Michelle: Thanks everyone for joining me for this course in the series of courses that we have put together to help prepare you for the ATP exam. Service delivery may not seem quite as exciting as some of our other more content-specific topics of assistive technology like seating or mobility, but it is very important. However it is important that we take a step back and reflect on how we deliver the services to our clients. This is a part of the exam that is addressed and so we need to review that here today.
What We Are Covering
- Standards of Practice
- Information Resources
- Service Delivery Systems
- Service Delivery Roles
- Consumer Empowerment
- Quality Assurance and Outcomes
- Product Development and Principles of Design
We will briefly go through each of these. Ethics are a very important part of what we do. It is something that is easy to not think about directly as we are cranking out reports, seeing clients, and filling out forms, but it is something that permeates everything that we do. Thus it is an important part of service delivery and the assistive technology professional credential. We need to agree to follow the RESNA Code of Ethics by obtaining this certification. We are also going to look at standards of practice; information resources; service delivery systems and roles; what we can do to empower the consumer; quality assurance, both of services but also products as well; outcomes; product development and principles of design; and finally liability.
The ATP Certification
The content in this series is to prepare you, the participant, to take the ATP certification examination. The Assistive Technology Professional (ATP) certification is offered through RESNA (Figure 1).
Figure 1. ATP certification.
It is designed to demonstrate a basic level of competence in the practice area of assistive technology. Currently, over 4,000 people hold this certification. Now the candidate must fulfill specific prerequisites before qualifying to take this exam, and that information is on the RESNA website. For occupational therapy practitioners with a Bachelor's or Master's degree, 1,000 hours of work experience is required over a six-year period of time.
Let's start with ethics. It is always good to start with the definition. Ethics is:
RESNA has a code of ethics, as does our other professional organizations such as AOTA. RESNA has decreed that anyone holding the assistive technology professional certification has to comply with both the RESNA Code of Ethics and Standards of Practice. Violation of either of those can result in punitive action. The credential is overseen by the Professional Standards Board, or PSB, and any complaints are filed to them just like other professional organizations. Someone has the ability to contact the governing board and make a formal complaint if there is a concern. By pursuing this certification, we are agreeing to follow this particular code of ethics. I would encourage you to pull these up on the RESNA website, but we are going to review some of the highlights here. Again, this is content that is included on that examination.
First, we need to hold paramount the welfare of persons served professionally. Now this is hopefully common sense to all of us. We have gone into this field to help the clients that we serve. Ultimately, what we are doing is for the client's benefit.
Another very important aspect of the RESNA Code of Ethics is scope of service. We agree to practice only in the areas of competence and maintain high standards. The example I like to give is splinting. Now in my own practice, I do not do splinting. I used to, but it was some time ago. I was actually pretty good at it, but it would not be ethical for me to try to split a client because I am not qualified to do so anymore. It is beyond my current scope of service. It is equally unethical of me to note a need and not do something about it. If I see a client that requires a splint, I refer them to someone who does know about splinting in my area. The is the same with assistive technology, just like all of our areas of practice. There are areas that I feel competent in, and I will see a client and deliver those services. There are other areas that I am not competent in. I need to make sure that I do not try to provide those services, but rather refer clients to other professionals as I do all the time. I see very complex clients, and I might need to refer them to a certain physician, maybe an orthopedist, maybe another occupational therapist that can do something like splinting.
Another key part of this code of ethics is to maintain the confidentiality of privileged information. Most of us are very aware of HIPAA. We need to be careful with confidential information and take care of the proper forms. If we are sharing information with other professionals, we have to make sure we have a release to do so. If we are taking photos, whether it is for education or to include with funding documentation, I need to make sure I have the proper releases. If not, I have to follow proper guidelines. The American Medical Association requires that the face be obscured or covered in a photo if there is not a release. That simple black box over the eyes is no longer considered acceptable by the American Medical Association. A larger portion of the face needs to be covered.
The next area is engage in no conduct that constitutes a conflict of interest or that adversely reflects on the association and, more broadly, on professional practice. Any of us could have a real or perceived conflict of interest. I do quite a bit of education as part of my job. Oftentimes, I am required to fill out forms that explain any potential conflict of interest. Part of that might be financial. For example, if I am being paid by a supplier of durable medical equipment to perform a seating evaluation, there is a potential conflict. I can try to be as objective in my evaluation as possible, but if they are paying me, it might be a conflict. If I know they are hoping that I will recommend some equipment, equipment that they can then provide and profit from, this is a conflict. Because of this very conflict, most suppliers will not pay a therapist to do any sort of evaluation. They will insist that another funding source, such as Medicare, Medicaid, private insurance. It is important that we do not engage ourselves in any activity that might constitute conflict of interest or that adversely reflects on our professional associations, whether that be RESNA, AOTA, APTA, and more generally, on our whole professional practice. Whenever we act in a substandard way, that is really a poor reflection on our entire practice.