaluating patients behavior and function in-groups. Individual evaluations are done to aid in diagnosis and treatment planning. The OT is also a case manager for up to four patients. The average length of stay for patients is three months. The OT observes patients for stability of mood and helps them work towards meaningful activity for after discharge.

TRANSITIONAL DAY PROGRAM (MGH)

1 part-time Occupational Therapist offers OT assessment and treatment of approximately 20 patients within a multi-disciplinary team. This unit functions as a 3-6 week acute intervention with the aim of shortening in-patient stay or preventing admission and stabilizing psychiatric illness. The Therapist also serves as a primary care professional for a portion of the patient census.

ADDICTIONS UNIT (MGW

3 part-time Occupational Therapists work within a multi-disciplinary team offering intake assessments, specialized individual and group therapies, dual diagnosis, interventions and cognitive assessment and training for a non-sectored anglophone population suffering from a variety of drug and alcohol addiction and abuse disorders.

REHABILITATION DAY CENTER (MGH)

2 part-time Occupational Therapists provide group and individual interventions to help maximize autonomy in the areas of interpersonal competence, self awareness, functional and cognitive skills prevocational skills, hygiene, finances, meals, etc. within a.6-month - lyear time frame. The Therapists also serves as a primary care professional for a portion of the patient census.

COMMUNITY LINK SERVICE (MGH)

1 full-time Occupational Therapist works as a member of a multi-disciplinary team to provide assertive community treatment for those patients suffering from severe and persistent mental illness. The Therapist offers a case management approach with the goal of stabilizing symptoms of psychiatric illness, enhancing integration within living environment and broadening access to services while concurrently working with families, landlords, police and legal system where indicated, and with a variety of community resources and support services.

CONTINUING CARE SERVICES (MGH)

4 part-time Occupational Therapists are affiliated with this umbrella service which offers a variety of medical and psychosocial interventions to a large population suffering mainly from psychotic disorders. Interventions offered are: group and individual therapies, dual diagnosis treatment also on a group or individual basis, with the aim of preventing deterioration, maintaining or improving level of functioning and general quality of life. This is done within a case management model.

CRISIS INTERVENTION UNIT & GENERAL PSYCHIATRY CLINIC (MGH)

1 Occupational Therapist serves as case manager for these 2 clinics offering therapeutic interventions on a short or long term basis which include: counseling, stabilizing of crisis situations, involving families and significant others where necessary and working with other hospital and community resources.

GERIATRIC DAY HOSPITALmVH

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 are provided by 1 FTE (MGH-13 east, and 1 FTE RVH-8 medical). A strong interdisciplinary approach is used on both sites. Family meetings and education to caregivers is an important part of the service. The overall goals are to increase functional autonomy and to coordinate 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.

TRANSITIONAL CARE UNIT/RVH

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 0 .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 improvetmaintain autonomy and quality of life on the unit. The average length of stay of patients is 45 days.

MEDICINE

The equivalents to 1.5 O.T. 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, CVA, general deconditioning 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 evaluationAADL 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.

ORTHOPEDICS

A 0.6 O.T. position is currently allocated to the trauma service for traumatic musculoskeletal injuries (TMSI's) excluding head injury. The types of clients seen are diverse including a significant amount of elderly for falls, motor vehicle accidents, suicide attempts, assaults, sports accidents and work accidents. The OT works in close co-operation with traumatologists and orthopedic surgeons from the ICU to the floor units and work is more challenging and intensive with multiple trauma victims. Physical assessment can be complex and team members work together to help the patient overcome the 'shock' and stress associated with the traumatic event.

PALLIATNE 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.

OUT-PATIENTS

Two occupational therapists at each hospital (MGH and RVH) offer services to the hand injured outpatient population. The majority of the caseload is referred by plastic surgery but referrals are also received froin 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.

INPATIENT-PLASTICS

The inpatient plastic referrals are treated by hand specialists. 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 therapists provide 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 0.T. is to inonitor 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 and spinal surgery 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

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 evaluatioiis 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 sewice 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.

MCI - LONG TERM CARE SERVICE

Occupational Therapy services (.3) OT are offered to the long-term care unit at the Montreal Chest Institute. This unit accommodates 50 long-term patients requiring specialized care for end stage respiratory disease, or respiratory complications of other chronic illnesses. The OT does a general screening of all patients admitted to determine any special needs that may affect autonomy and quality of life on the unit. Specific areas targeted for intervention are dysphagia, positioning, wheelchair adaptation to accommodate oxygen and respirators, and special needs related to instrumental activities of daily living on the unit, such as adapted telephones, TV remotes etc.

MCI - OUT PATIENT REHAB

The OT (.3) is a member of a multidisciplinary team that coordinates an 8-week rehabilitation program for respiratory outpatients. The OT role involves evaluating functional capacity with special attention paid to respiratory limitations such as shortness of breath and fatigue. Recommendations for adapted equipment, as well as education related to coping skills such as "Energy Conservation" and "Stress Management" are provided. Family members are encouraged to attend all education sessions.

ACUTE RESPIRATORY

Occupational Therapy services (.4) are provided to both the intensive care unit and the acute care ward at the Chest Institute. Intensive care referrals are primarily for dysphagia assessments for patients weaning from the respirator, and for splinting or special positioning needs due to immobilization. On the acute care service the OT contributes to discharge planning through providing information about the patients functional status, with a special focus in their respiratory limitations. Recommendations are provided when home help or adapted equipment are required to maintain independence.

Ref\d\fesap\service descriptions-new Rev(1): February 12,2001 a.m.

6'9 saullapln~ I I pue sp~epueas ~euo~ssajo~d I

Centre universitaire de sant6 McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MGH

TITLE: ACCESS TO MGH OCCUPATIONAL THERAPY SERVICES - PSYCHIATRY

POLICY I PROCEDURE #: 6.2 PAGE: 2 OF: 2

1 POLICY

YEAR 2000

Occupational Therapy Services shall be regularly available (Monday - Friday) and readily accessible, within the limitations of its physical and human resources utilisation of the service will be authorised by a written referral signed by a physician. In its absence, the particular service shall have a standing order approved by the hospital committee on admissions.

Location

Main Department - 5" floor B5-123

MONTH

1 0

T.D.P. (Transitional Day Programme) - 5' floor

1 Rehab Day Centre- J 1-116 & 118

DATE

3 0

Community Link - J 2- 122

Griffith Edward - Pine Avenue

YEAR

Local 2608

Local 2370

MONTH

Local 8012

Local 2614

OATE

Local 83 1 1

PATIENT CARE

Hours

Crisis Intervention & General Psychiatric Clinic: Monday, Tuesday, Thursday, Friday - 9:00 - 3:30

Wednesday - 9:OO - 4:OO Rehab Day Centre: Monday - 8.30 - 4:30 In Patient Service: Friday Community Link Transitional Day Programme: Monday - Thursday - 8:30 - 4:30 Drug and Alcohol Abuse: Monday - 8:30 - 4:30

Tuesday - 8:30 - 10:30 Wednesday - 8:30 - 4:30 .

Thursday - 8:30 - 10:30 .

Centre universitaire de sant6 McGill McGill University Health Centre


I TITLE: CONFIDENTIALITY - PATIENT INFORMATION

POLICY1 PROCEDURE #: 6.6

PAGE: 1 OF: 1

PATIENTS :

SECTION: 6

I

I YEAR 2000

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 t o the client.

EFFECTIVE DATE I I

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

REVISION # RNISE'D DATE I I

MONTH 03

See. also Policy 7.4 - Press Release.

No patient information relative t o diagnosis, patient's physical status or requirements may be issued t o a third party from this department. Any request for such information should be directed t o the Department of Medical Records.

DATE 2 0

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.

( PROCEDURE: I

YEAR

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

..\ *

: .., . 2. A direct request f i r m Medical Records for departmental information concerning a patient is released only

to the Medical Records Dept.

MONTH DATE PATIENT CARE

Centre universitaire de santC McGill McGill University Health Centre



CHARTING RECORDS

POLICY:

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: i Patient's name and unit number

Address and telephone number (home and work) Medicare nuinber 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"

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



I ~ T L E : PATIENT REFERRALICHARTING POLICY i PROCEDURE a; 7.7 I PAGE: 2 OF: 3

EFFECTFWE DATE SECTION: 7 CHARTING RECORDS ( YEAR ( MONTH 1 DATE I I YEAR I 1 I AND REPORTS

II. ASSESSMENT AND 1NTERVENTION PLANNING

1. Database

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

6. Can include: Age Sex Dominance H.P.I. (date of injury, date of admission, history of present illness, etc.) P.M.H. (past medical history) Social profileloccupation Medications Test results O.R. date and procedure

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 month".

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

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

0 stands for objective and refers to what you observe and do, any evaluation or observation you have made. This objective information is verijable 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 in light of (he facts as recorded in the S and 0 sections and in the rest of the medical record.

P stan& for plan and refirs to what you want to do or what you will do. The plan should includefiequency of intervention and re-evaluation schedule. The plan can be I ) short term or 2) long term (e.g. discharge planning, home program, equipment needs, follow-up care, re@a to another agency, etc.).

Centre universitairc de santC ivicGiii McGill University Health Centre



CHARTING RECORDS

Ill. INTERVENTION

1. Progress Notes

A. lnpatients Written in "progress record" section Write date, time, service Use S.0.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 hospital~zed 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" Outpatients - in O.T. department charts until discharged from act~ve treatment, then forwarded to

medical chart

IV. DISCHARGE I TERMINATION OF INTERVENTION

Discharge Note

Use S 0.A P. format (or short narrative when appropriate) lnclude - summary of treatment, status of patient on d~schargeltermination of O.T. ~ntenrention and follow-up plan (i.e refer to other service centre as needed) Note signed by O.T. I countersign student note

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

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

-

CHARTING STANDARDS - MGH PSYCHIATRY

Assessment and Intervention Planning - for all services

Initial Assessment and write up Date of assessment Age Sex Referral source Chief complaint History and present illness Past psychiatric history Past medical history Family history Alcohol and drug abuse Social history Mental status, diagnostic impression, rx plan (may be done in co-ordination with treating team)

Signed by OTIstudent notes countersigned

RTC date Should be written in ambulatory care sheets In the case of TDP, CLS, Addiction Unit and Day Center, the-above information is entered on the attached service specific intake forms

INTERVENTION

1 - progress notes

a) Inpatient- written in consultation section using yellow OT record

- write date - use brief narrative format - use measurable objectives where possible

frequency- when change takes place or every 1-2 weeks

b) Out-patient- - use ambulatory' care sheets - include date, service - use brief narrative format

frequency-

- as per visit - when change takes place - monthly - once every 4-6 weeks - as per service

Dischargeltermination of intervention

Discharge Note

- brief narrative format - include summary of treatment, clinical, psychosocial status and follow up plan

Signed by OTI countersign student note

In-patient- on yellow OT record, in consultation section of main chart

Out-patient- written on ambulatory care sheet, date, service and signature

Centre uriiversitaire de sante McGill McGill University Health Centre

POLICY AND PROCEDURE OCCUPATIONAL THERAPY SERVICES - MlJHC

1 PAGE: 2 TITLE: PATIENT DISCHARGE1 DlSCONTlNlJATlON OF TREATMENT1 REFERRAL TO OTHER SERVICE Psychiatry MGH

OF: 4 POLICY 1 PROCEDURE #: 6.14

EFFECTIVE PATE REVISION # REVISED DATE SECTION: : 6

PATIENT CARE

POLICY IN-PATIENTS

Patients will be discharged from O.T. when discharged from the hospital or when they have plateaued. *

POLICY OUT-PATIENTS 1. General Psychiatric Clinics and Crisis

No policy submited

2. Rehabilitation Day Center

Average length of stay is 6 months to 1 year.

Discharge would occur for any of the following reasons: - Person has made maximum gains within the program - Person no longer wishes to work actively towards improvement- participation is voluntary. - Even if 1 year has passed, in certain situations, length of stay can be extended to ensure gains

are consolidated and adequate community links are put in place. - If person arrives at program under the influence of alcohol or street drugs. - If any physical act of aggression is committed against another person or property. - If any strond tendency towards verbal aggression can not be contained with behavioral

interventions. - If level of funciton is too low to allow for participation for various reasons: egs. 1 ) psychosis

is not controlled adequately, 2) group participation raises social anxiety to an unmanageable level. Efforts are always made to modify structure and approach, however, the program must be geared t o a group/community benefit.

3. Continuing Care If a client moves out of the MGH sector, he could still be followed by Continuing Care Services or decide to be followed by another Hospital. If the client moves out of the country or does not come for his appointments, his file will remain open for six (6) months and then closed, if there is no change. Otherwise, the client is followed on a long term basis.


1 4. Transitional day Programme i

PAGE. 3 OF. 4

TITLE: PATIENT DISCHARGE1 DISCONTINUATION OF TREATMENT1 REFERRAL TO OTHER SERVICE Psychiatry MGH

1

Patients are discharged when they have: Met goals established at initial assessment Have been referred and accepted by another facility Stopped attendinglnon compliant with programme Decompensated (e.g. suicidal) Connected with new follow-up team (if patient is new) with MGH system.

POLICY I PROCEDURE #: 6.14

Exclusion Criteria for TDP Patients who: Require 2 4 hour care

Lack housing Actively suicidallhomicidal Have primary orgainc brain syndrome

EFFECTIVE DATE

5. Community Link Services

REVISION # REVISED DATE SECTION: : 6

Patient are discharged from the Community Link Services following 0 months of stability This stability would be indicated by:

Patient is able to keep appointments at the office Patient is compliant with medication Patient has a stable housing Patient has unfrequent psychosocial crisis

DATE

2 0

YEAR YEAR

2000

Patient that is discharged from the CLS is transferred to a more traditional service such as CCC, GPS, CLSC, etc.. . I

MONTH

0 3

1 6. Addictions Unit I

MONTH

Patients will be dishcarged from the unit when they have: Completed all recommended treatments Referred to another treatment facility Referred to another MGH unit Failed to attend group treatment Stopped attending Not complied with programme rules Become incarcerated

DATE PATIENT CARE

--

Jty McCiill University Health Centre

\ POLICY AND PROCEDURE

OCCUPATIONAL THERAPY SERVICES - MUHC

TITLE: PRlORlTY OF TREATMENT - PSYCHIATRY- MGH

POLICY/ PROCEDURE #: 6.1 5

I PAGE: 2 OF: 3

EFFECTWE DATE REV 180 DATE SECTION: 6

PATIENT CARE

POLICY:

I All referrals received by Occupational Therapy Services will be prioritised according to standards established wih111l , each unit. 1 1. Addictions Unit

Patients that are pregnant Patients referred from the E.R. Consultation transfers

2. General Psychiatric Clinics and Crisis No policy submitted

3. Rehab Day Center If a waiting list exists, patients are placed on the list in order of the date of referral. Generally assessment procedure and admission (if suitable) proceeds in this order i.e. 1" referred. The majority of patients referred are in fact patients with prior history and various treatments. In addition they are 1 actively being followed elsewhere e.g's: continuing care teams, general psychiatry, transitional day program, community link service. 1 Therefore a trial in longer term rehabilitation is generally not urgent. 1

I Rare exceptions to the rule (an individual may be moved up the list)

To catch them during a period of increased motivation Provide additional structurelsupport through an important transition, e.g.'s change in living situation, substantial recent loss.

4. Community Link Service There is no criteria established for CLS. Assessment are done on a first come, first served basis.

5. Transitional Day Programme ~atiknts from E.R. Patients from In-patient Unit Other out-patient clinics, CLSC

CODE OF ETHICS OF OCCUPATIONAL THERAPISTS Professional Code

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

DMSlON I

GENERAL PROVISIONS

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" : evefy 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

DUllES AND OBLIGATIONS TOWARDS M E PUBLIC

2.01. An occupational therapist must, unless he has sound reasons to the contrary, support evefy measure likely to improve the quality and availability of professional sewices 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 educatlon and information.

<<:.:::cc- . . ......... ......, . ..... -,:.:,:>- 2.04. An occupational therapist must be well informed

...:.'.>. .... 2. ..:.:.::,< . -li .. .,. . .-.:.:.. on new developments in the field of occupational therapy

.,,... . ,i .. practice so as to offer professional services of the highest

DMSION Ill

DU~ES AND OBUGATIONS TOWARDS CUENTS

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 intepiews 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 occupafional therapist must svoid 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 or another competent person, or refer him to one of 1 bese perms.

3.02.03. An occupational therapist must, as soon as possible, inform his client of the nature and method of the treatment he requires and, where applicable, must obtain his agreement in the matter.

3.02.04. An occupational therapist must refrain from expressing opinions or giving advice that is contradictory or incomplete. To this end, he must endeavour to have full knowledge of the facts before eqressing an opinion or giving advice.

3.0205. Unless he has sound and reasonable grounds to the contrary, an occupational therapist must explain to his client In a complete and objective manner the nature and implications of the problem as it appears to him from the sum total of facts which have been brought to his attention.

3.02.06. An occupational therapist who ascertains that his treatment is not likely to improve the clienls functional independence must notify him thereof immediately.

'

4;'. Avathbidg and dikgence

3.03.01. An occupational therapist must display reasonable availability and diligence in the practice of his profession.

3.03.02.' In addition to opinion and counsel, an occupational therapist must provide. his client with any explanation necessary to the understanding and evaluation of the services rendered to him.

3.03.03. An occupational therapist must give an account of his services to his client when so requested by the latter.

3.03.04. Where an occupational therapist is called upon to pursue work previously entrusted to another occupational therapist or a member of another order, he must, before accepting such work, inquire into the latter's mandate to see if it has actually terminated, provided he knows of Vlis mandate.

3.03.05. Unless he has sound and reasonable grounds to the contrary, an occupational therapist shall not cease to act on behalf of a client. The following shall, in particular, constitute just and reasonable grounds : ' ,

(a) the fact that the occupational therapist is placed in a situation of conflict of interest or in a context such that his professional independence could be call,ed in question ;

(b) the fact of being incited by the client to perform illegal, unfair or fraudulent acts.

3.03.06. Before ceasing to provide his services to a client, an occupational therapist must notify him thereof within a reasonable lapse of time and ensure that this will not cause him serious prejudice.

3.04.01. A noccupational lerapist must, in the practice of his profession, fully commit his personal civil liability. He is thus prohibited from inserting in a contract of professional se~ices any clause directly or indirectly excluding, in whole or in part, such liability.

$5. Iz&endence and [email protected]

3.05.01. An occupational therapist must ignore any intervention by a third party which cqu& influence the performance of his professional duties to the detriment of his client.

3.05.02. An occupational therapist must safeguard his professional independence at all times and avoid any situation which could put him in conflict of interest. Without restricting the generality of the foregoing, an occupational tlg-apist :

(a) is in conflict of interest when the interests at hand are such that he may be influenced to favour certain of them over those of his client or his judgment towards the latter may be unfavourably affected ;

(b) is not free to advise a client on a given act if he can derive a direct or indirect, real or possible personal benefit therefrom.

3.05.03. Except for the remuneration to which he is entitled, an occupational therapist shall not receive, pay or undertake to pay any benefit, rebate or commission in connection with the practice of his profession.

3.06.01. An occupational therapist must respect the secrecy of confidential information obtained in the practice of his profession.

3.06.02. An occupational therapist shall be released from professional secrecy only with the wniten authorization of his client or when so ordered by law.

3.06.03. An occupational therapist must avoid indiscreet conversations conceming 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 thecourse of research may be used for publication or teaching purposes only if the identity of Ule persons concemed is kept confidential.

3.06.06. An occupaUonal therapist must obtain the written permission of the client concemed when using audiovisua( techniques for purposes of therapy, teaching or research.

$7. Term and conditions ofthe extnise ofthe nkhtj o f access and cornchon pmvidedfor in sedon 60.5 and 60.6 of the Pmjsn'onal Code and obhgation for an ocnrpatlonal thertist to giue donlments to his ckent ,

. ... .:, . . . . . . . . . . ...,.

3.07.01. An occupational therapist may require that an ...: .-. :<:*,.:. . . .., ' .::.:.,:. :.>:.:?

application referred to in sections 3.07.02, 3.07.05 or :::I' . : ...., ..... .:;.: ..:: :

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

.:* ....,, :> .:.>:..

.::.... .... ;>:3: 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 concern him in any record made in his regard ;

(2) to obtain a copy of the documents that concern 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 f :he information, inform his client of the approximate mount he will have to pay.

3.07.04. An occupationai 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 hls regard shall inform his client in writing that the disciosure would be likely to cause serious harm to his client or to a third party.

3.07.05. In addition to the particular rules prescribsd 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 b e 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 inforrnation or an attestation that the information was deleted or, as the cass 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~trusted to him by his client.

An occupational therapist shall indicate in his client's record, where applicable, rhe reasons to support his client's application.

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: U!L(

pu!e6e pmas uaeq seq lu!e[dwo3 e ua4M JO

plaq aq 01 s! eoualeduo~ JO Ionpuoo leuolssajad s!q olu! hjnbu! ue leg pauojul s! eq uaqm luqsisse s!q JO apuk eq p uo!ss!~ed uagw loud eq lnoqp mu!eld eq QW 6u~e~!umuuoo (q)

! saqnras leuo!sse)o~d s!q 04 VoseJ 01 swal paleada~ JO 6u!ssa~d u! uos~ad e Bu~dtuo~d (e)

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" - ,'. Jaqloue slu!odde ls!de~aql (euogednooo ue UaqM '~0'8ty~

.sea4 s!q 40 luatuhd u!qqo oi (esods!p s!q le sueau r; sigi Jawo aql Ile pqsneqxa eAeq pnlu ls!deJayl pogednmo

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ue 'sbu!paaoo~d le6al 01 esJno3aJ 6u!wq aJojea 'SO'SO'~

s!q pay!]ou hlnp 6urheq ~a))e Kluo siunoo~e 6u!puqslno . +*:!< . . ..... . uo IsaJatu! palloo Aeur p!deJau leuo!ledna30 uy '9030'~ ., k:::. A. ..... . (, ... .::;:::

1 ... :.:..- -,.;... . , .C

*saD!Nas s!q jo ]so9 alew!xadde aql lo luap s!q /J!lou 'pueq Jalllo ew uo 'Isnu aq ! sayas s!q 40 luawKed aouewe Gu!puetuap WOJ~ u!eJp lsnw 1s!de~a4 leuogednooo uv 'EO'~O.E

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sag& gicauGdpuu xo.tltrU,waa '83

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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. Conhibution to the advancement of he pmfeson

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.

DMSION V

COND~ONS, OBUGA~ONS AND PROHIBITIONS IN RESPECT OF ADVERTiSlNG

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 rneans 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.

. . .

5.08. 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 date 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 khowledge of occupational therapy or the professional services covered by the advertisement and must :

(I) 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 secretaty 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 ergotherapeutes du Qu6bec.

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.

( September 1998

Associate Medical

MGH Dr. F. Ckapnon

-Pharmacy (MUHC) -Rehabilitation Program (A) -Trauma Program (A) - S M Q - Brain Injury Program -Clinical Departments (MOH)

'Under miew (A)Adult

Designated MUHC Transfusion Centre MNH Clinical

De~ariments

Executive Cmte J ------ --------

1 Associate Medical

Dr. C. Dupont -Infection Control '

' (MUHC) -Clinical Pediatric Dtpts. -Pediatric Clinical Ethics -Pediatric Clinical Investigation Unit - MCH Clinical Labs -Pediatric Pharmacy -MCH Complaints Mgmt -MCH CPDP Cmte's -MCH Residents' Oflice

I I

Associate Director Hospital Services

Ms S. lhmbb

-Medical Rccords (MUHC) , -Admitting 8t Discharge ,

(MUHC) -Clinical Pcrfkion (MOH/MCH) Child & Adolesc. Amb. Sew. -Audio-visual (MCWOH) -Child & Adolesc. Biobchevioraf Sciences Uriit -Child Life Dcpt. -Pediatric Clinical Nutrition -Pediatric Diagnostic Serv. -MCH Pastoral Serv. -Pediatric Anesthesia Techs. -Pediatric Rcspirabry Thenpy -MCH -Prttintrir- Social T r r a ~ t r n n Work Prnnme- Dcpt.

Associate Medical DPS RVH

Dr. M. Marcil

Associate Hospital Scrnices Services

Director (1) Ms ?? Gmab

-Clinical Depts. (RVH) -Montreal Chcst Institute

-Allied Rofessionals(A) *Physiotherapy * Occupational Therapy * Clinical Nutrition * Social Services * Psychology * AudiolagyfSpeech

Pathology

'P~storal

-Laboratoria (MUHC) -Diagnostic Radiology (MLIHC) -Ctudioreapiratory Tech (A) -Radiotherapy (MUHC) -Elcctrophysiology (A) -NuclearMedicint (MUHC)

-Radiation Safety (MUHC) 'Libraries -Biomedical Engineering (MUHC) -Food Services (MUWC) -Clinics (Adult) -Cardiology -MUHC Equipment Review Cmte * Cath Lab -Medical Physics ('MUHC) * Pacemakers * Echocnrdiolosy * ECC)

rri

2

POSITION DESCRIPTION

1. MANAGER OCCUPATIONAL THERAPY JOB TITLE NUMBER

sub-service :

division: Professional Sexvices

sub-sewice number:

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 that always puts 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.

" Revision 2 -November 11,2000

4, & 5 , GENERAL & SPECIFIC DUTIES

CLINICAL SERVICES

Creates in conjunction with staff a vision for Occupational Therapy Services. Consistent with the vision of the MUHC and provincial and national professional bodies, ensures that the MUHC OT Services assumes 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, and that they work in an multidisciplinary fashion.

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 as appropriate and ensures accreditation standards 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.

l 1 Revision 2 - November 1 1,2000

" Revision 2 -

Ensures that all staff receive the 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, job standards.

Ensures all staff while working are members in good standing with the Ordre des ergoth6rapeutes.

Creates a mechanism of compiling and reporting information (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.

COMMUNICATION/REPRESENTATION

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 profession.

November 1 1,2000

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.

~aintains accreditation - national, provincial and successfully participates in hospital CCHSA accreditation.

Effectively manages Human Resources, taking into consideration the Collective Agreement.

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.

8 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.

L1 Revision 2 -November 1 1,2000

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 attendances 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 a11 staff.

" Revision 2 -November 11,2000

7.6 NUMBER OF EMPLOYEES SUPERVISED (FTE):

OCCUPATIONAL THERAPY NUMBER AND LOCATION OF EXPLOYEES 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 ~n-patients 1 F.T.E. O.T. Out-patients 1.6 F.T.E. O.T.

Psychiatric Rehab Day Centre & Community Link Service

Out-patients 2.8 F.T.E. O.T.

Griffith Edwards House (addictions & substance abuse)

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.

Main Department A3.20 In-patients 3.5 F.T.E. Out-patients 2.5 F.T.E. Support staff 1.5 F.T.E.

Geriatrics M8.38 1.0 F.T.E. 2.2 F.T.E.

Geriatric Day Hospital Ross 4 1.0 F.T.E.

Montreal Chest Hospital 1.0 F.T.E.

Montreal Neurological Hospital 3.3 F.T.E.

Number of Employees

O.T. 4 O.T. 3 Senior Clerk 3

O.T. T.R.S.

O.T. 1

O.T. 1

O.T. 4

I' Revision 2 -November 11,2000

Allan Memorial Institute

Vocational Rehab 1.0 F.T.E. O.T. Day Hospital 1.0 F.T.E. O.T. In-Patients and Adolescens 1.3 F.T.E. O.T.

3.3 F.T.E. O.T.

15.6 F.T.E. O.T. 2 2 OT's 2.2 F.T.E. T.R.S. 3 TRS' 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 of each of 10 sections, effectively manage the overall resources, report as required, maintain effective communication links and represent the department both internally and externally.

8. 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.

" Revision 2 - November 1 1,2000

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:

DATE :

DATE :

DATE :

~ord/des.an Revised version: April 13, 2000 Revised version : " Revision 2 -November 11,2000

DRAFT 6.

POSITION DESCRIPTION IN-PATIENTS

1. OCCUPATIONAL THERAPIST JOB TITLE NUMBER 1231

Sub-service: Occupational Therapy

Division: Professional Services

Sub-service number: 24704

Position NO: 0137-24704-010

Hospital Site where position is budgeted: Montreal General Hospital

2. JOB SlJMMARY

Under the direction of the Manager of Occupational Therapy, and the Professional practice team leader the incumbent will provide a full range of occupational therapy services to adult clients of the MUHC, as well as undertake delegated tasks in teaching and research within clinical programmes.

2.1 JOB OUTLINE (Unionized Position)

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 beneficiaryr s file. (Translated from Collective Agreement).

3. MAJOR RESPONSIBILITIES

* 8 0 % 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.

* % negotiated pending on the position

GENERAL DUTIES Evaluates patients referred for Occupational Therapy using whenever possible standardized tools and outcome measurements to demonstrate evidence based practice.

Analyzes results and develops a plan with specific interventions in collaboration with the team.

Attends and participates in ward/multi-disciplinary rounds as appropriate.

... / 2

Involves the client,family in the plan when appropriate.

Collaborates with team members to formulate and facilitate the treatment and/or discharge process.

Ensures (as far as possib1e)that patient's 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 a learning experience and supervision/teaching of OT students (clinical training) and to other allied health care professionals when relevant.

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..

5.0 SPECIFIC DUTIES

Using standardized evaluations, observations and activity analysis. Assess clients functional, cognitive ADL and interpersonal skills.

Plans, organizes and implements OT groups focused on leisure activities, social skills training and basic life skills groups.


1. Ability to articulate the role of the OT and findings within the context of a multidisciplinary team and a large tertiary care facility.

2. Attainment of annual objectives.

3. Quality and quantity of patient care meets standards expected (chart and statistic audits).

... / 3

4. Responds appropriately and in a timely fashion to directives and requests.

5. Demonstrates interest and ability to participate in research, publications, presentations and teaching.

6. Responds to peer review.

7. Works autonomously, but acknowledges limitations, and acts appropriately.


7 .I DECISION MAKING

Initiates and prioritizes own work.

Operates within professional scope autonomously, while consulting the P.P.T.L. and/or OT Manager.

INTERNAL: Physicians, multid.isciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources (CLSC, ? ? ? ? )

7.3 INFORMATION AND DATA ON THE ADMINISTRATIVE UNIT

IS a full-time OT as part of a MD team dedicated to in-patient care which consists of Psychiatrists ( ? F.T. E. ) , ? Nurses. Is ( ? F.T.E.) , ? S.S. ( ? F.T.E.) , Psychologists ( ? F.T.E.) ? ? ? ?

7.4 SUPERVISION RECEIVED

Reports directly to the Manager of Occupational Therapy but responds to the P.P.T.L. regards day to day operations and quality of programme.

New staff or staff new to a service will be mentored by another therapist, assigned by the P.P.T.L.

7.5 SUPERVISION EXERCISED

2-3 students from UI, .UII or UIII are supervised each year.

7.6 NUMBER OF EMPLOYEES SUPERVISED (FTE)

None

7.7 WORKING CONDITIONS

35 hrs. per week.

Mon-Tues-Wed-Thurs-Fri: 7 hrs per day

8.0 QUALIFICATIONS

8 .1 EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with lrOrdre des Ergotherapeutes du Quebec

8.2 WORK EXPERIENCE

Experience relevant to the position.

8.3 OTHER

Fluent in both spoken and written French and English. Computer skills an asset Committed to life long learning Is flexible, self motivated and a team player

9 . 0 SIGNATURES

PREPARED BY :

AUTHORIZED BY:

AUTHORIZED BY :

REVIEWED BY:

DATE :

DATE :

DATE :

DATE :

REVISION 2- March 2, 2001 Ref/d/st/mgh/jobdescriptions

DRAFT 6.

POSITION DESCRIPTION REHABILITATON COMMUNITY LINK SERVICE





Position NO: 0137-24704-008


2. JOB SUMMARY



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 beneficiaryr s file. (Translated from Collective Agreement).


*80% Develops and provides patient evaluation and direct care. Plans, liaises and consults with client, family and team.




4.0 GENERAL DUTIES Evaluates patients referred for Occupational Therapy using whenever possible standardized tools and outcome measurements to demonstrate evidence based practice.



... / 2



8 Ensures (as far as possib1e)that patient's safety upon discharge is not compromised.








Assumes special responsibilities as delegated that promote and enhance the professional role within the institution and/or specific patient population.

5.0 SPECIFIC DUTIES

Responsible as primary care therapist for 12-15 clients. (patients are seen frequently).

Provide leadership role in the innovation Of OT treatments for Community Link Service.

Provide specialized expertise and teaching in the role of OT in the community to other members of the health care team, members of the community and other health care members.






5. Demonstrates interest and ability to- participate in research, publications, presentations and teaching.




7.1 DECISION MAKING



INTERNAL: M.Dfs, R.N.'S, S.Wfs etc ... EXTERNAL: Community resources, police, courthouse, prisons, public curator' s office, families, landlords, janitor, pharmacist, CP/specialized clinics.


Community Link Service's offices are located in the McConnell building. The OT (full-time) is part of a team that consists of ? ? ? ? ? R.N. s ( ? F.T.E. ) , Social Worker ( ? F.T.E. ) , Psychiatrists ( ? F.T.E.), etc ... ??





2-3 students from UII or UIII are supervised each year. Student supervision is a shared activity.


None

WORKING CONDITIONS

35 hrs. per week.

Mon-Tues- Wed- Thurs- Fri: 7 hrs per day (8:-4:OO)

8.0 QUALIFICATIONS

8 .1 EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with lrOrdre des Ergothbrapeutes du Quebec

8.2 WORK EXPERIENCE

A minilnuin of 5 years experience in psychiatry.

8.3 OTHER

Fluent in French and English. Able to work as a member of a M.D. team Comfortable working in a very unstructured setting Must be able to demonstrate qualities of flexibility, autonomy, innovation and ability to make quick decisions in critical situations. Committed to life-long learning. Computer skills an assett. .

9 . 0 SIGNATURES

PREPARED BY :

AUTHORIZED BY:

AUTHORIZED BY :

REVIEWED BY :

DATE :

DATE :

DATE :

DATE :


DRAFT 6.

POSITION DESCRIPTION REHABILITATON DAY CENTER & CONTINUING CARE


Sub-service: Occupational Therapy Sub-service number: 24704

Division: Professional Services Position NO: 0137-24704-003


2. JOB SUMMARY



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 beneficiaryfs file. (Translated from Collective Agreement).









... / 2



Ensures (as far as possib1e)that patient's safety upon discharge is not compromised'.









5 . 0 SPECIFIC DUTIES

RDC

As a member of the multi-disciplinary team provides a leadership role in the innovation of O.T. treatment for rehabilitation and continuing care clients.

Undertakes individual assessments to determine clients suitability for RDC.

Plan, organize and implement occupational therapy groups for regular census of 25 patients.

Responsible as a primary therapist for 5 patients

Responsible to maintain equipment and order supplies for RDC.

Co-ordinate referrals from continuing care and introduce new patients into groups.

Maintain liaison with case managers.

Conduct 2 groups per week for a census of approximately 20- 25 patients.

CCS

Acts as a primary therapist and case manager for 32 -35 patients.

Provide specialized expertise for multi-disciplinary staff requiring consultation and teaching.

Provide liason with community resources.










7.1 DECISION MAKING



INTERNAL: Physicians, multidisciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources (CLSC, ? ? ? ? )

... / 4

7.3 INFORMATION AND DATA .ON THE ADMINISTRATIVE UNIT

Is a . 6 of O.Tfs of 1.1 F.T.E. working within a multidisciplinary team of 3 R.N.'s ( ? F.T.E.), social worker ( ? ~.~.E.),psycho-educator( ? F.T.E.), music therapist ( ? F.T.E.), for the Rehabilitation Day Centre.

Is a part-time 0.T (.2) within a multi-disciplinary team of ? R.Nfs ( ? F.T.E.), Social Worker ( ? F.T.E.), Psychiatrist ( ? F. T . E. ) , Psycho-education ( ? F. T. E. ) for the Continuing Care Service.





2-3 students from UI, UII or UIII are supervised each year. Student supervision is a shared activity.

7.6' NUMBER OF EMPLOYEES SUPERVISED (FTE) None


28 hrs. per week.

Mon-Tues-Wed-Thurs: 7 hours per day (8-400)

QUALIFICATIONS

EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with lfOrdre des Ergotherapeutes du Quebec

8.2 WORK EXPERIENCE

Relevant to position.

8.3 OTHER

a Fluent in both spoken and written French and English. Computer skills an asset Committed to life long learning Is flexible, self motivated and a team player

9.0 SIGNATURES

PREPARED BY:

AUTHORIZED BY:

AUTHORIZED BY:

REVIEWED BY:

DATE :

DATE :

DATE :

DATE :

REVIS ION 2- March 2, 2001 ~ef/d/st/mgh/jobdescriptions

DRAFT 6.

POSITION DESCRIPTION TRANSITIONAL DAY PROGRAMME


Sub-service: Occupational Therapy Sub-service number: 24704

Division: Professional Services Position NO: 0137-24704-001


2 . JOB SUMMARY

Under the direction of the Manager of Occupational Therapy, and the Professional practice team leader the incumbent will provide a full range of occupational therapy services to adult clients of the MUHC, as well as undertake delegated tasks in teaching and research within clinical


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 beneficiaryrs file. (Translated from Collective Agreement).








Attends and participates in ward / rnu l t i -d i sc ip l ina ry rounds as appropriate.

... / 2












5.0 SPECIFIC DUTIES

As a member of the multi-disciplinary team provides a leadership role in the innovation of O.T. treatment for Transitional Day Programme patients.

Responsible as a primary resource person (PRP) for 5-7 patients.

As a member of the multi-disciplinary team provides a leadersip in the innovation of OT treatment for TDP patients.

Plan, organize and implement Occupational Therapy groups (community living skills, etc ...) for the entire TDP population.

Provide expertise in evaluations for cognitive, ADL, prevocational and overall functional skills.

Liaison with family members as part of treating team and provide psycho-education.

To be involved in various unit events, eg. Psycho-education Day, Grand rounds, Research committee, etc ...










7.1 DECISION MAKING



INTERNAL: physicians, multidisciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources (CLSC, ? ? ? ? )


Is a . 8 F.T.E. 0.T on the Transitional Day Programme and forms along with 2 R.N.'s (1.0 F.T.E.), the core staff. This team is supported by a social worker ( ? F.T.E. ) , a Psychiatrist ( ? F.T.E.), a secretary ( ? F.T.E.), Psychologist and team leader, (F.T.E.),educator ( F.T.E.), music therapist ( F.T.E.). All disciplines provide clinical stages throughout the year.





2-3 students from UI, UII or UIII are supervised each year.


None


28 hrs. per week.

Mon-Tues-Wed-Thurs: 7 hrs per day

8.0 QUALIFICATIONS

8 .1 EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with lfOrdre des Ergotherapeutes du Quebec

8.2 WORK EXPERIENCE

Relevant to position.

8.3 OTHER

Fluent in both spoken and written French and English. Computer skills an asset Committed to life long learning Is flexible, self motivated and a team player

SIGNATURES

PREPARED BY:

AUTHORIZED BY:

AUTHORIZED BY:

REVIEWED BY:

DATE :

DATE :

DATE :

DATE :


DRAFT 6.

POSITION DESCRIPTION REHABILITATON CRISIS &

GENERAL PSYCHIATRIC

1 OCCUPATIONAL THERAPIST JOB TITLE NUMBER 1231




Position NO: 0137-24704-002


2. JOB SUMMUtY



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).









... 1 2












5.0 SPECIFIC DUTIES

Serves as a case manager for approximately 65 patients affiliated with the Department of Psychiatry Crisis Intervention Unit and General Psychiatry Clinics.

Provides therapeutic interventions on a short (12 week) medium (6 months) or long term (indefinite) basis which includes counseling, mobilization of resources to stabilize crisis situations.










DECISION MAKING



INTERNAL: Physicians, multidisciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources (CLSC, ? ? ? ? )

INFORMATION AND DATA THE ADMINISTRATIVE UNIT

. 8 F.T.E. allocated to the following services:

1) Crisis Intervention Unit, OT .4 F.T.E., R.N. (6 F.T.E.), social worker (3 F. T. E. ) , Psychiatrist ( .1 F. T. E. ) , receptionist ( ? F.T.E.), intake co-ordinator ( ? F.T.E.)

Medical Students and Psychiatric residents:

2) General Psychiatry Clinic, OT .4 F.T.E.,? F.T.E. Psychiatrist

SUPERVISION RECEIVED




No students are allocated to this service.



28 hrs. per week.

Mon- Tues- Thurs- Fri: 9 - 2.30

Wed: 9 - 3.30

QUALIFICATIONS

EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with llOrdre des Ergothbrapeutes du Quebec

8.2 WORK EXPERIENCE

Previous experience an asset.

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JaAe~d me33 e pue pa3enraom gTas 'a~q~xa~g SI . 6uruxea~ 6uo~ agrT 07 paJJrunuo3 Tasse ue sTT?ys ~a~nduro3 . 'ys~~6uz pup y3uaJA UaJTTJM pue uayods yaoq u~ auanTd

DRAFT 6.

POSITION DESCRIPTION ADDICTION UNIT

1. OCCUPATIONAL THERAPIST JOB TITLE NUMBER 12 31




Position NO: 0137-24704-004


2. JOB S-Y



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).









... / 2

a Involves the client,family i.n the plan when appropriate.


a Ensures (as far as possib1e)that patient's safety upon discharge is not compromised.

a 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.

a Participates in ongoing departmental activities mandated to promote the wellbeing of patients and their families, the staff and the MUHC.

a Responsible to provide a learning experience and supervision/teaching of OT students (clinical training) and to other allied health care professionals when relevant.


a Provides coverage as needed.

a Responsib1.e to work and treat patients in a safe environment free from hazards.


a Assumes special responsibilities as delegated that promote and enhance the professional role within the institution and/or specific patient population.

5.0 SPECIFIC DUTIES

a As a member of the multi-disciplinary team provides a leadership role in the innovation of O.T. treatment for addiction/dual diagnosis clients.

a Provide specialized expertise on for interdisciplinary staff (i.e. Psychiatric residents, medical interns, psychologists requiring consultation, teaching or training.

a Acts as a case manager - assessment through programme completion for approx. . patients.

a Acts as group leader and organizes therapy groups for clients in both early and advanced stages of therapy for addiction.

a Undertakes cognitive and functional assessments and plans appropriate interventions.

... / 3

Uses projective techniques to

Undertakes prevocational assessments and interventions and offers life skill training. .

Uses a client centered approach.










7.1 DECISION MAKING



INTERNAL: Physicians, multidisciplinary professionals, nurses, patients, families, colleagues and OT students. EXTERNAL: with community resources (CLSC, & ? ? ? ? )


Is one of 3 O.Tfs (.7 of 1.8 F.T.E.) who are part of the staff allocated to the Addiction Unit, located in Griffith Edward's House on Pine Avenue. Other staff include 3 Psychiatrist (.7 F. T. E. ) . (1 of whom is the Medical Director of the Unit) . 2 Psychologists (Director of Research and Unit Director). 2 nurses ( ? F.T.E.) 1 Psycho-educator ( ? F.T.E.) , 1 Unit/clerk receptionist ( ? F.T. E. ) , 1 intake co-ordinator ( ? F.T. E. ) . All disciplines provide clinical stages throughout the year.

... 14

7.4 SUPERVI SION RECEIVED




2-3 students from UII or UIII are supervised each year. Student supervision is a shared activity.


None


24.5 hrs. per week. Tuesday - 10.5 hrs. Wednesday - 7 hrs. Thursday - 7 hrs.

8.0 QUALIFICATIONS

8.1 EDUCATIONAL

Bachelor of Science in Occupational Therapy or equivalent Member in good standing with llOrdre des Ergotherapeutes du Quebec

8.2 WORK EXPERIENCE

Knowledge and understanding of the nature of the Addiction process. Expertise in running groups. Demonstrates excellent verbal and non-verbal communication CL, 1 1 a U I L L 4. 4. U .

8.3 OTHER

Fluent in both spoken and written French and English, Computer skills an asset Committed to life long learning Is flexible, self motivated and a team player

9.0 SIGNATURES

PREPARED BY:

AUTHORIZED BY:

AUTHORIZED BY:

REVIEWED BY :

DATE :

DATE :

DATE :

DATE :


STUDENT SUMMARY u,, %: In addition to the above, the incumbent is res~onsible for

- the coordination of the clinical education probrame of the " ,

, section at the 3 This includes the orientation to Occupational Therapy, : hospital clinical experience and/or academic training of ' the:

1) Occupational Therapy students enrolled at McGill p"- E

University. 9 21 Occutsational Therapy students from outside the -

province - -

(including fore ign stud placement P-. being approved by the McGill Clinical Coordinator. $ 3 ) High School/CEGEP/career day activities.

4) Volunteer placements. $3 szj,, . <V;<, : bj;

3 . MAJOR RESPONSIBILITIES .'c!,., a<; IF K;

1, 43 5% (1.5 hours per week of clinical responsibilities) c 0 Clinical Education Program: Identifies and analyzes the

needs of students and staff, developing a comprehensive I. clinical education program.

SPECIFLC DUTIES

To collaborate with staff in developing a student contract for each level of student. To develop and review policies and pracedures pertaining to the clinical education progrant. To orient students, volunteers, visitors to' the department and hospital. To collaborate with staff in planning of placements. To organize treatment evaluations/demons"t,raEions '-if necessary and when possible. To mediate any conflicts which may arise kith. students during placements. To assist staff as requested in the-evaluation of a student and in documentation of reports. To evaluate the feedback from stag5 $nd students, develop and implement rentedi$ ' actibn as required. To participate in all meetfngs'at McGiLl pertaining to the clinical education program and to act as a liaison between McGill. and the ~e~&rtGnt,.

Centre universitaire de santt McGill McGil l University Health Centre


TITLE: PROFESSIONAL DEVELOPMENT

POLICY:

The MUHC is committed to improving the skills and knowledge of employees, to enhance their coctribution 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.

When possible, each FTE is allowed five days paid study leave per annum. This is not a union policy and may be rescinded. Approval to attend a course must be granted by Department Head. Limited funds are sometimes available to 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 to 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 to 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

REVISION #

POLICY I PROCEDURE # 8.3

REVISED DATE EFFECTIVE DATE

YEAR DATE

20 YEAR

2 0 0 0

MONTH

0 1

MONTH

'

DATE

Centre universitaire de sante McGill McGill University Health Centre


I TITLE: SUMMARY OF CLINICAL ACTIVITIES - ACTIVITY REPORT

PAGE: 1 OF: 1

POLICY / PROCEDURE t: 1.1 1

SECTION: 1

ADMINISTRATION/

ORGANIZATION

REVISION # REVISED DATE EFFECTIVE DATE

YEAR

"J

DATE

10 YEAR

2000

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.

PROCEDURE:

The Activities Report should be written on the reverse side of the Non Patient Care Activities.

MONTH MONTH 01

DATE

Centre universitaire de santC McGill McGill University Health Centre


The Montreal General Hospital Physical Medicine Section

External Courses Attended by Staff 1999-2000

Champoux

Champoux

Champoux, Christopher

Couturier

Newman

Newman

Newman

Krug, Couturier, Rosen

Christopher, Champoux

Formation en supervision d'etudiants et professionnels

Traumatologie : Defis

Colloque : La prise en charge des personnes blessees medullaires traumatique

Multiple Sclerosis - Focus on Rehab

Assurance de la Qualite et Credibilite Professionnelle

Assessment of Motor and Process Skills (AMPS)

Canadian Assoc. of Gerontology Conference

Stroke Management : Ethical Considerations and Issues for the New Millenium

3rd World Congress on Brain Injury

Newman, Krug, McGill Clinical Couturier Research Day

Montreal 4

Qc City 2

Montreal 2

Montreal .5

Montreal 1

Montreal 5

Ottawa ' 1

Montreal 1

Montreal 1

Montreal 1

April 27,2000

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 Franqoise Rollin-Gagnon, Prbsidente Organized by Madeleine Shaw

3. Quality Assurance in Service Given by Marilyn Kaplow

Membership of Staff in Special lnterest Groups

Dysphagia - RVHIMNHIMGH Group Cancer in Rehab Group OT working with TBI (regroupement des ergotherapeutes) Hand Interest Group (with other hospitals) Monthly hand meetings MGHIRVH Regroupement des ergotherapeutes en sante mentale de la Grande Region Metropolitaine Journal Club (Psychiatry)

Occupational Therapy i nlsewices Physical Medicine April 111999 - March 3112000

May 1811999 ICU Monitors - Part I by Sylvain Richard. RN 1 hour

June 111999 ICU Monitors - Part I1 by Sylvain Richard, RN 1 hour

1 hour June 1511 999 01 Journal Club

July 611 999 Charting Guideline Presentation by Janie Rosen 1 hour

Oct 1 211999 Leika LtdlTherapeutic Surfaces by Oanielle L'Ecuyer 1 hour

Trail Making B by Elaine Deguise

Nov 911 999 (MGHIRVH)

Driving Evaluation by C6line Couturier and Marie-Claude Champoux 1 hour

1 hour Nov 2311 999 I.V. Pumps, Feeding Pumps & MinClnfuser

by Nancy Tze, RN

Nov 3011 999 (MGHIRVH)

Dysphagia at Instltut universitalre de geriatric de i'U de Mti by Marie-France Jobin 1 hour

1 hour

1 hour

1 hour

1 hour

AMPS Course b$, Julia Newman

CSST lkformaiton bybenis Gravel (OTIPT)

Feb 1812000 New Student Evaluatlon Form by Julia Newman

March 912000 2"# Part of Student Evaluation Form by Julia Newman

March 2112000 Box & Block Manual Dexterity Test by Cbline Couturier

Supewlskn of Students by Marie-Claude Champoux 1 hour

External Courses Psychiatry - MGH

Location DaydHours

Geller Review of Novel Antipsychotic in Treatment of Schizophrenics

La Sapiniere 2 days Val David Ave.

Geller Treatment of Anxiety Mont Tremblant 2 days Mood & Psychotic Disorders (Qc)

Gingras Colloque d'ergo en Sante Mentale

Julien Sante Mentale a I'aube du 3e Millenaire

Pentney, Psychopharmacology Randolph in Addiction Treatment

Ual Diagnosis, Personality Disorder (Prof Dev. x l yr home study)

HBpital 1 Riv des Prairies

HBpital 2 Pierre Janet

Rolbin Polarity Therapy (Prof. Dev. x l yr study)

In-Services Psychiatry - MGH

Date Toplc Olven by Hours

0 1 10312000 Review of Use of Risperidol vs Jansen 2 Olanzepine in Schizophrenia Ortho

0911 111 999 Suicidal Patient Psychiatry Dept 2 a Systems Approach MGH

0811 011 999 Action ABC Lisa Lucas I Literacy Training and Addiction

0411 1 11 999 Youth Protection Services R. Bonderoff 1

17/02/2000 Celexa - Antidepression Lundbeck 1

0210611 999 Language in Dynamics Dr. A. Surkes 5