A Busy Day in Primary Care Fieldwork — from Home!

June 11, 2020
by Daniel

Fieldwork Life Hacks

This summer I am doing my level 2 fieldwork with my OTD residency site under the Lifestyle Redesign for Chronic Conditions Lab (LRCC) in primary care at the LAC+USC Adult West Clinic. This OTD residency is designed to expand occupational therapy (OT) services in primary care, focused on addressing chronic condition management among patients with diabetes and/or hypertension, using a Lifestyle Redesign® approach. This summer I am being trained by the current OTD Resident in preparation to take over the full caseload this Fall.

Currently, the primary care clinic does not have a video platform and we are not allowed to use Zoom to interact with patients, thus all of the appointments are three-way phone visits using Doximity (HIPAA compliant) with supervision from my clinical instructor (CI) through the phone and Zoom. I am able to lead appointments in English and Spanish, which is valuable for our predominantly Spanish speaking community at the clinic. The phone visits can be beneficial for some patients as they don’t have to travel far to get to their appointments and can talk to their providers from the comfort of their home. However, there are also barriers for our patients such as not having a quiet space at home or disconnected phone lines due to being unable to pay their phone bill as a result of the pandemic. We do our best to contact all our patients and provide as much support as possible to help them navigate these barriers and be able to manage their health.

Each day can look very different when doing telehealth in primary care, and below I wanted to share an example of a typical busy Wednesday! On this particular day, I started my day with an OTFP in-service learning about mental health when utilizing Lifestyle Redesign® approaches. Next, my CI and I started calling patients since we had done chart reviews the day before. During our phone visits, we discussed topics such as healthy eating, physical activity, stress management, medication adherence, habits and routines, resources, etc., to support their diabetes and/or hypertension diagnosis and overall health management. In the middle of the day we had consecutive meetings to discuss patient progress and how to better support them (care management); fieldwork/residency updates, logistics, and an opportunity to ask for guidance with clinical approaches (fieldwork supervision); and daily clinic updates and projects (daily brief). And perhaps you are wondering . . . when do you eat? Well, there are days when we don’t get an official lunch break, so we do our best to get food in between meetings! Thereafter, we began calling patients again for the rest of the day and documented in between appointments and during our assigned admin/documentation time at the end of the day.

Typical Wednesday

• 8-9AM – Occupational Therapy Faculty Practice (OTFP) In-Service
• 9-11AM — Patient Phone Visits
• 11AM-12PM — Care Management Meeting
• 12-1PM — Fieldwork Supervision Meeting
• 1:05-1:30PM — Clinic Daily Brief
• 1:30-4PM — Patient Phone Visits
• 4-5PM — Admin Time/Documentation

Tips for working from home

• Take stretch breaks: This is one of the most important things you can do for your body. Taking stretch breaks is important to prevent pain, aches, and cramps later on! You can even do stretches while sitting down.
• Snacks & water: Don’t forget to stay hydrated and have snacks in reach to have energy throughout the day!
• Ergonomics: Posture, posture, posture! Please take care of your bodies and follow proper posture and chair tips when working from home. This can easily be overlooked and if you don’t have fancy equipment, there are ways you can get creative! Your body will thank you later.
• Prepare meals: This can save you time on days when you may have a short lunch break or none at all!

I hope this paints a picture of what a busy day of telehealth primary care may look like! My intention is to be transparent with you all and share the good, the bad, and the busy days. I am often exhausted at the end of the day, but I am excited to continue to learn and the patients make it all worth it!

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