Introduction: Emergency departments (ED) seek ways to manage increased patient numbers, reduce inpatient admissions, prevent bed-block and re-presentations through safe discharge home or home-alternative. Occupational therapists (OTs) have provided services in EDs since the 1990’s. The last review of published evidence on OT in ED was almost 10 years ago.
Objectives: To provide a comprehensive summary and narrative synthesis of global evidence relating to the OT process in ED.
Methods: The PRISMA extension for Scoping Reviews (PRISMA-ScR) Checklist was used. Scopus, MEDLINE, CINAHL, Cochrane Library and Embase data-bases were accessed (any country, language, date). Data extraction included study and patient characteristics, assessments, interventions and outcomes. Content analysis was used to develop a narrative synthesis categorising data and presenting an evidence-based review of the OT process in EDs.
Results: There were 15168 sources, 11,393 title-abstracts screened, 420 full-text screened and 80 included from 10 countries (40% Australian); published 1997-2024 (67% since 2011). OT commenced only after patient-specific doctor referral in 35% of studies. 80% identified that OTs did assessments (only 16% standardised); 61% identified “OT intervention” was done but only 35% described the target (usually ADL), or type (commonly assistive technology and mobility aid prescription, patient education such as fall prevention/ home hazard reduction, and referral to community services.) Most common reported outcome was discharge disposition.
Conclusion: OT in ED is growing, global and has an increasing evidence-base. While there are common assessment and intervention practices, there is variability in referral, use of standardised assessments, specificity of intervention and outcome measures.