Clinical pathways in head injury: improving the quality of care with early rehabilitation

Abstract

Purpose: To improve the management of all hospital admissions with head injuries, including mild and moderate by developing a clinical pathway and a head injury team. Methods: A head injury team was set up to take over the care of all admissions with head injury and to manage appropriate referrals and discharges. A key role was to facilitate communication between the different services involved in head injury care, arrange follow-up, support relatives and to educate healthcare staff. Results: In the first year, the team took over the care of 196 admissions of whom 128 attended for 3-month follow-up with 66% having a good outcome. Patients and relatives feedback was excellent with an average score of 4.8/5 on overall satisfaction rating. Other centers in the United Kingdom are aiming to set up similar pathways, and the team has presented on head injury pathways extensively. Conclusions: A clinical pathway can improve the quality of care for all admissions with head injury and enhance the role for rehabilitation at an early stage.Implications for RehabilitationThe care of head injury patients is often haphazard with several specialties involved and no coordination of care.Rehabilitation medicine is usually involved later on in head injury care.Setting up an acute head injury team can improve service outcomes and represents a development opportunity for rehabilitation medicine.