Acute Care

Acute care is an inpatient hospital setting for individuals with a serious medical condition. These patients may have experienced a sudden decline in their medical and functional status due to a traumatic event (e.g., head trauma or spinal cord injury), a worsening of a progressive disease (e.g., emphysema or end-stage renal disease), or the onset of a new condition (e.g., myocardial infarction or stroke). The primary goal of acute care is to stabilize the patient’s medical status and address any threats to his or her life and loss of function. Emerging research in medicine provides strong support for  implementing early mobilization of patients in acute hospital and critical care settings (Needham, 2008). Occupational therapy plays an important role in facilitating early mobilization, restoring function, preventing further decline, and coordinating care, including transition and discharge planning.

The Occupational Therapy Role in Acute Care The unique perspective of occupational therapy focuses on a holistic view of individuals where many factors can influence the success of recovery and the rehabilitation process. Occupational therapy practitioners believe that intervention provided for people with physical disabilities should extend beyond a focus on recovery of physical skills and address the person’s engagement, or active participation, in occupation” (Pendleton & Schultz-Krohn, 2006, p. 5). The concept of occupation is meant to “capture the breadth and meaning of everyday activity” (AOTA, 2008, p. 628). Occupational therapy practitioners contribute a broad range of clinical skills to acute/critical care services that include the following:
♦ Knowledge of the disease process, and surgical and medical interventions.
♦ Education in anatomy, kinesiology, and neurology, and their practical application to physical rehabilitation.
♦ A systematic process of client-centered evaluation, intervention, and task modification to facilitate progress toward identified goals (AOTA, 2008). This begins with establishing an occupational profile, identifying activities that the client needs and/or wants to do and the abilities or barriers to participating in those activities.
♦ Consideration of pre-hospitalization roles and the patient’s likelihood of resuming them. Practitioners will also consider such factors as discharge destination, and potential need for adaptive equipment and/or modifications for safety and driving, and/or community mobility needs.
♦ Development of an intervention plan with performance-based goals. Intervention and the process of discharge planning may occur simultaneously due to the short length of stay in the acute care setting.