Using Evidence to Promote the Distinct Value of Occupational Therapy

Christina A.Metzler is Chief Public Affairs Officer, AOTA, Bethesda, MD. Providing best practice has always been at the forefront of occupational therapy. With the advent of health care reform in public and private sectors, the passage of the Patient Protection and Affordable Care Act (ACA; Pub. L. 111–148), and ongoingMedicare reforms, payers andhealth care systems are requiring more and more evidence-based practice (EBP), resulting in definable outcomes that will affect payment. Since 1998, the American Occupational Therapy Association (AOTA) Evidence-Based Practice project has promoted best practice by developing and providing resources that enable occupational therapy practitioners to access and use research evidence that supports their practice. AOTA’s (2007)Centennial Vision includes and has strengthened the goal of using evidence and provides a clear path for occupational therapy practitioners working with all persons, groups, and populations by stressing excellence in service that is informed by evidence. One of the primary purposes of EBP is the use of evidence to inform and guide clinical decision making. This framework follows the evidence-based philosophy of Sackett, Rosenberg, Gray, Haynes, and Richardson (1996) and requires the integration of information from three sources: (1) clinical experience and reasoning, (2) preferences of clients and their families, and (3) findings from the best available research. In a recent article, Lamb and Metzler (2014) stretched the boundaries of this framework to include policy implications and discussed the importance of linking the value of occupational therapy to the priorities of the health care system, one ofwhich ismanaging chronic conditions. According to Berwick, Nolan, and Whittington (2008), value can be determined through the model of the triple aim, a concept developed to frame better ways to provide health care while reducing costs (Beasley, 2009). Berwick and colleagues identified the goals of triple aim as “(1) improving the individual experience of care, (2) improving the health of populations, and (3) reducing the per capita costs of care for populations” (p. 760). The triple aim provides the mechanism to link existing evidence to occupational therapy’s role in improving quality of care, increasing the efficiency of the system, and reducing health care costs (Lamb&Metzler, 2014). The AOTA Practice Guidelines series provides a major evidence resource for occupational therapy practitioners. Practice guidelines provide clinicians and educators with a concise summary of the existing evidence on a given topic and use clinical examples that demonstrate how to integrate the research findings into practice. Current evidence for AOTA’s practice guidelines is based on findings from systematic reviews that cover key concepts of interventions within the scope of occupational therapy practice. Content experts with experience in critically appraising, synthesizing, and summarizing the research literature