Supporting Occupational Therapists in Predischarge Home Visit Decision‐Making: Development and Evaluation of a Decision‐Making Support Tool

Introduction: With little evidence to guide practice, the decision to conduct a predischarge home visit poses challenges for occupational therapists. This study is aimed at evaluating the impact of a newly developed support tool for home visit decision‐making on therapists’ confidence, ease, and accuracy in decision‐making and stakeholders’ satisfaction in the communication of the decision and examining its clinical utility and reliability. Method: The predischarge home visit decision‐making support tool was trialed by occupational therapists from five facilities across an Australian metropolitan health service. Using a pre–post study design, therapists completed a purposefully developed questionnaire on decision‐making practice including ease and confidence in decision‐making. Accuracy of decision‐making was also evaluated using case studies. Clinical utility and reliability data was also gathered. Results: While therapists’ confidence and ease in decision‐making did not change with use of the tool, accuracy in decision‐making improved regardless of therapist’s experience in home visiting. The interrater reliability of the tool was moderate, with a Fleiss’ kappa value of 0.51. Good internal consistency was demonstrated with the removal of one item ( α = 0.83). Clinical utility was supported with therapists rating the tool as timely and easy to use. Conclusion: The developed tool offers therapists a reliable tool to support clinical practice, by providing guidance in clinically reasoning the decision to conduct a home visit.