Professional standards for accountability establish essential competencies for clinical practices and provide strategies for professional advancement. This study examines the perspectives of a sample of occupational therapists on their capacity to engage in continuing education, to provide evidence-based practices and to have confidence in the effectiveness of available quality assurance mechanisms within restructured contexts of occupational therapy practice. The analysis of in-depth interviews with participants from program management, managed competition and private practice suggested three urgent needs: the development of strategies to assist therapists' translation of research evidence into clinical practices, research to determine the effectiveness of models of professional leadership within the workplace that promote professional accountability and alliances to advance policies that eliminate workplace barriers to professional accountability.
AngellM. (1993). The doctor as double agent. Kennedy Institute of Ethics Journal, 3, 279–286.
2.
Association of Canadian Occupational Therapy Regulatory Organizations. (2001). Essential competencies for occupational therapists in Canada. Toronto: Author.
3.
BeardwoodB.WaltersV.EylesJ. & FrenchS. (1999). Complaints against nurses: A reflection of ‘the new managerialism’ and consumerism in health care?Social Science & Medicine, 48, 363–374.
4.
BennettS. & BennettJ. W. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47, 171–180.
5.
BraymanS. J. (1996). Managing the occupational environment of managed care. American Journal of Occupational Therapy, 50, 442–446.
6.
Canadian Association of Occupational Therapists, Association of Canadian Occupational Therapy University Programs, Association of Canadian Occupational Therapy Regulatory Organizations, Presidents' Advisory Committee. (1999). Joint position statement on evidence-based occupational therapy. Canadian Journal of Occupational Therapy, 66, 267–269.
7.
CockerillR.ScottE. & WrightM. (1996). Interest among occupational therapy managers in measuring workload for case costing. American Journal of Occupational Therapy, 50, 447–451.
8.
College of Occupational Therapists of Ontario. (1998). Quality assurance program. Toronto: Author.
9.
CresswellJ.W. (1998). Qualitative inquiry and research design. Choosing among the five traditions. Thousand Oaks, CA: Sage Publications.
10.
CurtinM. & JaramazovicE. (2001). Occupational therapists' view and perception of evidence-based practice. British Journal of Occupational Therapy, 64, 214–222.
11.
CusickA. & McCluskeyA. (2000). Becoming an evidence-based practitioner through professional development. Australian Occupational Therapy Journal, 47, 159–170.
12.
DeberR.NarineL.BaranekP.SharpeN.DuvalkoK.Zlotnick-ShaulR.CoyteP.PinkG.WilliamsA.P. (1996). The public-private mix in health care, (pp. 423–547). In National Forum on Health, (ed.), Striking a balance: Health care systems in Canada and elsewhere. Ottawa, ON: Department of Health and Welfare, Government of Canada.
13.
DexterL.A. (1970). Elite and specialized interviewing. Evanston, IL: Northwestern University Press.
14.
DuboulozC.J.EganM.VallerandJ. & von ZweckC. (1999). Occupational therapists' perceptions of evidence-based practice. American Journal of Occupational Therapy, 53, 445–453.
15.
EganM.DuboulozC. J.von ZweckC. & VallerandJ. (1998). The client-centred evidence-based practice of occupational therapy. Canadian Journal of Occupational Therapy, 65, 136–143.
16.
EmanuelE.J. & GoldmanL. (1998). Protection of patient welfare in managed care: Six safeguards. Journal of Health Politics, Policy and Law, 23, 634–659.
17.
EvansR.G.BarerM. & HertzmanC. (1991). The 20-year experiment: Accounting for, explaining, and evaluating health cost containment in Canada and the United States. Annual Review of Public Policy, 12, 481–518.
18.
FawcettL.C. & SricklandL. R. (1998). Accountability and competence: Occupational therapy practitioner perceptions. American Journal of Occupational Therapy, 52, 737–743.
19.
FotoM. (1997). Preparing occupational therapists for the year 2000: The impact of managed care on education and training. American Journal of Occupational Therapy, 51, 88–90.
20.
GageM. (1996). Re-engineering of health care: Opportunity or threat for occupational therapists?Canadian Journal of Occupational Therapy, 62, 197–207.
21.
GoodeW. J. (1960). Encroachment, charletonism, and the emerging profession: Psychology, sociology and medicine. American Sociological Review, 25, 902–1014.
22.
GruchyC. & RogersL. G. (1990). Quality assurance: The current challenge. Canadian Journal of Occupational Therapy, 62, 109–115.
23.
Health Professions Legislation Review (1989). Striking a new balance: A blueprint for the regulation of Ontario's health professions. Toronto: Ontario Government.
24.
Health Services Research Group (1992). Quality of care: 1. What is quality and how can it be measured?Canadian Medical Association Journal, 146, 2153–2158.
25.
HollingsworthJ. R.HageJ. & HannemanR. S. (1990). State intervention in medical care: consequences for Britain, France, Sweden and the United States, 1890–1970. Ithica, NY: Cornell University Press.
26.
HolmM. B. (2000). Our mandate for the new millennium: Evidence-based practice. American Journal of Occupational Therapy, 54, 575–585.
27.
HumphrisD.LittlejohnsP.VictorC.O'HalloranP. & PeacockJ. (2000). Implementing evidence-based practice: Factors that influence the use of research evidence by occupational therapists. British Journal of Occupational Therapy, 63, 516–222.
28.
LawM. & BaumC. (1998). Evidence-based occupational therapy. Canadian Journal of Occupational Therapy, 65, 131–135.
29.
LawM.CooperB. A.StrongS.StewartD.RigbyP. & LettsL. (1996). The Person- Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9–23.
30.
LawM.RyanB.TownsendE. & O'SheaB. (1989). Criteria mapping: A method of quality assurance. American Journal of Occupational Therapy, 55, 104–109.
31.
LysaghtR.M.AltschuldJ.W.GrantH.K.HendersonJ.L. (2001). Variables affecting the competency maintenance behavior of occupational therapists. American Journal of Occupational Therapy;55, 28–35.
32.
KronickR. (1999). Waiting for Godot: Wishes and worries in managed care. Journal of Health Politics, Policy and Law, 24, 1099–1106.
33.
MechanicD. (1998). The functions and limitations of trust in the provision of medical care. Journal of Health Politics, Policy and Law, 23, 661–686.
34.
MurphyE. J. (2000). The availability and sufficiency of quality assurance mechanisms in private insurance-based practices. Unpublished manuscript, Department of Occupational Therapy, University of Toronto.
35.
SaulJ. Ralston (1999). Health care at the end of the twentieth century: Confusing symptoms for systems. In SomervilleM.A. (Ed.), Do we care? Renewing Canada's commitment to health (pp. 1–20). Montreal: McGill-Queen's University Press.
36.
RappoltS. (1999). From paymaster to manager: State structures, processes and medical power. Health and Canadian Society, 5, 113–137.
37.
RappoltS. & TassoneM. (2002) How rehabilitation professionals learn, evaluate and implement new knowledge. Journal of Continuing Education in the Health Professions, 22, 170–180.
38.
RobertsA. E. K. & BarberG. (2001). Applying research evidence to practice. British Journal of Occupational Therapy, 64, 223–227.
39.
RobinsonJ. & KlaimanD. (2001). Everything you wanted to know about competency profiles…. OT Now, 3, 31.
40.
RobinsonS. (1996). Audit in the therapy professions: Some constraints on progress. Quality in Health Care, 5, 206–214.
41.
StoneD. A. (1997). The doctor as businessman: The changing politics of a cultural icon. Journal of Health Politics, Policy and Law, 22, 533–556.
42.
StraussA. & CorbinJ. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
43.
SweetlandJ. & CraikC. (2001). The use of evidence-based practice by occupational therapists who treat adult stroke patients. British Journal of Occupational Therapy, 64, 256–260.
44.
TassoneM. & HeckC. (1997). Motivational orientations of allied health care professionals participating in continuing education. Journal of Continuing Education in the Health Professions, 17, 97–105.
45.
Tickle-DegnenL. (1998). Using research evidence in planning treatment for the individual client. Canadian Journal of Occupational Therapy, 65, 152–159.
46.
TrujilloS.BeggsC. & BrownJ. (1996). Health care delivery restructuring – influences on the rehabilitation professional. Canadian Journal of Rehabilitation, 9, 109–116.
47.
TuohyC. J. & WolfsonA. D. (1978). Self-regulation: Who qualifies? In SlaytonP. and TrebilcockM. (Eds.), The professions and public policy (pp. 111–122). Toronto: University of Toronto Press.
48.
Varela-BursteinE. A.VoightE. A. & PantelE. S. (1997). The impact of managed care on the practice occupational therapy by hand therapists. Occupational Therapy in Health Care, 10, 33–52.
49.
WalkerK.E. (2001). Adjustments to managed health care: Pushing against it, going with it, and making the best of it. American Journal of Occupational Therapy, 55, 129–137.
50.
WilliamsAPBarnsleyJLeggatSDeberRBBaranekP.Long term care goes to market: Managed competition and Ontario's reform of community-based services. Canadian Journal on Aging18, 125–153.
