The vignettes below give examples of various therapy scenarios and outline the way in which each instance should be recorded on SSNAP. these examples were developed and brought to our attention by the ReAcT study. For more information please see
1) A band 5 OT accompanies Patient A on a home visit. They leave the hospital in a taxi at 11.00am and arrive at the patient’s home at 11.20am. During the journey the OT informs Patient A of what will happen when they reach his home, but does not subsequently address him. When they arrive at his home, she completes her assessment, and they leave the house at 11.57am, returning to the hospital at 12.20pm. The therapist records 80 minutes of OT in the SSNAP data record.
Therapy does not include travel time alone, however if the patient is being taught how to get in, and out of the car, or positioning whilst in the car – then this would count as time towards therapy on SSNAP. Similarly, time spent describing what will happen during the therapy would count as therapy time on SSNAP. The therapist should record 37 minutes of therapy time, plus any time in the car describing what will happen, and any further OT in the car.
2) A band 6 SLT plans to assess Patient B’s swallow and sits down to read his medical record at 3.00pm. She subsequently approaches his allocated nurse, and discusses with her how he has been managing with his thickened drinks. At 3.10pm, she approaches Patient B and gains consent to complete a bedside swallowing assessment. He agrees and she leaves to make up a thickened drink in the kitchen, returning some 3 minutes later. She conducts the assessment and provides him with recommendations following an upgrade. She updates a whiteboard above Patient B’s bed and leaves the patient at 3.25pm, before returning to the nurse to handover updated information, then writing her recommendations in Patient A’s medical record. She completes her work at 3.45pm and records 45 minutes in her SSNAP data record.
It is suitable to include the time speaking with the patient’s allocated nurse in the recorded therapy time. The therapy therefore occurred between 3:00pm to 3:25pm; therefore 25 minutes of therapy should be recorded. Documentation is not included in therapy time.
3) Patient C was discharged from active physiotherapy on 3rd November, but is awaiting discharge to an intermediate care facility. On 18th November, she attends a chair-based exercise group, alongside three other patients, staffed by a band 6 physiotherapist and a band 3 TA. The group lasts for 50 minutes and Patient C completes the exercises independently. The physiotherapist describes the aim of the session for Patient C was to maintain her current level of functioning and does not record any therapy minutes in the SSNAP data record.
This is correct, as the patient will have already been discharged on SSNAP.
4) A generic therapy assistant approaches Patient D for therapy at 11.40pm. During a ten-minute session, she directs him to complete a number of tasks, including threading beads on to a string and moving blocks from one box to another, using his affected upper limb. The TA records 10 minutes of OT in the SSNAP data record.
If the therapy assistant was under supervision, then this is correct, and 10 minutes of OT should be recorded. In this instance supervision would mean that therapy was directed and agreed by the qualified therapist, the qualified therapist does not need to be present for the therapy.
5) A PT and an OT approach Patient E at 11.10am. Together, the therapists assist her to walk with her stick to the gym, where the PT completes a Berg Balance Assessment. The PT asks the OT to help Patient E if she needs it and the OT provides physical assistance during the session while the PT reads the instructions and completes the assessment form. When the assessment is complete, the OT directs Patient E to walk back to her bedside, encouraging her to read from signs on the way. The session ends at 11.55am. 45 minutes of OT and 45 minutes of PT are recorded in the SSNAP data record.
This is correct, if two therapists of different professions treat a patient at the same time, you should record the total number of minutes for each therapy – this is providing that both the PT and OT are treating the patient holistically (ie. From both professional perspectives). If the OT is only assisting the PT, then it would only count as OT time.