Occupational Therapy Patient Flow and Clinical Operations Protocol

Standardized Protocol for Patient Management and Clinical Workflow

Occupational Therapy

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Last updated: Mar 24, 2025

1. Initial Patient Contact

Pre-Appointment

  • Schedule initial evaluation
  • Send intake forms electronically
  • Insurance verification
  • Medical history collection

Check-in Process

  • Patient arrives 15 minutes before appointment
  • Verify identification and insurance
  • Complete remaining paperwork
  • Collect copay/payment

2. Clinical Assessment Phase

Initial Evaluation (60 minutes)

  • Review medical history
  • Conduct standardized assessments
  • Document functional limitations
  • Establish baseline measurements
  • Identify occupational goals

Treatment Planning

  • Develop evidence-based intervention plan
  • Set SMART goals
  • Determine frequency and duration
  • Document plan of care

3. Treatment Implementation

Regular Sessions (45-60 minutes)

  1. Brief reassessment (5-10 minutes)
  2. Treatment activities (30-40 minutes)
  3. Home program review (5-10 minutes)
  4. Documentation (10-15 minutes)

Progress Tracking

  • Update goals every 4 weeks
  • Document outcome measures
  • Modify treatment plan as needed

4. Discharge Planning

Criteria for Discharge

  • Goals achieved
  • Plateau in progress
  • Insurance limitations
  • Patient request

Discharge Process

  • Final assessment
  • Home program instruction
  • Referral coordination if needed
  • Documentation completion

5. Documentation Requirements

Each Visit

  • Treatment notes (SOAP format)
  • Billing codes
  • Time tracking

Regular Intervals

  • Progress notes (every 10th visit)
  • Updated plan of care
  • Insurance authorization requests

6. Quality Assurance

Weekly Review

  • Chart audits
  • Outcome measure tracking
  • Patient satisfaction surveys

Monthly Analysis

  • Productivity metrics
  • Cancellation rates
  • Treatment effectiveness

Note: Modify protocol based on facility requirements and state regulations.

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