OUTCOMES OF AN OCCUPATIONAL THERAPY DRIVING ASSESSMENT PATHWAY FOR PEOPLE WITH STROKE AND MILD COGNITIVE IMPAIRMENT IN AN IRISH ACUTE CARE HOSPITAL

Background Assessing fitness to drive in the clinical setting is an area of practice that therapist often feel ill-equipped to address. An agreed pathway for assessing fitness to drive in an acute care hospital setting was... [ view full abstract ]

Background
Assessing fitness to drive in the clinical setting is an area of practice that therapist often feel ill-equipped to address. An agreed pathway for assessing fitness to drive in an acute care hospital setting was established. The pathway is led by occupational therapy (OT) with inputs from the stroke physician/geriatrician, and the on-road driving assessor.

Method
The assessment pathway includes several standardized measures including the Rookwood Driving Battery, and OT DORA, the pathway has been operational since 2012. A retrospective chart audit is currently underway to review the outcomes of the pathway.

Results
In the first 30 months 172 occupational therapy off-road assessments were completed. Preliminary findings indicate that a fitness to drive decision could be made for 52% of the stroke group, and 25% of the MCI group based on the OT assessment alone. A greater proportion of the MCI group (75%) needed on-road testing. Initial findings indicate that driving classification based on the Rookwood Driving Battery is overly cautious and not reflective of final outcome among this sample. Successful outcomes following on-road testing is high (100% for stroke, 61% for MCI).

Conclusion
Incorporating evidence based standardized tools to assess fitness to drive in practice is essential, however, functional assessment and clinical reasoning must underpin the interpretation of the tests.

Application to Practice
The pathway can be delivered as part of everyday OT practice and the findings show that occupational therapists in clinical setting have a key contribution to make in the overall assessment of fitness to drive.