Abstract

To evaluate an innovative paediatric neurorehabilitation model in relation to improving quality of neurorehabilitation and reducing length of stay (LOS) for children with acquired brain injury. A process evaluation approach was conducted in line with Medical Research Council evaluation of complex interventions guidance. Analysis was conducted on routinely collected patient data from 2017 to 2018, including LOS and family feedback. Descriptive and inferential statistics were used for quantitative analysis and qualitative data was analysed thematically. Outcomes for 70 children (0-16y, median age 5y, IQR 1-11y, 46 males, 24 females) referred to the service indicated improved function and reduced complexity of need. The mean LOS was 10.6 days compared to baseline mean LOS of 41 days (2011-2012). High satisfaction from the families was recorded; however, ongoing needs and service gaps regarding long-term support were identified. This service model is effective in delivering quality paediatric neurorehabilitation, demonstrating a sustained impact on LOS, and positive patient outcome data and family feedback for this group of patients. What this paper adds Investment in early intensive neurorehabilitation and supported discharge impacts length of stay (LOS) for children with acquired brain injury. Early intensive neurorehabilitation and supported discharge is effective. This is demonstrated by a sustained reduction in LOS, positive patient outcomes, and family feedback.

Highlights

  • RACHEL KEETLEY1 | EMILY BENNETT1 | JANE WILLIAMS1 | IAIN STEWART2,3 | WILLIAM P WHITEHOUSE1,3 | PAULINE PILLING1 | JOSEPH C MANNING1,4

  • After an initial pump-priming pilot of the service model commencing October 2014, ongoing NHS England specialist services funding was agreed in March 2016.9 The service delivers early intensive neurorehabilitation and early supported discharge to all children (0–18y) admitted to a specialist regional centre with an acquired brain injury (ABI) or other neurological injury

  • The team consists of a 0.2 whole time equivalent (WTE) consultant neurodisability paediatrician, 1.5 WTE physiotherapists, 1.5 WTE occupational therapists, 0.5 WTE speech and language therapist, 0.4 WTE clinical psychologist, and 1 WTE therapy support worker

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Summary

Objectives

The aim of this study was to comprehensively evaluate the impact of an innovative paediatric neurorehabilitation service. The aim of this study was to comprehensively evaluate and describe the ongoing impact of an innovative regional paediatric neurorehabilitation service on children with central nervous system injuries, their families, and other stakeholders

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