RECR 392- Program Analysis Criteria

1. TR Process
2. Assessment
3. Name the assessment(s) used at your agency. If your agency does not use an assessment, identify an assessment that maybe appropriate for the agency

Include whether the assessment is standardized or an “in-house” tool.

  -Standardized assessments used are the MMSE and the GDS. In house assessments are the Senior Services Support and Resource Needs Assessment and the Senior Eligibility Screening Assessment and Part B of the Applicant Information Sheet. Informal interactions are useful in collecting information about participants as well. 

Completion of assessments

1. Applicant Information Part A- completed by Senior Center front desk staff, Directors/Assistant Directors (not always completed if participant is intercepted by RT/Case Manager prior to front desk/Senior Center staff)
2. Applicant Information Part B- completed by RT/Case Manager 
3. Senior Center Eligibility Screening Assessment- completed by RT (in-home assessment)
4. MMSE- completed by Case Manager (standardized assessment)
5. GDS- completed by Case Manager completed only if necessary (standardized assessment)
6. Senior Services Support and Resource Needs Assessment- completed by RT (completed for individuals on Senior Services case status who require monitor, support, or transition services)
7. If not eligible for Senior Center under Senior Services care referral form to Fairfax County Adult Day Health Care program is complete or other resources (assisted living, memory care programs, etc.) are provided. 

1. Describe the on-boarding process- registration, admission, etc.

-Once the tour and orientation to the agency is completed the therapist then initiates the assessment process. The assessment process can take a couple of days. Once assessments are finished the participant fills out the Fairfax county membership form and pays a fee. 

1. Tour is provided to the participant by Senior Center staff or Senior Services staff. If Senior Center staff deem assessment is required will complete Applicant Information Sheet Part A. The Senior Services team will then complete the assessment process described above to determine eligibility of services or need of transition to Adult Day Health Care. This assessment process may take a few meetings which includes a trial day for observation. If the participant is deemed eligible for the Senior Center (placed on Senior Services case status if assessment deems this is required) the participant will complete membership form and pay fee. Transportation can be arranged as well. 

iii. Identify other documents or resources that assist in the assessment process (past records, families, other providers).

-Senior Services prioritizes participant answers as well as observation of participant’s functioning skills (physical and cognitive) and social interactions with the participant  but information is sometimes collected from families or caregivers. If medical information is important (pacemaker, allergies, medication, history of diagnosis) medical records are considered but are not required. 

1. Other- list any other aspect of the assessment process or details you deem important to include here. 

-For the resource and needs assessment it is important to consider the information from it because it can help figure out what is available to the participant to be successful within the program as well as outside of the program. 

Also, trial days are provided if a clear decision of the participant’s success in the program is undetermined during the assessment. Therefore allowing the Senior Services team to observe the participant during activities and determine the level of support required or any health/safety concerns that warrant a higher level of care (e.g. Adult Day Health care, assisted living, memory care, etc.). 

 

1. Plan 
2. Describe the planning process at your agency. Be sure to identify the role of the assessment in planning.

-Recreation Therapists at Senior Services considers the wants and needs of their participants through open communication with the seniors and with the formal assessment processes. They accommodate their participants by adding desired programs and consistently revising existing programs to ensure the most fulfilling experience. Senior Services uses the results of the assessments to assist in the determination of what programs would benefit them the most (high impact exercise program or low impact). For example, the MMSE helps therapists understand the cognitive or social needs of the participant. The therapist can then encourage a participant to participate in a specific program to assist in maintaining current cognitive/social skills. 

1. Identify any documents used in the planning process.

-Assessments. The Senior Center Eligibility Assessment aids the Senior Services providers with choosing the appropriate level of care (monitor, support, or transition). Information about the participants is mainly collected from informal conversations. 

iii. Describe other departments, sources, allied professionals that are involved in the planning process.

-Senior Center Directors and Assistant Directors, volunteer instructors, paid instructors, joint-programming with the Adult Day-Care Program

1. Describe how activities/interventions/programs are selected. Give examples.

-Based on the demand, needs, and interests of participants, the Senior Center staff will reach out to the Volunteer Solutions program to request for a volunteer instructor of certain programs as well as advertising for paid instructors specifically fitness programs requiring Certified instructors.  For example, the participants have been asking for Zumba so the Senior Center staff reached out to the volunteer solutions to advertise for a volunteer Zumba instructor or paid instructor. 

1. Provide a monthly and weekly schedule of programming/activities at the agency/setting. 

scheduleseniorserv

^click link for detailed schedule

 

1. Implementation
2. Describe the implementation procedure. Give an example.

-The facility is open from 9-4 and activities are scheduled throughout the day as well as availability to enjoy independent activities (table top, etc.). Participants are free to attend most any activity they please. For example, my mentor implements a fall prevention program called “SAIL” which stands for “Stay Active and Independent for Life”. SAIL is a 12 week program, a fitness check is completed at the beginning and end of the 12 weeks. Participants sign up for the program and are expected to attend at least 2-3 sessions a week.   

1. Identify how implementations are documented. Explain what information is required in this documentation.

-Most of the activities at the Senior Services facility do not use any documentation for their implementations. 

Senior Services uses the calendar to schedule daily activities. The Recreation Therapist completes the research for materials, instructions, etc for the activities planned (i.e cognitive activities, arts and crafts programs, special presentations). Fitness program (SAIL) follows a structured lesson plan in which the Recreation Therapist has been trained and certified. 

1. Evaluation
2. Describe how the client’s progress is evaluated. Be sure to mention all documents used to evaluate client progress.

-If a participant has a change of health status or any kind of decline observed through day to day interactions, functioning during participation and formal re-assessment, progress notes are recorded about those events. Otherwise, progress notes are completed quarterly if participants’ health status and level of participation is stable. Progress is typically evaluated  through observation and day-to-day monitoring. 

1. Describe how the program’s progress is evaluated. Be sure to mention all documents used to evaluate programming and how programming improvement is made.

-Pre and post fitness check tests are used for the SAIL program. Most program evaluations are collected from participant feedback from conversations.

iii. Describe how the therapist’s skills are evaluated. Be sure to mention all documents associated with this process. Describe how the therapist uses feedback to improve their skills.

-An annual performance evaluation is a formal document to evaluate the therapist’s skills. This document touches on areas such as has the therapist met goals set for the current performance year or what goals weren’t met and how he or she can work towards meeting their goals. Always being open to constructive criticism and reflecting on feedback. 

1. Program Outline
2. Programming– create an outline of all RT programming offered at your assigned agency/setting
3. Interventions/activities (no more than 10)– list all the activities/interventions, with a brief description and the expected outcomes. Include the duration and frequency of the activity within the program. Identify whether each intervention/activity is evidence-based. 

SAIL-EVB

Tai Chi- EVB

Yoga- EVB

Art-EVB

 

III. TR Process Delivery Flow Chart

11. Flow Chart– a flow chart is a visual model depicting a process. There are several types of flow models. You will make a detailed flow model. The Institute for Healthcare Improvement (2013) has an excellent tutorial on how to make a flowchart (http://www.ihi.org/education/IHIOpenSchool/resources/Pages/AudioandVideo/Whiteboard11.aspx). You will make what they refer to as a detailed flowchart. You will use circles, boxes and diamonds as they instruct to identify parts of the process. It will begin with the client’s entry point to the agency, will follow the client through the APIE and/or service delivery process, and end with their exit. Here is an example flowchart that all of you should be familiar with from Healthy Innovations (please note, this is of the documentation only, yours must include the service delivery process). 

 

1. SWOT Analysis– conduct a SWOT analysis of your agency. It should be based upon all the information gathered thus far to include the agency summary, market scan, population summary and program analysis. The SWOT analysis should be used to help identify a course project for you to pursue for the remainder of the internship.
2. Strengths– what are the strengths of the RT program?

-All the RT providers are certified by the NCTRC and all are certified in SAIL, others are certified in other activities like Zumba, good relationships with participants, little turnover with RT providers so they have a strong team dynamic

1. Weaknesses– what are the weak areas of the RT program?

-Staff and participants not understanding the depth and therapeutic benefits of recreation therapy 

1. Opportunities– what are potential opportunities to expand, obtain resources, or broaden the market?

-Technology grants, volunteers, broaden the market of population served to mental health population

1. Threats– are there areas that threaten the existence of the program? This may include non-compliance with regulatory bodies, lack of funding, or loss of resources. 

-Lack of funding, government funded agency, volunteers leaving, CARF standards

 

Criteria for Success/Rubric: