CAOT Position Statement
Health Human Resources in Occupational Therapy (2011)

To promote effective occupational therapy human resource planning, CAOT will:

1.  Promote the benefits occupational therapy provides to the health and wellness of Canadians among decision-makers and funders.
2.  Promote occupational therapists as key members of interprofessional health teams in health human resource planning.
3. Sensitize decision-makers to the funding disparities among health professionals in community practice and the subsequent impact on access to occupational therapy services.
4. Work with members and stakeholders to build a strong advocacy base at all levels of government.
5. Promote and participate in the development of research that will advance best practices in health human resource development and planning.
6. Build and maintain existing partnerships with government, stakeholders and other professional organizations that share a vision for an integrated health human resource workforce.
7. Develop and disseminate resources to members to assist them with health human resource initiatives.
8. Develop and promote quality standards for education and the delivery of occupational therapy services.

Background

1. Occupational therapists, the primary service providers of occupational therapy, are university educated and understand the effects of factors like disease and injury on the ability of individuals, groups and communities to engage in the occupations of life. Occupational therapists are regulated health professionals in each Canadian province and have skills and knowledge to provide an evidence-based approach to help others identify, engage in and achieve their desired potential in their occupations.

2. Participation in meaningful occupation is an important determinant of health. Occupational therapists improve and enhance health by enabling individuals, groups and communities to identify, engage in and achieve desired potential in the occupations of life. Occupational therapy also enables Canadians to maximize productivity, reduce lifestyle restrictions and avoid unnecessary dependency.

3. The Profile of Occupational Therapy Practice in Canada provides the vision for workforce planning for our profession (CAOT, 2007); it articulates the broad range roles occupational therapists may assume in their work. While rooted in the goal of enabling engagement in occupation, the roles, settings and approaches of occupational therapists may vary greatly. To enable diversity, social inclusion and occupational justice, occupational therapist can act in roles such as clinicians, researchers, policy-makers, educators or administrators and work in a broad range of sectors including health, education, community and social services and business (von Zweck, 2010).

4. Occupational therapists are one of five health professions included in the Health Canada-funded Health Human Resources Database Development Project coordinated by the Canadian Institute for Health Information (CIHI). This project annually collects data from Canadian occupational therapy regulatory organizations and CAOT for a database of supply-based demographical and practice information regarding occupational therapists in Canada. An annual report on the database information  is published by CIHI.

5. The distribution of occupational therapists in Canada varies greatly among provincial/territorial jurisdictions and urban/rural communities (Canadian Institute for Health Information, 2010). For example, only 5% of occupational therapists work in rural communities. The per capita distribution of occupational therapists in jurisdictions such as Saskatchewan is less than half the province of Quebec where shortages continue to be reported.  Such variations in distribution impact access to occupational therapy services. 5. A significant and frequently overlooked factor influencing the size of the occupational therapy workforce in Canada is attrition from the profession. As the age profile of occupational therapists registered to practice in Canada appears to indicate significant attrition after the age of 45 years (CIHI, 2010), concentrated efforts are required to retain the highly valued expertise of experienced practitioners. A recent leadership forum was held in May 2010 with Canadian occupational therapy organizations to explore issues relating to workforce attrition and define strategies to promote continued use of title as an occupational therapist (von Zweck, 2010).

6. The CAOT position statement on Quality Occupational Therapy Services, identifies strategies to attract and retain occupational therapists (CAOT, 2010). Workplace factors play a significant role in recruiting and retaining occupational therapists; one such factor is the disparity in caseload assignment and management issues. CAOT has taken steps to address this through a Health Canada-funded project to review best practices in caseload assignment and management as well as develop a caseload management tool (CAOT, 2011).

7. In 2006, CAOT completed work as a partner in two Health Canada-funded initiatives to develop a national framework and guiding principles to enhance interdisciplinary collaboration in primary health care and mental health services. The intent of both initiatives was to have a significant impact upon the reform of Canada’s primary health care system by identifying and creating awareness of conditions necessary for health providers to work together effectively, in order to produce best possible outcomes for clients. (Canadian Collaborative Mental Health Initiative I, 2006 & Enhancing Interdisciplinary Collaboration in Primary Health Care, 2006).

8. Work was completed in November 2006 on the Enabling the Workforce Integration of International Graduates (von Zweck, 2006), a 19-month initiative funded by the Government of Canada Foreign Credential Recognition Program (FRCP) that investigated issues and solutions for helping international graduates to work as occupational therapists in Canada. The final report reflected input provided by over 150 participants and outlined seven recommendations for future action. In follow up to the recommendations, CAOT received funding in 2007 from FRCP for a project with the Association of Canadian Occupational Therapy Regulatory Organizations (ACOTRO) and the Association of Canadian Occupational Therapy Education Programs (ACOTUP). The project identified the pathway(s) followed by international graduates from the point of initial consideration of immigration to successful registration and integration into practice. The project serves to identify assessments, remediation and supports needed as international graduates move through the pathway (von Zweck, 2007).  In 2008, the IEOT Web Portal project was launched as a joint initiative of CAOT, ACOTUP and ACOTRO. In the fall of 2009 with funding from FRCP, the resulting portal (www.gocanadaot.com) now serves as an online electronic information gateway for internationally educated occupational therapists to centralize information regarding living and working in Canada as an occupational therapist. The National Occupational Therapy Examination and Practice Preparation Project funded by FRCP currently partners CAOT with McMaster University and several additional universities across Canada to offer a national curriculum to assist internationally educated occupational therapists to practice in Canada.

9.  Over the past 19 years, CAOT has been an active member of the Health Action Lobby (HEAL), a coalition of  national health and consumer associations and organizations dedicated to protecting and strengthening Canada’s health care system. HEAL is taking action to engage government interest in health human resources issues development and assessment of policy options concerning integrated health human resources planning(HEAL, 2006).
10. CAOT recognizes that occupational therapy support workers are an important component of the occupational therapy workforce. The CAOT position statement on Support Personnel in Occupational Therapy Services(CAOT, 2011b) addresses education, utilization and accountability of support workers. The CAOT Guidelines for the Supervision of Assigned Occupational Therapy Components outline supervisory responsibilities of occupational therapists and identifies service components that should not be assigned to support personnel.  The CAOT Practice Profile for Support Personnel in Occupational Therapy outlines the continuum of knowledge, skills and abilities needed by occupational therapy support personnel in Canada.

References

Canadian Association of Occupational Therapists. (2007). Guidelines for the Supervision of Assigned Occupational Therapy Service Components.

Canadian Association of Occupational Therapists. (2010). CAOT Position Statement: Quality occupational therapy services. Retrieved June 10, 2011, from  http://www.caot.ca/default.asp?pageid=1115

Canadian Association of Occupational Therapists. (2011b). CAOT Position Statement: Support Personnel in occupational therapy services. Retrieved June 10, 2011, from  http://www.caot.ca/default.asp?pageid=1115

Canadian Association of Occupational Therapists. (2011). Caseload Management Tool. Retrieved July 2011, from http://www.caot.ca/default.asp?pageid=2331

Canadian Collaborative Mental Health Initiative (2006). Charter. Retrieved May 28, 2006, from
http://www.ccmhi.ca/en/index.html

Canadian Institute for Health Information (2010). Workforce Trends of occupational therapists in Canada, 2009, Retrieved June 10, 2011 from https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1557&lang=en&media=0

Enhancing Interdisciplinary Collaboration in Primary Health Care. (2006). Guidelines and Framework. Retrieved May 28 2007, from   http://www.eicp.ca/

Health Action Lobby. (2006). Core principles and strategic directions for a pan-Canadian health human resources plan. Retrieved on May 28, 2007 from http://www.physiotherapy.ca/HEAL/pdfs/HEALGreenPaper.pdf

Health Canada. (2005). Health Human Resources Strategy. Retrieved May 28, 2007, from http://www.hc-sc.gc.ca/english/hhr/index.html

von Zweck, C. (2006) Enabling the Workforce Integration of International graduates. Ottawa, CAOT Publications. Retrieved May 28, 2007 from http://www.caot.ca/pdfs/wip/WIP%20Report.pdf.
von Zweck, C. (2007). CAOT 2006-2007 Midyear Report. Occupational Therapy Now, 8(3), 10 -13.

von Zweck, C. (2010). Building Workforce Capacity for Occupational Therapy in Canada
Occupational Therapy Now

Position statements are on political, ethical and social issues that impact on client welfare, the profession of occupational therapy or CAOT. If they are to be distributed past two years of the publication date, please contact the Director of Professional Practice, CAOT National Office, CTTC Building, 3400-1125 Colonel By Drive, Ottawa, ON. K1S 5R1. Tel. (613) 523-2268 or e-mail: practice@caot.ca.

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