The question of mental models and how we show up as OTs as well as the river metaphor feels especially timely for me as an acute care OT working in a health care system that increasingly feels on the verge of collapse. This river has class IV rapids and it is so important to remember that none of us can hold back the waters. Rocky shores are littered with obstacles including understaffing and lack of post discharge options. Important times to remember to navigate the currents and invest in collaborative partnerships. Our collaborative relationships suffer in the setting of burn out, understaffing and what can feel like a heartbreaking inability to get patients what they need. This of course feeds a cycle of bad morale and reduced productivity.
Oh @joan! I feel this. Thank you for sharing. It certainly feels like we as society are collectively in rapids, and I know that that is particularly true for those of you in acute care.
Thank you for the work you are doing. Iâm sorry you are having to navigate so much. I hope each day you can find ways to take of yourself- and release the things you cant control.
I hadnât thought about this aspect of the mental model river: but, something comforting is that the river does always level out into calm at some point. I think as OTs, we need to be visualizing that future for ourselves, and keep taking steps forward to get there.
Thank you for being here, and for sharing.
Sridevi,
Sometimes I am a very literal person. I think that my living along a river, and passion for rivers has made me extra sensitive and I realize my privilege for instant access to rivers is clouding my judgement. Perhaps, Iâm not as creative and would not do as well conjuring up river images-however, in this technological world that seems unrealistic.
I agree with all that youâve written. I too battled through all the rocks and boulders that you are talking about. Obstacles at almost every turn that the river thinks maybe easier.
However, in time hopefully things will get better. It will certainly NOT happen sooner than later. It will take time. The entire industry, rather healthcare services have to look within themselves to find solutions. They cannot just follow the herd along the banks of the river.
If indeed productivity is the ultimate goal-then all teams need to ask themselves and each other-who are we being productive for, and why ? Is productivity giving better results.
If client satisfaction is the end goal-then rocks and driftwood would certainly fall into place slowly but surely.
And so on and on. Much one can discuss.
Thank you 
Sarah,
Is this a live podcast with Dr. Iwama? Iâm trying to set up my week and would love to make it if its live.
Thanks
Brie
KAWA model is very inclusive and patient centered. Reading this article reminded me of the conversation that was with Arameh Anvarizaden on equitable practices and inclusivity in OT.
Functional and meaningful interventions start with an inclusive occupational evaluation. I would love to discuss how the KAWA model can be used in the acute evaluation process.
As we know, in acute care there are pressing priorities/flow of time management and team communications. It also reminds me of ABIM âchoose wiselyâ is about being effective in our outcomes by using our time with the patient in the most influential way. Visual learning like the KAWA model is very effective and efficient.
From an OTs point of view being aware of patientâs backgrounds, cultures and communities would be represented by the flow and sometimes the spaces, which act as a learning opportunity.
Hey @brie! At this time we donât do any live conversationsâŚbut the good news is that I JUST published the podcast! I canât wait for you to listen to it!!
https://club.otpotential.com/t/25-collaboration-and-the-kawa-model-with-michael-iwama-ce-course/828
First of all, melissa I am an acute care rehab OT and I love my job. We need more OTâs in the hospital setting! It is interesting that you mention the gentle, common language as a benefit of the Kawa Model. Acute care language and culture could use a tilt towards the gentler side. Because the acute setting is so dynamic team work is vital. I think youâre right that a very skilled and persuasive facilitator would be important.
Maybe the river metaphor could nudge us towards more greater humility. Most people are in the hospital because things are not going well. The structure and culture of the setting promotes a tendency to fix problems quickly and move patients out. Getting patients out of the hospital is an excellent goal but our fixes will fail if we donât work in partnership with patients and understand their environment and values.