Background: Patients with prolonged disorders of consciousness (PDOC) are a clinically and ethically challenging subset of the brain injury population, requiring a cohesive interdisciplinary approach to enable delivery of high-quality rehabilitation. Building on a previous scoping review and consultative design process, a 12-week assessment and management framework was developed and implemented for PDOC patients admitted to the Brighton Brain Injury Service (BBIS).
Aim: This project aimed to evaluate the implementation of the framework.
Methods: All PDOC patients admitted to BBIS between July 2022 and May 2023 were included in the evaluation of the 12-week pathway. Retrospective chart audits of admitted patients and a pre-post survey of BBIS clinicians were undertaken to assess fidelity, attitudes, knowledge, and compliance with international care standards for this patient group.
Results/Outcomes: During the project timeframe, four patients were admitted to the pathway, with 66% of the framework's key components being delivered as planned. Surveyed staff agreed the pathway was beneficial for their clinical practice and for patients and families. Auditing of service and patient records revealed improved alignment with the American Congress of Rehabilitation Medicine and Royal College of Physicians PDOC clinical guidelines.
Recommendations/Implications: The evaluation demonstrated the feasibility and positive perception of the 12-week assessment and management framework at BBIS, benefiting patients, families and staff. It increased the provision of evidence-based care and improved PDOC specific service recommendations compliance. Limitations of the study included the small number of patients and time constraints. Future research will incorporate additional implementation science principles to enhance scalability within other Queensland Health settings.