Internationally, there is evidence that hospital discharge to home for older adults is a complex and challenging process that is dependent upon multidisciplinary team working. At the centre of the discharge process is the management of risk, which involves occupational therapists and other healthcare professionals managing perceived dangers and determining why some dangers are seen as presenting risks while others are not. This study did not aim to explore interprofessional differences but to ascertain a greater understanding of professionals' perceptions of risk in acute care settings. This qualitative study utilised 12 semi-structured interviews with seven occupational therapists and five physiotherapists in the United Kingdom (UK). During the interview, therapists were asked to read and answer questions on a validated vignette. The interview data were subjected to thematic content analysis and the vignettes to template analysis. Our research is one of the first studies to explore therapists' perceptions of risk with older adults in acute care settings. Our study has highlighted that perception of risk does have an impact on discharge decision-making and location. Therapists used negative terminology to refer to patients who wanted to take risks, which could be a reflection of the therapists' anxiety. Mental capacity, and patients' functioning and safety were key factors in risk decision-making with older adults. Our research has highlighted the potential value of multidisciplinary working to manage risk situations and the need for reflection and discussion regarding how persons who do not have capacity wishes are managed within acute care settings. There is a need to develop an interprofessional care pathway to guide clinicians through the risk decision-making process which needs to ensure that the client's opinions and wishes are taken into account throughout.
In acute care hospitals, risk assessments are integral to therapy practice. However, to date, this area has not been explored in any specific depth within occupational therapy or physiotherapy, although there is evidence that the management of risk causes uncertainty and anxiety among professionals. Different perspectives of risks may have an influence on the discharge end point. Method: This study explored the self-reported risk-taking behaviours of occupational therapists and physiotherapists. A qualitative approach was taken, with reflective diaries used to record the self-reported risk-taking behaviours of therapists in a teaching hospital. Eight therapists recorded 16 reflections in total, which were analysed using template analysis. Findings: The findings suggest that support from members of the team, collegiality and clinical confidence were important to manage risks. Therapists were willing to take risks in order to meet patient goals, to facilitate the rehabilitation process or to enhance the patient's quality of life. However, there may be instances of interprofessional differences that need to be managed. Conclusion: This research has highlighted the need for therapists to reflect continually upon risk situations in professional practice. There is a need for support and guidance to be put in place to enable positive risk taking.
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