Priority 8 from the Occupational Therapy PSP

UNCERTAINTY: What is the role or impact of occupational therapy in reducing hospital admissions? (JLA PSP Priority 8)
Overall ranking	8
JLA question ID	0100/8
Explanatory note	Occupational therapy is increasingly being recognised as having a role in preventing people from vulnerable groups (such as frail, older people and people living with long-term conditions) from being unnecessarily admitted into hospital. Experience suggests that home/access visits, access to occupational therapy in primary care settings, and inclusion in prevention and response services reduces hospital re/admissions. This question aims to explore this area in more detail to provide stronger evidence about the nature of the role and the impact it has. This includes the impact on the lives of the people accessing those services, the impact on the demands for, and effectiveness, timeliness and efficiency of acute services.
Evidence	Other than the non-OT specific paper listed, no up-to-date evidence found. This is an area of uncertainty. Chown, G. and T. Soley (2016). "A Phenomenological Study on the Perception of Occupational Therapists Practicing in the Emergency Department." Open Journal of Occupational Therapy (OJOT) 4(1): 1-15. College of Occupational Therapists (2015). Urgent care: the value of occupational therapy. London. James, K. (2016). "Occupational therapists in Emergency Departments." Emergency Medicine Journal: EMJ 33(6): 442-443. James, K., et al. (2016). "Occupational therapy and emergency departments: A critical review of the literature." British Journal of Occupational Therapy 79(8): 459-466. James, K., et al. (2018). "Occupational therapists in emergency departments: A qualitative study." British Journal of Occupational Therapy 81(3): 154-161. Lloyd, C., et al. (2017). "Emergency department presentations of people who are homeless: The role of occupational therapy." British Journal of Occupational Therapy 80(9): 533-538. Packer, R., et al. (2019). "Can non-pharmacological interventions reduce hospital admissions in people with dementia? A systematic review." Plos One 14(10): e0223717-e0223717. Spang, L. and K. Holmqvist (2015). "Occupational therapy practice in emergency care: Occupational therapists' perspectives." Scandinavian Journal of Occupational Therapy 22(5): 345-354.
Health Research Classification System category	Generic Health Relevance

Extra information provided by this PSP
Original uncertainty examples	The effectiveness of home/access visits in reducing hospital readmissions Would fewer people be admitted to hospital if there were more occupational therapists in primary care? ~ Does occupational therapy reduce readmission rates of patients with frequent hospital inpatient stays? ~ What is the impact of including occupational therapists within prevention and response services such as paramedics and fire services? ~ What percentage of OT assessments/interventions result in either admission prevention or preventing re-admission? What interventions in particular are achieving this?
Submitted by	Occupational therapists

Extra information provided by this PSP

Original uncertainty examples

The effectiveness of home/access visits in reducing hospital readmissions
Would fewer people be admitted to hospital if there were more occupational therapists in primary care? ~ Does occupational therapy reduce readmission rates of patients with frequent hospital inpatient stays? ~ What is the impact of including occupational therapists within prevention and response services such as paramedics and fire services? ~ What percentage of OT assessments/interventions result in either admission prevention or preventing re-admission? What interventions in particular are achieving this?

Submitted by

Occupational therapists

PSP information
PSP unique ID	0100
PSP name	Occupational Therapy
Total number of uncertainties identified by this PSP.	66 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	27 July 2020