Informing the Development of a Framework to Support Occupational Therapists’ Clinical Reasoning Processes Regarding Pre-Discharge Home Visits

Introduction: Pre-discharge home visits are routinely conducted. There is variation in practice and limited evidence to support their efficacy. Aims: This study explored the perceptions of key stakeholders: therapists, clients and carers, and multidisciplinary care-providers. Information gained will be used to develop a clinical reasoning framework in a later phase of the overallproject. Method: A qualitative descriptive methodology, utilizing six focus groups, each with six to eight participants, was used. Focus groups consisted of: occupational therapists from a metropolitan health service with (i) less than two years experience; (ii) more than two years experience; (iii) occupational therapy managers; (iv) clients and carers with a subacute admission who had a pre-discharge home visit; (v) clients who have not had a home visit; (vi) multidisciplinary stakeholders. Purposive sampling was employed for broad representation. The semi-structured focus groups were audio-taped and led by a moderator, with a note-taker present. Data will be analysed using suitable software, coding of categories and themes, peer review and triangulation across focus groups. Results: Preliminary themes support the usefulness of a matrix-style clinical reasoning framework addressing the goals and timing of home visits. Data suggest it may incorporate practice domains and align with the ICF framework. Conclusion: Data will contribute to the current knowledge base regarding pre-discharge home visits. A later clinical reasoning framework will support decision-making and guide evidence-based occupational therapy practice