A link to a nice summary of the SOAP note along with a comment from me about DAP notes.

http://metaot.com/quick-notes-note-writing-in-soap-notes#comment-29656

It's a nice article, very useful. The following was my explanation of the DAP note:

What do you think of DAP notes?

Our Inpatient Rehab has been using them for a long time and the Acute Rehab in the Hospital has been for about a year. It essentially melds the S and the O into a D... for DATA.

The DAP note then mixes the subjective comment into the objective thing you are saying. Here's an extreme example (for effect):

S: Patient states "It hurts." Patient states, "that feels better." Patent states, "I don't feel too good."

O: Patient reported pain on deep palpation of supraspinatus. Patient performed pendulum exercises followed by reaching and placing cans with internal and external rotation at abdomen level with relief noted above. Patient vomited right after they said line 3 above.

Instead of

Data: Patient reported pain on deep palpation of supraspinatus. Patient stated, "It's hurts." Patient performed pendulum exercises followed by reaching and placing cans with internal and external rotation at abdomen level, when asked how it felt patient stated "That feels better." On performance of a follow up deep palpation patient became pale, stated "I don't feel too good." and vomited.

Again, an extreme example, but it might help to anchor the benefit of the alternative note structure. DAP might not spell something that we wash with but it is useful. I contend that S and the O are only broken out that way because they spell SOAP... Does anyone know the history?

A and P (Assessment and Plan are the exact same as in the SOAP format). So it's:

D: Data

A: Assessment

P: Plan

Hope this helps in the pursuit of the perfect note.

Yours,

Ed Kaine, OTR, RFTPresident of the League of Functional Therapists

Website: http://www.functionaltherapist.org/

Blog: http://www.registeredfunctionaltherapist.blogspot.com/

email: RegisteredFunctionalTherapist@gmail.com

Functional Therapy... the Next Generation of Occupational Therapy!

Crucial Converstations Training being considered for League of Functional Therapists

Over the last 30 years an innovative company call Vital Smarts has done research to find skills for exceptional communication. It has been applied in particular to Health Care in several settings. At Maine General Hospital they found that the training alone improved care.

Check out: Crucial Conversations® Training Improves Patient Safety at Maine Healthcare System http://www.vitalsmarts.com/userfiles/File/pdf/case_studies/mainegeneral_health.pdf

Just by taking this training their hospital improved in all the following ways.

They took the training across the board and they saw massive improvements.

What could you do if you were a better communicator? How would your health care facility improve? How would your relationships in your work and in your life improve? Who wouldn't be better if they were better able to hold conversations where emotions were strong?

These skills are skills for life. We are considering offering this course for practicing and non-practicing RFT and RFTAs, and our supporter members. This may be in mid 2010 depending on interest. To let you know, the course could cost $995 is you were just taking this training. However; since you are members or considering membership we should be able to significantly reduce that price. We are in dialogue about it currently with Vital Smarts team.

We are very excited about the prospect of offering these life changing lessons to our membership. Let us know what you think about it.

Please check out http://www.vitalsmarts.com/ and http://www.vitalsmarts.com/crucialconversationstraining.aspx?id=frombanner to get more information on these exciting courses.

Yours,

Ed Kaine, OTR, RFT

President of the American League of Functional Therapists

RegisteredFunctionalTherapist@gmail.com

Functional Therapy... the Next Generation of Occupational Therapy!

Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial

This is a very important article for patients anticipating or recovering from ICU stays. In this randomized controlled clinical trial, Occupational And Physical Therapists took ventillated patients through a course of functional tasks. In the process they had a trememdous impact on patient's lives.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60658-9/fulltext

This shows that it is not just about surviving. Healthcare has the technology to save your life, but it's therapy, and particularly "Functional Therapy", that cares about getting you back to a life of purpose and meaning.

Congratulations to the excellent teams at the University of Pennsylvania, University of Chicago and University of Iowa. The effort to take and confirm scientifically things we know (or think we know) intuitively is very appreciated.

Go Therapy, even in this critical and frightening time in a person's life, the worry that you are too sick to do therapy is turned on it's head. You might be too sick not to do therapy.

Yours,

Ed Kaine, OTR, RFT
President of the American League of Functional Therapists
http://www.functionaltherapist.org/

Functional Therapy... the Next Generation of Occupational Therapy!

Change... the easy path.

We were having a meeting the other day about how to increase the awareness of Functional Therapy and get more OTs and COTAs to join. We got to talking about how difficult change is. Lindsay Neumann, RFT, said, "Sometimes it's just easier to go along the way that things are. Most times actually."

Well it didn't take long for it to come around to how difficult it has been for each of us to be Occupational Therapists. There were a cascade of difficulties:

1. To learn about the profession in time to choose it as a career - Very Difficult.
2. To explain to your family what you were studying - Very very difficult... because you barely knew yourself.
3. Graduating, finding a job. Not too difficult... because so many people were beat by #1. Therefore there is a huge shortage of OTs. Easy to find job, but...
4. Staffing for OTs is largely influenced by the difficulty that upper administration has in understanding what OT might do. Incredibly difficult.
5. Then, let's mention the many discussions you'll have trying to explain OT. Difficult but fun.
6. Then, your ears perk up when someone says Occupation or Occupational and you wonder if they are talking about anything related to your profession. They aren't. Our definition still hasn't got into the dictionary - difficult.
7. Then you do this for year after year... it was so much more fun when I started. Difficult.
8. Then you get involved with a group who wants to provide an alternative name and change is difficult.

So, the only thing that would have made this easier would have been to do something about it 89 years ago, or 8 or 9 years ago. There is no time like the present. Make the change now and maybe we'll get past some of this stuff.

Please check us out at www.FunctionalTherapist.org and look at joining us. And if you're already a member let's get to work popularizing Functional Therapy.

Yours,

Ed Kaine, OTR/L, RFT

President of the American League of Functional Therapists

Contact us at: RegisteredFunctionalTherapist@gmail.com

Suffolk News-Herald | Occupational therapy a vital healthcare link

Suffolk News-Herald | Occupational therapy a vital healthcare link

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We are opening up Comments as of June 4th, 2009.

I was asked if I would consider opening comments up on our Blog. We talked about it and here it is.

As a trial of the commenting process we are looking to see what you think about our content. You can go back to former articles and post comments or you can just use this feature going forward.

We have a lot we'd like to say and we'd like to hear it in a public forum too. Please be open and courteous. A differing opinion is just that. It is really an opportunity to learn more about another person's perspective.

As always, you can email us directly at RegisteredFunctionalTherapist@gmail.com or check us out at www.FunctionalTherapist.org. Thank you for all your support so far.

Yours,

Ed Kaine
President of The American League of Functional Therapists

Functional Therapy... the Next Generation of Occupational Therapy!

The Challenge: Let's get our definition in the dictionary!

I am an Occupational Therapist and a Registered Functional Therapist. I believe that Functional Therapy will be the best name going forward in terms of helping people to understand what we might be able to do.

I claimed in my last post that our definition was not in the dictionary. Here is a snapshot of Definitions of Occupational and Occupation.

This is the Date: June 2nd, 2009.

Here is the challenge:
Can we get a good definition of Occupation and Occupational into the Dictionary?

Steps:

1. Let's get a definition we are happy with. Send your ideas to OccupationDefinition@gmail.com. (Maybe even for glorious prizes... yet to be determined.)
2. Let's figure out a way to get it in the dictionary. Again, ideas to OccupationDefinition@gmail.com. Maybe you have a friend at Webster's, we need your help.
3. Let's get it into the Dictionary! (Let's do it by December 31st, 2009!)

Here is what we start with for Occupational:

oc⋅cu⋅pa⋅tion⋅al   /ˌɒkyəˈpeɪʃənl/ Show Spelled Pronunciation [ok-yuh-pey-shuh-nl] Show IPA Dictionary.com UnabridgedBased on the Random House Dictionary, © Random House, Inc. 2009.
–adjective
1. of or pertaining to an occupation, trade, or calling: occupational guidance.
2. of or pertaining to occupation: occupational troops.
Origin: 1840–50; occupation + -al 1 Related forms:
oc⋅cu⋅pa⋅tion⋅al⋅ly, adverb

The American Heritage® Dictionary of the English Language, Fourth EditionCopyright © 2006 by Houghton Mifflin Company.Published by Houghton Mifflin Company. All rights reserved.

oc·cu·pa·tion·al (ŏk'yə-pā'shə-nəl) adj. Of, relating to, or caused by engagement in a particular occupation: occupational hazards.oc'cu·pa'tion·al·ly adv.




WordNet® 3.0, © 2006 by Princeton University.
occupational
adjective
of or relating to the activity or business for which you are trained; "occupational hazard"

Merriam-Webster's Medical Dictionary, © 2002 Merriam-Webster, Inc.

Main Entry: oc·cu·pa·tion·alPronunciation: "äk-y&-'pA-shn&l, -sh&n-&lFunction: adjective: relating to or being an occupational disease —oc·cu·pa·tion·al·ly /-E/ adverb

Dictionary.com UnabridgedBased on the Random House Dictionary, © Random House, Inc. 2009.

And todays definition of "Occupation":


occupation

Dictionary: oc·cu·pa·tion (ŏk'yə-pā'shən)
n.
An activity that serves as one's regular source of livelihood; a vocation.
An activity engaged in especially as a means of passing time; an avocation.
The act or process of holding or possessing a place.
The state of being held or possessed.
Invasion, conquest, and control of a nation or territory by foreign armed forces.
The military government exercising control over an occupied nation or territory.
[Middle English occupacioun, from Old French occupacion, from Latin occupātiō, occupātiōn-, from occupātus, past participle of occupāre, to occupy. See occupy.]

Business Dictionary: Occupation
Trade, job, business, or vocation of an individual. An occupation is the principal means by which one earns a livelihood.
Thesaurus: Occupation
noun
Activity pursued as a livelihood: art, business, calling, career, craft, employment, job, line, métier, profession, pursuit, trade, vocation, work. Slang racket. Archaic employ. See action/inaction.
The holding of something, such as a position: incumbency, occupancy, tenure. See place.

Antonyms: occupation
n
Definition: profession, businessAntonyms: entertainment, fun, hobby, pastimen
Definition: seizure, takeoverAntonyms: giving up, surrender, yielding

US Military Dictionary: Occupation
n. the action, state, or period of occupying or being occupied by military force: the Roman occupation of Britain crimes committed during the Nazi occupation.
See the Introduction, Abbreviations and Pronunciation for further details.

Britannica Concise Encyclopedia: Occupation (of Japan)
(1945 – 52) Military occupation of Japan by the Allied Powers after its defeat in World War II. Theoretically an international occupation, in fact it was carried out almost entirely by the U.S. under Gen. Douglas MacArthur. During the Occupation period, Japanese soldiers and civilians from abroad were repatriated to Japan, arms industries were dismantled, and political prisoners were released. Wartime leaders stood trial for war crimes, and seven were executed. A new constitution, vesting power in the people, replaced the Meiji Constitution; in it Japan renounced its right to wage war, the emperor was reduced to ceremonial status, and women were given the right to vote. The Occupation administration also carried out land reform, reducing the number of farmers who were tenants from 46% to 10%, and began the breakup of the zaibatsu (business conglomerates). Labour unions were initially encouraged, but as fears of leftist organizations grew with the advent of the Cold War, stronger governmental control of labour was supported. The education system, seen as elitist, was revised to resemble the U.S. system. Though the U.S. wanted to end the Occupation in 1947, the Soviet Union vetoed a peace treaty with Japan; a treaty was signed in 1951, and the Occupation ended the following year.
For more information on Occupation (of Japan), visit Britannica.com.

Word Tutor: occupation
IN BRIEF: A person's profession. The first step toward success in any occupation is to become interested in it. — Sir William Osler (1849-1919), Canadian physician, M.D., teacher, medical historian.

Quotes About: Occupation
Quotes: "Occupation is the scythe of time." - Napoleon Bonaparte"Monotony is the law of nature. Look at the monotonous manner in which the sun rises. The monotony of necessary occupation is exhilarating and life giving." - Mahatma Gandhi"My mother has always been unhappy with what I do. She would rather I do something nicer, like be a bricklayer." - Mick Jagger"It is neither wealth nor splendor; but tranquillity and occupation which give happiness." - Thomas JeffersonQuotes about Occupation supplied by Quotations Book.-->

Wikipedia: Occupation

Look up occupation in Wiktionary, the free dictionary.
Occupation may refer to:
In business:
Employment, a person's job or work in service of an employer
Profession, an occupation requiring specialized knowledge
Vocation, an occupation pursued more for altruistic benefit rather than for income
Career, a person's occupational history
Day job, an occupation solely for income, while pursuing another preferred career track
List of occupations
Standard Occupational Classification System, developed and used by the U.S. government
Occupational prestige, the relative esteem in which a particular job is held
Occupational therapy, assisting people who have difficulty performing occupational functions
Occupational science, the study of humans as occupational beings
Occupational disease, chronic ailment resulting from work
Occupational crime, opportunistically committed in the course of legal occupation
In a military context:
Military occupation, control of a territory by a military force
Law of occupation, portions of the law of war which relate to military occupation
List of military occupations, notable historical instances of military occupation
In film and television:
Occupation 101, a 2006 documentary film about the Israeli–Palestinian conflict
Occupation: Dreamland, a 2006 documentary film about the Iraq War
Occupation (TV serial), a 2009 television serial about the Iraq War
Occupation Double, a Canadian reality television show
"Occupation" (Battlestar Galactica), an episode in the third season
In music:
Occupation: Foole, a comedy album by George Carlin
"The Beautiful Occupation", a song by the band, Travis
Other meanings:
Occupation (protest), the temporary forceful occupation of a building, space or symbolic site
Occupancy, use of a building for shelter or support of persons, animals, or property

Translations: Occupation Top
Home > Library > Literature & Language > Translations
Dansk (Danish)n. - beskæftigelse, erhverv, besiddelse, besættelse, indtagelseadj. - beskæftigelses-
Nederlands (Dutch)bezigheid, beroep, bezetting, occupatie, inbezitneming, bewoning, activiteit, bezettings-
Français (French) n. - occupation, installation, (Mil, Pol) occupation (de), métier, profession, activité de loisiradj. - d'occupation
Deutsch (German) n. - Beschäftigung, Beruf, Tätigkeit, Besetzung, Besitz, Besatzungadj. - Beschäftigungs...
Ελληνική (Greek) n. - κατάληψη, κτήση, κατοχή, απασχόληση, ασχολία, επάγγελμα, επιτήδευμα, εργασία, κατοίκηση, ενοίκηση
Italiano (Italian) occupazione, presa di possesso, mestiere, professione, presa
Português (Portuguese) n. - ocupação (f), profissão (f)
Русский (Russian) занятие, оккупация
Español (Spanish) n. - ocupación, quehacer, actividad, entretenimiento, profesión, oficio, vocación, habitación, residenciaadj. - relacionado con o perteneciente a la ocupación o actividad
Svenska (Swedish) n. - sysselsättning, yrke, ockupation, besittning, inflyttning
中文（简体）(Chinese (Simplified)) 职业, 占有期间, 占有, 职业的
中文（繁體）(Chinese (Traditional)) n. - 職業, 佔有期間, 佔有adj. - 職業的
한국어 (Korean) n. - 직업, 점유adj. - 점유하는, 직업적인
日本語 (Japanese) n. - 職業, 何かすること, 時間の使い方, 占有, 居住, 占領
العربيه (Arabic) ‏(الاسم) احتلال, مهنه‏
עברית (Hebrew) n. - ‮כיבוש, השתלטות, ישיבה, דיירות, תפיסה, חזקה, עיסוק, החזקה, מקצוע, עבודה, תעסוקה‬adj. - ‮לשימוש הבלעדי של המחזיקים בקרקע שמדובר בה‬

American Sign Languagecommtechlab.msu.edu

So, that is our starting point. I don't know if you agree that it's not defined in these dictionary samples. For me the definition of OT as "assisting people who have difficulty performing occupational functions" doesn't cut it because we already know that will lead to the "vocational" conversion. Mind you, I'm glad it says "functions". Go ahead and check now because the American League of Functional Therapists is seeking to have a working definition within 7 months... by the end of 2009.

So sharpen up your pencils or grab a definition from your college days. You just may be the one who's words grace the pages of history.

We believe in this concept of Occupation, people want to understand. We can help them.

Thank you so much for participating. I'll keep you updated here as to how we are coming along on the project.

Yours,

Ed Kaine, OTR/L, RFT
President of the American League of Functional Therapists


Functional Therapy... the Next Generation of Occupational Therapy!

email: RegisteredFunctionalTherapist@gmail.com
Check out: http://www.functionaltherapist.org/