Clinical pathways in head injury: improving the quality of care with early rehabilitation

Abstract

Purpose: To improve the management of all hospital admissions with head injuries, including mild and moderate by developing a clinical pathway and a head injury team. Methods: A head injury team was set up to take over the care of all admissions with head injury and to manage appropriate referrals and discharges. A key role was to facilitate communication between the different services involved in head injury care, arrange follow-up, support relatives and to educate healthcare staff. Results: In the first year, the team took over the care of 196 admissions of whom 128 attended for 3-month follow-up with 66% having a good outcome. Patients and relatives feedback was excellent with an average score of 4.8/5 on overall satisfaction rating. Other centers in the United Kingdom are aiming to set up similar pathways, and the team has presented on head injury pathways extensively. Conclusions: A clinical pathway can improve the quality of care for all admissions with head injury and enhance the role for rehabilitation at an early stage.

Implications for Rehabilitation

• The care of head injury patients is often haphazard with several specialties involved and no coordination of care.

• Rehabilitation medicine is usually involved later on in head injury care.

• Setting up an acute head injury team can improve service outcomes and represents a development opportunity for rehabilitation medicine.

Keywords::

• Brain injury
• clinical pathways
• quality
• rehabilitation

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.