title: The development of the modified blaylock tool for occupational therapy referral (MBTOTR): a preliminary evaluation of its utility in acute care.
abstract: Acute hospitals are facing more complex admissions with older people at increased risk of functional decline. This study aimed to create and trial the feasibility of a new screening tool designed to identify patients at risk of functional decline who need an occupational therapy referral within acute care.
  
  
  
  Ten screening tools were reviewed and the Modified Blaylock Tool for Occupational Therapy Referral (MBTOTR) was developed. The MBTOTR was applied in a retrospective chart review of 50 patients over the age of 65 years who were admitted to five acute wards. Data on patients identified at risk of functional decline were compared to patients who were referred to occupational therapy.
  
  
  
  Occupational therapy referrals were made by ward staff for 14 out of the 50 patients reviewed (32.5%). Only 14% (n = 7) of patients did not require a referral. The MBTOTR identified no irrelevant occupational therapy referrals. However, 66.5% of patients identified as needing an occupational therapy referral did not get one.
  
  
  
  The MBTOTR identified high risk acute patients requiring an occupational therapy referral who were not referred to occupational therapy. Use of the MBTOTR would facilitate early occupational therapy referrals for complex patients, and potentially better discharge outcomes. Implications for rehabilitation The MBTOTR can be used in acute care settings to facilitate relevant occupational therapy referrals. Without a screening tool, many older people who should have an occupational therapy assessment may not receive a referral for occupational therapy. Nursing and medical staff need to use this tool to identify older people in their care who may benefit from occupational therapy assessment and intervention. If occupational therapy referrals can be made early, this may contribute to reducing delays to discharge plans for complex patients.
authors.affiliation: a Discipline of Occupational Therapy , University of Sydney , Lidcombe , New South Wales , Australia ;
authors.forename: Emma Su Zan
authors.initials: ES
authors.lastname: Tan
authors.affiliation: a Discipline of Occupational Therapy , University of Sydney , Lidcombe , New South Wales , Australia ;
authors.forename: Lynette
authors.initials: L
authors.lastname: Mackenzie
authors.affiliation: b Discipline of Occupational Therapy , Royal North Shore Hospital , St. Leonards , New South Wales , Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Travasssaros
authors.affiliation: b Discipline of Occupational Therapy , Royal North Shore Hospital , St. Leonards , New South Wales , Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Yeo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D009788:Occupational Therapy / Q000379:methods / Q000592:standards; D010351:Patient Discharge / Q000592:standards; D058996:Quality Improvement; D012017:Referral and Consultation; D018570:Risk Assessment / Q000379:methods*
keywords: Functional decline; hospital admission; hospital discharge; prioritisation; screening tool; triage