A framework to support early team-based provision of vocational rehabilitation for adults with acquired brain injury

Abstract

Purpose

Specialised vocational rehabilitation (VR) following acquired brain injury (ABI) positively impacts return to work, however access to this is limited globally. Providing VR as a component of standard ABI rehabilitation may improve access to VR and influence vocational outcomes. This study aimed to develop an evidence-based framework for the delivery of ABI VR during early transitional community rehabilitation.

Materials and Methods

The development of the ABI VR framework utilised an emergent multi-phase design and was informed by models of evidence-based practice, national rehabilitation standards, guidelines for complex intervention development, model of care and framework development, and the knowledge-to-action framework. Four study phases were undertaken to identify and generate the evidence base, with findings synthesised to develop the ABI VR framework in phase five.

Results

The framework provides a structure for the systematic delivery of VR as a component of team-based ABI rehabilitation, through five phases of rehabilitation: assessment; goal setting and rehabilitation planning; intervention; monitoring and evaluation; and discharge. It details the activities to be undertaken across the phases using a hybrid model of ABI VR (involving program-based VR and case coordination) and contains service delivery features.

Conclusion

The framework has the potential to translate to other similar service contexts.

IMPLICATIONS FOR REHABILITATION

• An evidence-based framework has been developed to support the provision of vocational rehabilitation as a component of team-based rehabilitation for adults with acquired brain injury, within the context of early, community rehabilitation.

• Providing vocational rehabilitation as a component of team-based rehabilitation should improve access to vocational rehabilitation and may positively influence client return to work outcomes.

• The vocational framework may assist clinicians to identify components of vocational rehabilitation that they can deliver in practice in their own service context.

Keywords:

• Vocational rehabilitation
• brain injuries
• delivery of healthcare
• return to work

Acknowledgements

We would like to thank all the individuals involved in this research - adults with lived experience of ABI, their significant others, and the health and rehabilitation professionals, who have generously shared their experiences, views and time across these studies.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was conducted with the support of Seed Grant funding (2018) from The Hopkins Centre (Metro South Health and the Menzies Institute, Griffith University). The transitional community rehabilitation service (Acquired Brain Injury Transitional Rehabilitation Service (ABI TRS)) was implemented as a pilot project (2016-2022) within Queensland’s publicly funded state-wide Brain Injury Rehabilitation Service. The ABI TRS pilot was funded through the Motor Accident Insurance Commission (MAIC), Queensland Treasury, Queensland Government, Australia (2016-2021); and through MAIC and Queensland Health (Metro South Health and Department of Health) (2021-2022).