Evaluation of a driving clinical decision pathway for generalist occupational therapists: Pilot test of practice change

Scand J Occup Ther. 2024 Dec;31(1):2423712. doi: 10.1080/11038128.2024.2423712. Epub 2024 Nov 12.

Abstract

Background: Few evidence-based resources exist to support generalist occupational therapists address driving in practice. This pilot study aimed to evaluate whether a driving clinical decision pathway can assist generalist occupational therapists to address driving with clients.

Methods: Using a before (Timepoint-1) and after (Timepoint-2) design, data were collected at a multi-site outpatient community rehabilitation service. Medical record audits documenting how driving was addressed in practice and descriptive surveys of therapist's perceptions of pathway use were collected at Timepoints 1 and 2. A driving clinical decision pathway was implemented over 6 months. Descriptive statistics and content analysis were used to analyse and compare data over time.

Results: Timepoint-1 data from 102 client medical records, and 13 clinician surveys were compared against Timepoint-2 data from 144 records and 8 surveys. Following implementation of the pathway, the number of assessments used by generalist occupational therapists increased three-fold, to inform driving process recommendations which increased two-fold. Clinicians' self-reported knowledge, skills and confidence also increased two-fold.

Conclusion: A comprehensive driving clinical decision pathway provided clinicians with increased structure and support to guide practice change and promote role fulfilment in addressing return to driving with adults following a change in health status.

Keywords: Occupational therapy; adults; automobile driving; clinical pathway; rehabilitation.

MeSH terms

  • Adult
  • Aged
  • Automobile Driving*
  • Clinical Competence
  • Critical Pathways
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapists*
  • Occupational Therapy*
  • Pilot Projects
  • Surveys and Questionnaires