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Investigating the Model of Community-Based Case Management in the New South Wales Brain Injury Rehabilitation Program

A Prospective Multicenter Study

Simpson, Grahame, PhD; Mitsch, Virginia, MOT; Doyle, Margaret, BAppSc(SpPath); Forman, Marcella, MA(Counselling); Young, Denise, MSW; Solomon, Vicki, BAppSc(OT); MacPherson, Margaret, MHA; Gillett, Lauren, DPsych(ClinNeuro); Strettles, Barbara, RN

The Journal of Head Trauma Rehabilitation: November/December 2018 - Volume 33 - Issue 6 - p E38–E48
doi: 10.1097/HTR.0000000000000370
Focus on Clinical Research and Practice

Objective: To investigate a model of community-based case management (CM).

Setting: New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP).

Participants: All clinicians (N = 72) providing CM within 14 BIRP community rehabilitation teams.

Design: A prospective, multicenter study.

Main Measures: A purpose-designed survey.

Methods: Participants from the 12 adult and 2 pediatric services (8 located in metropolitan areas, 6 in rural areas) completed a 3-part survey investigating their organizational context, clinical approach, and CM interventions. Between-groups analyses explored differences among individual services, as well as differences based on age (adult vs pediatric) and location (metropolitan vs rural).

Results: All services provided a direct service model of CM. The underlying principles were uniform across services (more direct than indirect service provision; with more client-related than administrative-related tasks; more holistic than service-led in defining client needs; with decision making equally directed by staff and clients; and undertaking a more comprehensive than minimalist range of tasks). CM interventions included the provision of individual support, family support, advocacy, and community development alongside assessment, monitoring, referral, and liaison tasks. There were little differences in practice based on age or location.

Conclusion: The NSW BIRP has drawn upon the results to produce a model of service for CM.

Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia (Dr Simpson and Dr Gillett and Ms Strettles); Liverpool Brain Injury Rehabilitation Unit, Sydney, New South Wales, Australia (Dr Simpson and Ms Forman); John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia (Dr Simpson); South West Brain Injury Rehabilitation Service, Murrumbidgee Local Health District, Albury, New South Wales, Australia (Ms Mitsch); Westmead Brain Injury Rehabilitation Service, Sydney, New South Wales, Australia (Ms Doyle); Mid Western Brain Injury Rehabilitation Program, Bathurst, New South Wales, Australia (Ms Young); Mid North Coast Brain Injury Rehabilitation Service, Port Macquarie, New South Wales, Australia (Ms Solomon); Rural and Regional Health Services, Hunter New England Local Health District, Tamworth, New South Wales, Australia (Ms MacPherson); Department of Neurology, Liverpool Hospital, Sydney, New South Wales, Australia (Dr Gillett); and New South Wales Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation, Sydney, New South Wales, Australia (Ms Strettles).

Corresponding Author: Grahame Simpson, PhD, Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, c/o Liverpool Brain Injury Rehabilitation Unit, Liverpool Health Service, Locked Bag 7103, Liverpool BC, NSW 1871, Australia (grahame.simpson@health.nsw.gov.au).

The authors thank Annabel Gibson and Rachel Cotter for their contribution to the early phase of this project.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.headtraumarehab.com).

The authors declare no conflicts of interest.

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