Background: Patients with prolonged disorders of consciousness (PDOC) constitute a small, yet clinically and ethically challenging subset of patients with brain injuries. Delivering high-quality rehabilitation necessitates a cohesive team-based approach. This approach includes precise diagnosis, targeted sensory instigative rehabilitation, and structured approaches to bioethical discussions and best interest decision making.
Aim: This project aimed to develop a model of sub-acute rehabilitation care tailored specifically for PDOC patients within the Metro North Health. Objectives included: enhancing efficiency, consistency of care, and improving the experiences of both patients and their families.
Methods: A comprehensive scoping review was conducted, including an examination of national and international guidelines, benchmarking with other institutes, one-on-one clinician and consumer interviews, and qualitative chart and service audits against established guidelines. The findings from the scoping phase informed the subsequent design phase. A consultative approach was employed to develop a model that includes a core PDOC goal set, levels-of-care framework, a criteria-led admission pathway and a range of evidence-based resources that are both innovative and tailored to the context.
Results/Outcomes: A 12-week assessment and management framework was successfully developed and implemented. Further funding was secured for a 12-month implementation pilot to evaluate, refine, and establish the framework as standard practice.
Recommendations/Implications: Patients with PDOC require a specialised and personalised approach rehabilitation to ensure accurate diagnosis and improve their quality-of-life based on individual preferences. The newly developed PDOC Assessment and Management Framework aims to enhance coordination, consistency, and equity of care for this vulnerable patient population and their families, which is sustainable and scalable.