Development of a new occupational therapy service usually begins with an idea for a new programme or recognition of an issue that needs to be addressed within a community, for example, a gap in existing services that results in unmet health or social needs. Careful planning and consideration of a range of factors is necessary for developing such ideas into a successful occupational therapy service.
A process is described below that will guide the development of a new occupational therapy service. Progression through the planning process may vary; work on several steps may occur simultaneously or in a different order, depending on factors such as the needs of the local community, available resources and regulatory frameworks.
When planning, collaboration is necessary with different groups who have interest or will be impacted by the proposed occupational therapy service, particularly service users. Identifying interested groups and locating networks and people to assist with the planning process should be considered from the outset. For example, contacts for WFOT member organisations and regional groups, as well as tools such as the Occupational Therapy International Online Network (OTION) may be resources for the planning process.
Information on this webpage can also be accessed by reviewing the WFOT publication ‘Occupational Therapy Service Development’.
Service planning begins by documenting the need for a new occupational therapy service, considering factors such as the population, culture and society in which it will operate. Key issues affecting decision-making include:
- Population health needs
- Priorities of the local economy
- Regulatory frameworks
- Philosophical views of organisations that may fund or house the service
- Professional standards
A situational analysis involves gathering data and reflecting on issues known about the needs for the occupational therapy service and the context in which it will be provided. Sources of information may include:
- Community surveys
- Epidemiological data
- Government reports
- Professional associations
- Funding groups
- Regulatory organisations
WFOT resources that may be helpful during the situational analysis include:
Consultation with interested groups through meetings or surveys may be necessary to obtain relevant information. For example, a survey of proposed service users can provide insight regarding interest in accessing the service and assess priorities for its design. Contact with education programmes, governments, embassies, insurance companies and nongovernmental organisations can provide information regarding available funding, required insurance and permits and costs and standards of health services. Topics that may be considered in the situational analysis can be accessed here.
The purpose statement briefly and clearly describes the overall service aims and intentions that will serve as the basis of future decision-making and planning.
To define the purpose statement, consider the following:
- Who will receive the service?
- What resources (e.g. staffing, equipment and supplies) are required to deliver the service?
- How will the resources be used in the delivery of services?
- What changes are expected to occur as a result of the service?
Answers to the above questions can be integrated to form a purpose statement. As an example, answers to the questions regarding a new wheelchair service may be combined to state:
‘People with mobility impairments (answer to question 1) …. will receive services of an occupational therapist in an outpatient clinic setting (answer to question 2) … to obtain mobility products using best available evidence (answer to question 3) … resulting in an increase in their ability to access their community and safely participate in activities that provide life satisfaction (answer to question 4).’
Service design involves planning starts to describe requirements and expectations in relation to:
- Resources and processes needed to meet the aims and intentions outlined in the purpose statement
- Specific outcomes expected from the service.
Questions that may be considered in planning the service design can be accessed here.
The purpose of an evaluation framework is to provide a mechanism to monitor how well the occupational therapy service meets the overall purpose statement.
There are many benefits of an evaluation framework, including:
- Providing objective data for planning and organising service delivery.
- Enabling accountability for the resources used to provide the service.
- Building knowledge about the benefits of the occupational therapy service.
- Identifying opportunities for continuous improvement of the service.
- Demonstrating the value of the occupational therapy service to advocate for continued or increased resources.
The WFOT Quality Evaluation Strategy Tool (QUEST) provides an organised and systematic approach to develop an evaluation framework for an occupational therapy service using quality indicators. QUEST identifies seven core quality indicators applicable to services provided by all occupational therapists, regardless of geographic location, practice settings and populations served. Worksheets for developing indicators for an occupational therapy service using QUEST are available to guide the indicator development process.
To illustrate use of QUEST, a case study is available that outlines how quality indicators were developed for a new occupational therapy service for a homeless inclusion programme. More information regarding quality indicators and QUEST is available at https://wfot.org/quest, including online videos and additional case studies.
It may be desirable to use quality indicators to conduct an economic evaluation of the new occupational therapy service. An economic evaluation determines the impact of the new service therapy in relation to financial costs of providing the intervention. The analysis compares the costs of occupational therapy with an alternate (control) intervention to determine:
- Is occupational therapy more beneficial than the control intervention to attain desired outcomes, such as increased independence or improved quality of life?
- What is the difference in cost between occupational therapy and the control intervention?
- How beneficial is occupational therapy in relation to costs, when compared with the control intervention?
For more information, see the WFOT publication Economic Evaluations – A resource for occupational therapy available from the WFOT website. The resource explains how QUEST core indicators can be defined to provide data for an economic evaluation.
A formal service description consolidates information generated in the previous steps. By completing the service description, information is summarised that can be customised for a number of uses, including for programme and funding proposals for the occupational therapy service.
Core information that may be included in the service description is summarised below:
- Reflects the findings of the situational analysis.
- Justifies the need for the new occupational therapy service.
- Describes context in which the occupational therapy service will operate.
- Describes the overall purpose of the new occupational therapy service.
- Describes the occupational therapy service.
- Provides an outline of projected costs (budget) and proposed funding.
- Outlines how the service will be implemented and operated.
- Describes how the new occupational therapy service will be monitored in relation to quality expectations necessary to meet the overall purpose statement.