Traumatic Brain
Patient and Family Traumatic Brain Injury Education - An Effective Model
Combined Sections Meeting- APTA 2008, Nashville TN
Title: An Effective Model for Patient and Family Traumatic Brain Injury Education: Tools, Process, and Resources
Authors: Lawrence, Suzanne D, PT O’Malley, Kristine, OTR/L, Sweet, Ellen, PT, Drudge, Owen, PhD Medical Psychologist, Couture, Ashley, MS, CCC-SLP, Dufresne, Cherlyn, CRRN, Knakal, Roger, MD
Institution: Acute Inpatient Rehabilitation, Fletcher Allen Health Care, Burlington, VT, USA
Purpose: This presentation will describe an evidence based tool that helps to identify the patient’s and family’s need for support and traumatic brain injury education, an effective educational process, and multi-modal educational resources.
Description: Clinicians at our acute inpatient rehabilitation center expressed concern about the inconsistencies and adequacy of traumatic brain injury (TBI) education for patients and their families. We initiated an interdisciplinary quality improvement project to tackle the problem. After completing a search of the literature and contacting 5 Model TBI Centers, we determined that there were no national standards for educating patients and their families about TBI. Feedback was gathered from patients and families using a post-discharge phone survey. Our survey results were consistent with the research finding, patients and families are dissatisfied with the support and education they received. Staff were surveyed to identify critical educational topics, current practice, and areas of needed improvement. They reported dissatisfaction with the current educational process. The "TBI Family Needs Questionnaire" (FNQ), a standardized TBI outcomes tool on the COMBI web site, was trialed with 5 patient-families. This tool did not meet the patient-family needs due to its length, complexity, and lack of clarity. The questionnaire was modified using the feedback from patients, families, clinicians, and research. A new tool, "Family TBI Education Questionnaire", was developed and trialed. This tool received favorable feedback. Like the FNQ, this new tool was designed to help identify the patient and family TBI education and support needs. Concurrently, a new TBI education process for the administration of the questionnaire, delineation of discipline-specific and inter-disciplinary staff responsibilities for education, and clinical documentation was developed and implemented. Web-based TBI educational materials were researched, the locally developed "TBI Educational Manual" was updated, and a user-friendly web-based educational resource list was implemented. Informal feedback has been positive. A post-implementation survey was carried out with patients, families, and clinicians. The clinician survey results demonstrate greater satisfaction with the educational process, interdisciplinary cooperation, clarity about staff roles and responsibilities. Patients, families, and clinicians are satisfied with the new educational approach.
Summary of Use: Research has shown that patient and family TBI education often results in dissatisfaction and a lack of preparedness for community re-entry. This project describes new tools, processes, and resources for patient and family TBI education and support that provide the patient, family and clinician with greater satisfaction.
Importance to Members: Effective patients and family TBI education and support is essential for recovery and reintegration. Clinicians with an inpatient rehab and outpatient TBI clinical practice will find these tools, processes, and resources immediately helpful.
Family TBI Education Questionnaire
Patient and Family TBI Education Resource List 2007
Family Education Questionnaire Flowchart Process
Patient and Family Traumatic Brain Injury Education - An Effective Model
Author: Kristine O'Malley, OTR/L.
Fletcher Allen Health Care, Colchester, VT, USA.
Abstract:
Clinicians at our acute inpatient rehabilitation center expressed concern about the inconsistencies in traumatic brain injury (TBI) education for patients and their families. We decided to develop an interdisciplinary quality improvement project to tackle this problem. After completing a search of the literature and contacting 5 Model TBI Centers, we determined that there was no national standard for educating patients and their families. Post-discharge patient/family phone surveys were conducted to gather feedback about the adequacy of TBI education. Our survey results were consistent with the research findings, patients and families are dissatisfied with the support and education they receive. Staff were surveyed to identify key educational topics, current practice and areas of needed improvement. The "TBI Family Needs Questionnaire" (FNQ) which is listed as a standardized TBI outcomes tool on the COMBI web site was trialed with 5 patient-families and did not meet the patient-family needs due to length, complexity, and lack of clarity. Our interdisciplinary team modified the questionnaire by incorporating the feedback gained from patients, families, clinicians, and research. The new tool, "TBI Family Education Questionnaire", was developed and trialed. Feedback on this tool was favorable from families and clinicians. Like the FNQ, this new tool was designed for the purpose of identifying patient and family TBI educational and support needs. We developed a new TBI education process for questionnaire administration, delineation of discipline-specific and interdisciplinary responsibilities for education, and clinical documentation. Lastly, the team researched web -based patient/family educational materials, developed a TBI Education Manual for patients and families, promoted TBI support groups, utilization of BIA of VT resources, and implemented an educational resource table for patients, families, and clinicians. Informal feedback from patients, families, and clinicians has been positive. Post implementation surveys suggest that patients and families are more satisfied with the TBI Family Education Questionnaire, educational process and tools. Clinician survey results indicate that there is greater interdisciplinary cooperation, clarity about education, and better utilization of resources.
References:
1. Paterson B, Kieloch B, Gmiterek J. They Never Told Us Anything: Post Discharge Instruction for Families of Persons with Brain Injuries. Rehabilitation Nursing. Mar/Apr 2001, 26(2):48-53.
2. Serio CD, Kreutzer JS, Witol AD. Family Needs after traumatic brain injury: a factor analytic study of the Family Needs Questionnaire. Brain Injury, 1997;11(1): 1-9
3. Kreutzer JS, Serio CD, Bergquist S. Family needs after brain injury: A quantitative analysis, J Head Trauma Rehabilitation 1994;9(3):1004-115
4. Murray HM, Maslany GW, Jeffery B. Assessment of family needs following acquired brain injury in Saskatchewan. Brain Injury, June 2006, 20(6):575-585
Abstract Synopsis:
Research has shown that educating patients with traumatic brain injury (TBI) and their families often results in dissatisfaction, a lack of preparedness for community involvement and participation in occupational roles. We aim to describe an evidence based standard for TBI education, tools, processes, and educational resources.
Speaker Qualifications:
Kristine O'Malley, B.S., OTR is a 1999 graduate from the Occupational Therapy program at the University of Buffalo. She has over 7 years of experience treating in the inpatient rehabilitation setting, and has a clinical focus treating clients with acute traumatic brain injury (TBI). In the last 2 years, Kristine has served as the facilitator of an Interdisciplinary Patient and Family TBI Education Quality Improvement Project at Fletcher Allen Health Care. The goal of this project has been to implement an evidenced based treatment approach to supporting and educating patients with TBI and their families.
TBI Patient and Family Education Poster
