Heidi Davies

Community-based service supporting timely discharge from hospital. Optimising clients occupational performance using a client centred, rehabilitative approach within patients' homes.

Efficiently manage and co-ordinate caseload – delegate tasks to Allied Health Assistants (AHA) when/where appropriate. Timely record keeping adhering to departmental policy. Timely efficient/effective communication with RITH team.

Assess, plan, develop, implement and evaluate specially tailored, evidence based, individualised therapeutic intervention plans for complex clients and their carers using a goal centred approach.

Assess/evaluate/implement, minor/major home modifications and assistive technology (AT) options for complex patients with, physical, cognitive, perceptual, psychosocial limitations. Recommendation of devices that will optimise their safety, occupational performance and autonomy within home environment/community.

Adopt a solution focused problem-solving approach to patient care. Regularly reflect on own/others practise in order to improve development and that of the RITH service.

Actively seek out/participate in learning opportunities relevant to RITH service and keep up to date with mandatory training.

Build therapeutic relationships with client's. Respecting their values and their homes and demonstrating empathy patience and understanding of their unique challenges. Empowering them to take ownership of their goals and working with them to optimise their occupational performance.

Identify and co-ordinate joint working, case conferences and family meetings if/when indicated in the care of the patient, working collaboratively with members of RITH Multi-disciplinary Team (MDT) to optimise patient outcomes/goals and maintain consistency across disciplines.

Working with complex cases at high risk of readmission to hospital - involving extensive liaison with multiple internal/external agencies in order to work toward a sustainable/seamless discharge beyond RITH – Provision of relevant information via e-referral, written reports, verbal handover, discharge letter, support letters and to ensure a seamless transition.

Referrals - Triage e-referrals/telephone queries - screen for appropriateness, seek additional information when required and provide feedback/education to referers when needed/requested from internal/external hospitals. If patient is not accepted to RITH provide support in exploration of alternate discharge solutions if needed. Progress referral as per RITH's current referral procedure. Identify if/when further education of acute staff is required.

On call - Saturday roster. Monitor incoming referrals assess need for weekend visit, provide assessment/intervention in patients home if required. Respond to phone queries regarding RITH service from internal/external providers.

Discharge planning – Provision of clear and concise education to patients/family/carers regarding discharge planning beginning at the initial visit and ceasing at conclusion of service. Summary of intervention and discharge plan given. Written documentation provided when/where appropriate.

Service Development – support inter-disciplinary team to optimise/streamline service, assisting in formulation, development and implementation of procedures/plans for RITH service - Working towards a seamless service and greater client satisfaction outcomes – reduce time spent on administrative tasks - monitoring via Red Caps.

Provide support to Coordinator/Manager - analysing information/data and reporting back.

Supervision -

• Partake in annual performance review - Loop. Provide clinical/professional.
• Support/train/guide/feedback to AHA's and junior staff, review their progress and assist in prioritisation/co-ordination of their caseload with wider MDT.
• Provide supervision/training to Students.

Carry out duties in accordance with - Occupational Therapy Association of Australia's code of ethics, National/State Government, WA Health, WACHS and departmental/ RITH specific policies/procedure incl of but not exclusive to Fleet Driver Management policy. Follow these policies and complete daily risk assessment of work/patient environments to increase safety of individuals, colleagues, patients and wider community.

Provided Occupational Therapy Services to patients on rehabilitation ward.

• Improved patient outcomes via evidence-based assessment, individualised treatment plans and monitoring progress. Delivered individually, within group settings and through joint working with other members of MDT.
• Prioritised active caseload. Completed goal setting with patients and their families.
• Built therapeutic relationships with clients and worked closely with MDT to deliver effective and seamless service for client and their families, take active role in MDT and family meetings in order to advocate for client and their needs.
• Provided education to patients and families on coping strategies, adaptive equipment, and safety modifications.
• Liaised with other stakeholders as/when necessary, in order to meet need of patients and their families.
• Worked with/directed AHA's in patient related care provided Education/training in AHA competencies and offered informal supervision when needed
• Worked with/trained OT students.
• Maintained clear, concise and accurate patient records in compliance with local and national standards. Following care plan objectives, keeping records of attendance and client progress.
• Kept up to date with mandatory training and competencies.
• Participated in annual loop review and sought assistance from senior members of team when required.
• Attended/participated in OT management meetings.

Provide Occupational Therapy services, to neurological clients within community who were members of MSWA or were under the NDIS scheme.

• Completed Goal planning/setting and prioritisation.
• Assessed, identified, recommended need for specialist equipment. Completed funding applications for equipment and Introduced, provided and educated client's in its use.
• Assessed and completed funding application and project management of major bathroom adaptations.
• Assessed, planned, developed, implemented and evaluate specially tailored individual therapeutic management programs for clients and their carers.
• Identified need for, set up/established MSWA Wheelchair clinic in Busselton - Posture/seating/equipment, assessment/review.
• Identified need for MDT initial screen Trialled/established/set up Documentation.
• Identified need for and initiated outreach group for members with M.S. in Busselton – feedback forms supplied and reviewed Quarterly.
• Identified need for increased resources/staff successfully - new premises and additional staff.
• Identified lack of supervision – initiated peer supervision monthly. Put case forward for Senior OT in south west position established 12 months later.

General Medicine(12 months), Stroke/Neurology Acute (12 months), Stroke/Neurology Rehab State Rehab service(12 months provided, acting P2 8 weeks to cover extended leave), Spinal State Rehab Service (12 months),Maternity leave(12 months) Leave relief (4 months), Weekend Cover(P2 8 months), Ortho Geri's(12 months).

• Prioritised caseload, assessed, planned, developed, implemented and evaluated specially tailored individual therapeutic care plans and managed their progress for improved patient outcomes.
• Attend, participated and facilitate Family meetings; Goal setting meetings and discharge meetings with MDT and other stake holders where appropriate in order to feedback on patient progress and effectively monitor, plan and co-ordinate patient journey.
• Liaised with internal/external agencies in order to meet client needs and deliver a seamless service.
• Assessment and treatments included but were not exclusive to Activities of Daily living, Cognition, Splinting, Return to driving, Community access, public transport training, transfer training, postural management, hoist training, equipment, return to work, functional Home Visits, discharge planning.
• Built strong therapeutic relationships with clients, through empowerment and advocating for them when and where necessary.
• Key worker for patients whilst working in state rehab unit on Neuro rehab and Spinal.
• Social outing Coordinator for spinal patients – organised/co-ordinated monthly social outings with Occupational Based focus.
• Provided a positive team environment by modelling excellent communication skills
• Weekend on Call – fabrication of Spinal hand splints for spinal pt's in ICU/Trauma Wards RPH.
• Maintained clear, concise and accurate patient records in compliance with local and national standards.
• Presented to Allied Health Forum, in Grand rounds and OT department.
• Completed Quality Improvement projects.

Community based service working with the over 55's providing an integrated services to promote faster recovery from illness, prevent unnecessary acute hospital admissions, support timely discharge and maximise independent living. Using a client centred, rehabilitative approach within Clients home and/or Intermediate Care Team (ICT) bed and transition to home.

• Prioritised, assessed, planned, developed, implemented and evaluated specially tailored individual therapeutic care plans for clients and their carers.
• Assessed, recommended, provided of AT within the community.
• Coordinated discharges from ICT beds incl of staged discharge or case conferences for a client/Arranged admission into step up bed for patients if required.
• SMART goal setting completed with MDT and reviewed weekly with MDT.
• Joint working with members of the MDT in order to meet Client goals where identified and able.
• Provided training/education/supervision/support to AHA's in their practise and their AHA competencies.

Acute Diversion Team:

Provide a rapid response service to the over 55's in the clients home it's purpose to respond to or avert a crisis/ admission to hospital, main source of referral G.P's:

• Assessed and managed risk to client. provided Assistive Technology to promote safety.
• Provided education to client and carers.
• Screened Clients within acute and community setting to establish client need and co-ordinated appropriate service and/or arranged step/down up bed if required.

Community OT service working across Health, Social Services and Education. Using holistic approach in assessment, treatment and management of babies, children and Young People with wide range of conditions. Interventions carried out in; Nurseries, Primary Schools, Secondary Schools, Child Development Centre, Hospice, Clinics and Home Environment.

• Prioritised, assessed, planned, developed, implemented and evaluated children's occupational performance through play.
• Assessed, recommended, introduced and sourced funding and/or provided specialist equipment, minor and major adaptations within the home/community setting as outlined above e.g. ground floor ext, through floor lifts, specialist seating to increase child's functional independence and inclusion
• Prepared reports, activity/therapy programs and maintained up to date records and case files.
• Actively participated in Service Development .

Worked in Hospital and Community settings, including; acute medical, Stroke Rehabilitation Unit, Paediatrics and intermediate care (6 monthly rotations).

• Assessed, planned, developed, implemented and evaluated programs for clients and their carers.
• Completed functional Home Visits.
• Manual Handling keyworker – provided training to OT staff.
• Mentor in Cumbria PCT Mentoring Scheme.
• Occupational Therapy Union Rep.