Occupational Therapy — Discharge to Community OT after Cardiac Surgery
An inpatient occupational therapist discharges a 72-year-old man to the community OT following coronary artery bypass graft surgery. The discharge letter must hand over the sternal precautions, the current ADL status, and the energy conservation programme so the community OT can continue rehabilitation at home.
Letter type
Discharge
Write to
Community Occupational Therapist
Target length
190–210 words
The case notes
Patient: Mr Patrick Sweeney, 72 years old; retired; coronary artery bypass graft (CABG x3) 10 days ago; discharged home today
Sternal precautions (12 weeks): No lifting more than 2 kg with either arm; no pushing or pulling with arms (use legs to rise from chairs); no driving for 4–6 weeks (surgeon decision); no lifting arms above shoulder height; these precautions prevent sternal wound dehiscence
ADL status: Independent in: bed transfers, dressing lower body, washing standing at sink; Assistance required: dressing upper body (shoulder movement restricted by precautions); unable to prepare hot meals independently (lifting and carrying hot items >2 kg)
Energy conservation: Fatigue is significant — taught sit-down tasks where possible, alternating rest and activity, prioritising tasks; daily step goals: 10 minutes twice daily walking increasing by 2 minutes every 3 days as tolerated
Equipment: Raised toilet seat (10 cm); long-handled sponge; dressing stick — all issued
Goal: Independent in all ADLs within sternal precautions by 6 weeks; return to light housework and cooking by 8–10 weeks
Task: Write a discharge letter to the community OT, Ms Dawn Sharpe, summarising Mr Sweeney's functional status and the sternal precautions for ongoing rehabilitation.
Writing task
Write a discharge letter to the community OT, Ms Dawn Sharpe, summarising Mr Sweeney's functional status and the sternal precautions for ongoing rehabilitation.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The sternal precautions (12 weeks): no more than 2 kg, no pushing or pulling with arms, no lifting above shoulder height
Sternal wound dehiscence is a life-threatening complication. The community OT must know these precautions to design safe ADL activities and to avoid recommending exercises or tasks that violate them.
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Current ADL independence: independent in lower body dressing and sink washing; needs assistance with upper body dressing; unable to prepare hot meals
The baseline tells the community OT where the patient is and what the priority rehabilitation targets are. Hot meal preparation is the highest functional priority.
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The energy conservation programme and the 10-minute walking progression
Post-cardiac surgery fatigue management is a core OT role. The specific walking progression — 10 minutes twice daily, plus 2 minutes every 3 days — allows the community OT to monitor compliance and advance it at the right rate.
Leave out
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The surgical detail of the CABG procedure
The community OT needs the functional implications, not the cardiac surgery. 'CABG x3 10 days ago' is sufficient context.
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Driving restriction
A surgeon and DVLA matter, not an OT matter. A brief mention — 'surgeon has advised no driving for 4–6 weeks' — confirms it without making it an OT action.
Criterion in focus · Content
Cardiac surgery OT discharge letters are assessed on whether the sternal precautions are stated precisely and completely. A letter that says 'sternal precautions apply' without specifying the weight limit or the postural restrictions fails Content — the community OT cannot safely run an ADL programme without knowing the specific constraints.
Now write the letter — and find out what is blocking your Grade B
Write a 190–210 words discharge letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.