Designing a best practice model of care for rehabilitation of patients with a prolonged disorder of consciousness (PDOC).
Kirsten Sue See1,2, Kerry Anderson Kay2, Erin Gothard1 1Queensland Health, Metro North Community And Oral Health, 2Health Excellence and Innovation Metro North Health, Brain and Spinal Cord Injury Project
Abstract
Background:
People experiencing a prolonged disorder of consciousness (PDOC) represent a small, but clinically and ethically challenging, proportion of the brain injury population. Quality rehabilitation for this vulnerable group is characterised by a cohesive team approach; inclusive of accurate diagnosis, targeted sensory instigative rehabilitation; and facilitated best interests discussions tailored to the unique needs of the patient and family. This project aimed to scope and synthesise current best-evidence to design a sub-acute rehabilitation model of care specifically for PDOC patients in Metro North Health, to improve efficiency, consistency of care and family experience.
Method:
Scoping phase: Review of national and international guidelines, national/international benchmarking, 1:1 clinician and consumer interviews, qualitative chart and service audits against guidelines.
Design phase: Consultative development of a 12-week assessment and management framework reflective of scoping outcomes. Including core PDOC goal set, levels of care framework, criteria led admission pathway and both novel and contextualised evidenced-based resources.
Results:
A 12-week criteria driven assessment and management framework for PDOC rehabilitation has been developed and launched. Funding for a 12-month implementation pilot has been secured to evaluate, refine and embed as standard practice in MNHHS.
Discussion:
Patients in PDOC require a specific and specialised model of sensory instigative rehabilitation to ensure accuracy of diagnosis, and to optimise their likelihood of achieving a quality of life acceptable to them. This newly developed PDOC Assessment and Management Framework seeks to improve coordination, consistency, and equity of care for this vulnerable patient cohort and their families, which is sustainable and scalable.
Biography
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