Selection of discharge destination for patients with moderate-to-severe traumatic brain injury

Abstract

ABSTRACT Objectives To investigate criteria acute care interdisciplinary providers use to select discharge destination for patients with traumatic brain injury (TBI). Design Cross-sectional, exploratory survey study. Methods Data were collected from interdisciplinary providers at a U.S. Level I trauma centre via electronic survey. We invited 199 providers to participate and 27 responded (13.5% response rate). Responses were received from physicians and physical, occupational, and speech therapists. Results Findings showed variability in standard criteria and clinical judgment criteria providers used to select discharge destination for patients with TBI receiving acute care. There was limited agreement on standard criteria used to select discharge destination. Findings showed some agreement between providers on clinical judgment criteria used to select home as discharge destination and to prevent discharge to home. Most common clinical judgment criteria included therapists’ recommendations on discharge location, patient’s level of independence in activities of daily living, planned family support and ventilator dependence. Agreement on clinical judgment criteria became more limited when stratifying by discipline, frequency of patient care and experience. Conclusions Findings on clinical judgment criteria providers use to select acute care discharge destination for patients with TBI are inconclusive.