Patient navigation for traumatic brain injury promotes community re-integration and reduces re-hospitalizations

ABSTRACT

Objective: To determine the effectiveness of a Navigation programme for patients with traumatic brain injury.Design: Prospective programme evaluation.Setting: Inpatient rehabilitation facility and community settings.Participants: Eighteen individuals who suffered a traumatic brain injury (TBI), were between the ages of 16–70 years, and had a Rancho Score greater than IV.Intervention: Patient navigation programme focused on identifying and addressing barriers to positive outcomes, including coordination of care and facilitating communication among the family and healthcare providers, psychosocial support, caregiver support, adherence to treatment, education, community resources and financial issues.Main outcome measures: Functional status, re-hospitalizations, falls, neurobehavioral symptom inventory, neuroendocrine status, activities of daily living, community integration and caregiver burden.Results: There was a significant reduction in re-hospitalization and fall rate when comparing individuals who received navigation services and those who did not. We also observed improved adherence treatment plans and a significant increase in community integration, independence level and functional abilities.Conclusions: This study begins to highlight the effectiveness of a patient navigation programme for individuals with TBI. Future research with a larger sample will continue to help us refine patient navigation for chronic disabling conditions and determine its sustainability.

KEYWORDS:

• Activities of daily living
• brain injury
• cognition
• community integration
• depression
• outcomes
• patient navigation
• rehabilitation
• re-hospitalizations
• social work

Acknowlegments

The authors would like to thank Dr Loverso, the Casa Colina Board of Directors, and the Casa Colina Foundation for supporting this research. We would also like to thank all the clinicians and research assistants who contributed to this study including Dr Adeel Popalzai, Dr Diem Ha Hoang, Dr Elizabeth Cisneros, Dr David Patterson, Dr Kelli McSwan, Dr Jose Fuentes, Cathy Temple, and Susie Wong-Okomoto.

Declaration of interest

The authors certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are affiliated.