Innovation in Action

November 1, 2016

Miriam Webster Dictionary defines innovation as the act or process of introducing new ideas, devices, or methods. Typically when I think of innovation, the first things that come to mind are technological advances like the latest smart phones and self- driving cars. But in the fields of healthcare and education, innovation is often represented in new ideas and methods rather than tangible items.

A popular quote that has been circulating media groups by Joe E. Martin, states, “If children aren’t learning the way we are teaching, maybe we should teach the way they learn.” When it comes to behavioral health and special education, innovation happens on a small scale every day. As an occupational therapist, I am constantly aware of looking for the optimal person, environment, occupation fit. Each of these elements impacts an individual’s performance and finding the right balance is a key component of success. A lot of times finding that balance requires innovation on the part of the therapist, the client, or the teacher.

As a child growing up with a parent with a spinal cord injury, I learned at a young age how to use everyday things to modify a task to assist my dad with routine daily life activities. For example, those over the kitchen sink wire racks make excellent book holders to raise items to be easily reached with a mouth stick and velcro helps attach just about anything to a chin control for easy access. Using everyday items to adapt the environment and task is just one example of how we use innovation in our classrooms. I have used binders as angled writing surfaces and pool noodles used to make pencil grips. There are so many different ways we can use ordinary objects to assist our clients and students with completing tasks of daily living, but it is not the only example of innovation I see at work.

A lot of focus in education and healthcare is on evidence based practice. We research and discuss methods that others have tested and found to work well. However, sometimes we have a case that doesn’t fit the mold for what others have done in the past. That is when we become innovators. We look at the needs of the client and the environment and start making changes and then collecting data to create evidence to support our methods. We change our strategies dependent on the outcomes we have recorded. It is imperative that in the midst of using evidence based strategies that we remember to be innovative in our approach when necessary.

As an occupational therapist, another way to be innovative is not only to vary the intervention methods and adapt the environment, but to also examine how services are provided. Under most models, in order for a client to benefit from occupational therapy services, there is an order of some sort, either a medical prescription or referral in hospital based settings or IEP mandated services in school based settings. The direct care service model is evidence based and works for those specific individuals who qualify. However when looking around our schools and treatment centers, one often sees people that would benefit from the unique perspective of a specialized clinician, but does not qualify for services for various reasons. Using a model of consultation and indirect service allows us to provide our specific level of expertise and collaborate with teachers, therapists, and other stakeholders in the clients’ lives that can positively impact outcomes. One of the hurdles to delivering this type of indirect services is time for providers within schools and other settings. Often therapists carry high caseloads or may be split between multiple locations. After sessions are completed, notes are written, data tracked, and other administrative duties completed, there is little time available for observing and addressing the needs of clients not on the caseload.

At Grafton, a position was created to provide occupational therapy consultative services not linked to direct service delivery. This freedom has allowed me observe clients across settings, meet with staff both in the classroom and residentially, provide staff trainings, develop programs, and attend meetings that would otherwise interfere with treatment sessions. In the changing demands of the behavioral health and school based practices change, it is important to remember the unique roles of all of the team members and how they can contribute outside of the traditional service delivery models. I am proud to be a part of the innovation that is happening at Grafton and within the profession as an indirect service provider for our Winchester region community based services. It is my hope that this collaborative model can be replicated within other behavioral healthcare and education facilities.