In Aotearoa systematic assessment of traumatic brain injury (TBI) in patients admitted to hospital with major trauma was inconsistent, inequitable and was in places very limited. If left undiagnosed, presence of TBI can impact long-tern outcomes, delayed functional recovery and reduced quality of life.
The aim of this work was to improve identification of TBI through PTA assessment for major trauma patients, to ensure all brain injured patients receive timely rehabilitation.
Between October 2022 - June 2023, eleven teams from across Aotearoa participated in a national quality improvement (QI) collaborative. Teaching focused on QI methodology, consumer co-design and health equity tools to facilitate improvement to local services.
Quantitative and qualitative data was analysed to understand if the collaborative aims were met.
Over 18 months, all but one collaborative site demonstrated median PTA completion rates higher than the national average for major trauma patients with head/face ISS codes and two system injuries. Median PTA assessment for collaborative sites was 82% compared with 54% for non-participating sites.
Qualitative results demonstrated that:
The TBI collaborative has resulted in lasting service improvement initiatives that have improved the assessment of brain injury for the most seriously injured New Zealanders.