FOXcast PT: Improving Collaborative Care Between Physical And Occupational Therapists

The stereotype is OT takes upper extremity and PT takes lower extremity. But we go away from that a little bit. We both find what it is that we’re good at that we can specialize and work together for that one patient.

Welcome to FOXcast PT. A podcast for clinicians made by clinicians. It’s brought to you by FOX rehabilitation. Find out more at foxrehab.org.

Jimmy McKay, PT, DPT: Welcome to FOXcast I’m your host physical therapist Jimmy McKay. Joining me on the program today. Ally Edgell and Jenna Darrenkamp. Physical therapist and occupational therapist respectively. Ladies welcome to the program.

Ally Edgell, PT, DPT, LSVT: Thank you. Thank you.

Jimmy: And the reason we bring a PT and an OT on the show today at the same time is we’re talking about collaborative care between PT’s and OT’s. So you need to have one of each. So I promised no hard questions before we started the show today. But I lied. We’re going to start with a really hard one. Are you guys ready for that?

No.

Jimmy: I’m sure this question comes up often. And now what I have a PT and an OT on the show right now at the same time. I want how each of you answers this when you’re asked by a client what the difference is between PT and OT, what do you usually say?

Ally: For me I’m a PT. So for me I’ll tell them we’re kind of working toward different goals. I might look more at gait. I might look more at strength or range motion specifically. That’s the way that I describe physical therapy and I will let Jenna do a little bit of the OT.

Jenna Darrenkamp: I usually tell them based an evaluation. I may look at their strength their balance their endurnace. All these things then I relate it back to what they’re having difficulty with. IDL’s after ADL tasks. Things like that put it in perspective for them. Then I make sure I always add in their social participation and things like that especially in a personal care facility or assisted living which is where we are. The importance of those things too. So we look at them holistically.

Jimmy: Good explanation. I like how I prep you for that and you still have great answers. Well done. Let’s start, collaborative care between physical and occupational therapy. I’m imagining you guys share clients pretty often. Where do you start there? How to collaborate best between professions.

Ally: Jenna and I are in a senior living community. Together were primarily in this location and then we have a couple community patients. The biggest thing for us is just figuring out how it works for us because we both came in as almost or a completely new grads. One of the biggest things is finding out exactly what you’re good at and what your counterpart is good at is something when we talk about a lot. I might take over a shoulder. Somebody got something like that going on versus something Jenna is way better would be the hands. The stereotype is OT take upper extremity and PT takes lower extremity but we go away from that a little bit and both just find what it is that we’re good at that we can kind of specialize that to work together best for that one patient.

Jimmy: I do want to commend both of you for not using that as your stereotypical answer.

Ally: We try to veer away from that as much as possible.

Jimmy: So you guys had the benefit of coming in without necessarily having a lot of bad habits because you were as you mentioned new grads or relatively new to the professions. So you came in and knew what you were good at. Knew what maybe you could improve upon and figured out what your counterpart was actually good at and you used that. That’s great.

Ally: Absolutely it helped to have somebody to bounce your ideas off of to have another benefit to it for sir.

Jimmy: Where do you guys want to go next?

Ally: So we don’t do the stereotypical cotreating here. We treat a lot of the same patients. And we’re working together or collaborative care approach to their overall plan of care. We try to treat the whole patient rather than treating at the same time and just doing each to our own part.

Jenna: Ally and I we have pretty good communication in general. We talk a lot even while we’re working with our patients. You know what they want to do that day in PT and OT. If Ally gets one of you know our common patients first and she says okay today you know we’re going to work on your balance. Obviously I’m not going to see them right there and work on their balance also. Even though it’s for different reasons they’re not going to do two full hours of balance tasks. So we kind of communicate that way to make sure that we’re not duplicating the same thing even daily with them. Her and I having good communication helps our patients in the long run. We’ve explained many times we’re very lucky to have each other versus you know in some other setting where you’re not as comfortable talking to other therapist. You know Ally and I have tried to build our own rapport for the benefit of the patient and ourselves.

Ally: I think that’s pretty big. You go into something especially not really knowing the other person who you are going to be working with in a building you’re working with them all the time. It’s important to not only build your relationship with your counterpart like while you’re in the building but then outside of that. Learn what type of things they like what type things they don’t like and try to be available to fill the gap for each other as much as possible and just having that really good relationship and open communication helps everybody have a better day.

Jimmy: I can imagine it would. All right we’re going to stay with Ally for this question but we’re coming to you too Jenna. Allly as the physical therapist. What’s one thing you’ve learned from as an occupational therapist?

Ally: Oh that’s a good question. I think they’re going to kind of go back to what I started with is to not think that I have to do it all. To find the things that I’m good at and to kind of give away some of the things I’m not necessarily good at. Because there’s somebody else there who’s very capable of picking up the pieces.

Jimmy: Jenna same question. What’s something you’ve learned from PT and working with Ally?

Jenna: I’ve learned a lot from Ally. Even the different interventions you know I’ll bounce ideas off of her. But one thing I’ve learned to look at a little bit more just because a lot of what she’s doing is working with people on their gait. Trying to kind of reinforce what she’s doing while I’m working with people on functional mobility. That way it’s carried over not just between therapy but then also educating staff here and having kind of everybody on board. It’s not just one person reinforcing it. And a lot of things that she does like heel strike and all that. And the fancy terms. I pay more attention to those things now whereas before I’m like what am I going to do to help them get from point A to Point B this is their goal. Not looking at obviously is not my job to look at all those other things but really trying to work together to reinforce them.

Jimmy: Learning from the other professions is only going to benefit you in the short term but then your clients in the long term as well.

Ally: Right.

Jimmy: Last part of the show that we do is you’re FOXtale you ready for that? Why did you decide to work with older adults?

Ally: I kind of grew up in a senior living community visiting a lot because my grandpa was there. He had Alzheimer’s so I was always very comfortable in that setting. And that’s actually probably my favorite specific population to treat those with dementia. I really just always leave laughing. And I have a good time and obviously there’s challenges but I also tend to get bored if things get too easy. So I think they kind of keep me on my toes some. Those about dementia and I like learning lots of lessons from them because they are a lot more experienced than me and can teach me a lot more about life in general while I’m trying to teach them about physical therapy.

Jimmy: That’s a great answer, Jenna same question what’s your FOXtale?

Jenna: When I was 16 my grandfather had a stroke and he was a big time golfer. And I was still at that point and you know in high school I was trying to figure out what I want to do. And he obviously went to an outpatient rehab hospital and that whole thing. But while he was in acute rehab the occupational therapist worked with him a lot and making his food, making sandwiches things like that. And his biggest thing that he took away is you know after he had a stroke the doctor told them you’re probably never going to golf again. The OT their words with him playing Wii golf. Like I got to go to some of his sessions. Now he lives in Florida and golf’s almost every day. So I love seeing what OT could do for not only my family but now you know I want to do that for other people. Maybe not to that extent sometimes. I think it’s so cool. You know being positive reinforcement for this population whereas you know the kids everybody loves the work with kids. They kind of have it made. And I think it’s so important for both PT and OT to kind of be the reinforcement for this population because they’re going through that end stage of life and we’re kind of there to keep their life going as well as possible. That’s why I love it.

Jimmy: Love it. That’s a great story. Thank you guys for sharing that. Appreciate you guys giving some insight into collaborative care between PT’s and OT’s and even more important the practice like FOX. Where we have physical, occupational and speech therapists along with our exercise physiologists. Working together is deafly going to benefit each other as well as our clients. Thank you guys for taking some time out to share some insight.

Jenna: Absolutely. Thanks for having us.

Thanks for listening to FOXcast PT. A clinically excellent podcast. It’s brought to you by FOX Rehabilitation. Listen to other episodes or read articles and position papers at foxrehab.org.