The role of the occupational therapist in case management in South Africa.

Abstract

ABSTRACT Case Management has evolved as an important strategy in managing healthcare to ensure quality and cost effectiveness. Various health professionals utilise case management in numerous practice settings and the researcher has been observed that occupational therapists have adopted this approach in managing disability and incapacity in the workplace when illness or injury impacts on work ability and retention of the employee. The occupational therapist as case manager has been documented in international literature however the role of the occupational therapist in South Africa is not defined and their contributions to the field is not well recognised. The aim of the study was to identify the occupational therapists’ role and scope of practice in case management in South Africa. A quantitative research method for a descriptive study was selected to establish associations between variables and to draw conclusions based on the data collected. This entailed compilation of a questionnaire as a data collection tool that was informed by literature on case management. A pilot study preceded data collection. Purposive sampling was used and the questionnaire was distributed electronically using Surveymonkey to a targeted group of 180 occupational therapists working in private practice, health consulting, for RAF and Workmen’s Compensation given the field of work and their experience in managing individuals with long term medical conditions and incapacity due to ill-health/injury. The data collected was exported to excel for analysis using the mean and a bivariate study to present the non-random associations between two categorical variables. Data from open ended questions were categorised into subthemes and themes using manual coding and was presented thematically. Results of the study revealed that occupational therapists are involved in case manager functions and the extent and intensity of involvement was in relation to the practice area. The findings suggest that occupational therapists in South Africa have adopted case management as an operational component of disability management and as an element of vocational rehabilitation. The results further indicate the standards applied in case management, the models used, the skill base and knowledge relevant to case management and a description of the challenges and effectiveness of case management as experienced by occupational therapists. These findings highlight the need for occupational therapists to expand their knowledge and to promote their skills in the field to enable appropriate and timely uptake of the service. Moreover these results indicate areas for further research on academic preparation relative to the field, evidence to validate the effectiveness and standards of practice to strengthen the occupational therapist as a case manager.