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Tips and tricks for embedding clinical excellence into day-to-day community-based allied health practice.

By Sonia Borg

We often hear buzz words like clinical excellence and evidence-based practice, but what do these look like in day-to-day community work as an allied health therapist?

Working in a participant’s natural setting, whether that is their home, school, day program or local community, gives us a unique opportunity to deliver client-centered care. It means we can tailor our interventions based not just on clinical frameworks, but also on the individual, their support, the goals they want to achieve, and where they want to achieve them.

Here are six quick, practical tips to help embed clinical excellence into your everyday community practice:

Be curious

Being curious is one of the most important tools we can bring into our daily practice. It helps us discover the why behind what is going on for that participant and puts the participant as the expert in their own lives.


At the start of each session, be curious and ask questions like:

  • “Has anything changed since last week?”
  • “What do you think made the difference?”
  • “How did you go with …”
  • “What worked / didn’t work for you this week?”


Goal focused

It is easy to get pulled in many directions when working in the community. Using the participant’s goals serves as an anchor to keep coming back to align therapeutic direction. Ask yourself: “Is what I am doing right now helping the participant move towards their goal?”

Using the participant’s goals supports:

  • How to structure the session.
  • What to emphasis in our clinical case notes.
  • What interventions do we use.
  • What recommendations we make.

It is also important to revisit goals regularly, to identify mini wins, to adapt based on the participant’s needs, as well as to develop new goals from new priorities.

Meaningful and functional interventions

Working in people’s natural environments is dynamic and can be unpredictable. It is therefore important to ground interventions into small, purposeful, intentional, and meaningful actions that move the participant towards their goal. This is important as it keeps things simple and achievable, while building consistency in daily routines and environments that the participant is in every day. The intervention should make sense in the participants’ life.

This can look like:

  • Acknowledge the small wins to build motivation and momentum.
  • Building achievable steps into the intervention approach.
  • Modelling them for the participant’s informal and formal support to continue between sessions.

Reflective documentation

Clinical case notes are a powerful clinical tool. It supports clear communication, reflective practice, clinical reasoning, goal tracking and accountability, and compliance with funding and legal requirements.

Effective documentation:

  • Communicates the session summary clearly for the participant and their support.
  • Links directly to the participants’ goals.
  • Captures clinical reasoning and reflective practice.
  • Includes observations.

Collaboration

When working with people in their natural environments, we also work with the participant’s support system. This can include family members, support workers, teachers, day program staff and other allied health professionals. Collaboration within the support system is not just about communication, it is about alignment across goals and consistency. It creates a strong system around the participant.

Good quality collaboration should:

  • Be proactive, rather than reactive.
  • Be led by the participant’s goals.
  • Timely and efficient.
  • Use plain language to reduce the use of jargon.

References

Australian Health Practitioner Regulation Agency. (2018). Occupational therapy competency standards. Occupational Therapy Board of Australia. https://www.occupationaltherapyboard.gov.au/Accreditation/OT-Competency-Standards.aspx


D’Amour, D., Ferrada-Videla, M., San Martin Rodriguez, L., & Beaulieu, M.-D. (2005). The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care, 19(S1), 116–131. https://doi.org/10.1080/13561820500082529


Occupational Therapy Australia. (n.d.). Practice guidelines and documentation standards.


Physiotherapy Board of Australia. (2021). Professional capabilities for physiotherapists. https://www.physiotherapyboard.gov.au/Accreditation/professional-capabilities.aspx


Speech Pathology Australia. (2020). Code of ethics. https://www.speechpathologyaustralia.org.au/SPAweb/About_us/Governance/Code_of_Ethics.aspx


Unsworth, C. A. (2004). Clinical reasoning: How do pragmatic reasoning, worldview and client-centredness fit? British Journal of Occupational Therapy, 67(1), 10–19. https://doi.org/10.1177/030802260406700103


World Health Organization. (2001). International classification of functioning, disability and health (ICF). https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

About the author

Sonia is KEO Care’s PBS Clinical Service Manager. She is an experienced paediatric occupational therapist and specialist positive behaviour support practitioner. She specialises in working with children and families, focusing on supporting children to achieve their goals in their everyday life. She has had experience working across multiple settings, including specialist schools, in clinic environments and in the community.