The development of aboriginal brain injury coordinator positions: a culturally secure rehabilitation service initiative as part of a clinical trial.

Elizabeth Armstrong,Melanie Robinson,Juli Coffin,Meaghan Mcallister,Rebecca Clinch,Kathy Mccoy,Kym Heine,Renee Speedy,Natalie Ciccone,Maureen Merritt

doi:10.1017/s1463423621000396

Abstract

Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage 'on their own' following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role of Aboriginal Brain Injury Coordinator (ABIC) to assist in navigating information and services, particularly after discharge from hospital. Eight positions for this role have been instigated across metropolitan and rural regions in the state. Healing Right Way's aim is to enhance rehabilitation services and improve quality of life for Aboriginal Australians after brain injury. The ABIC's role is to provide education, support, liaison and advocacy services to participants and their families over a six-month period, commencing soon after the participant's stroke or injury has occurred. This paper outlines the development of this role, the partnerships involved, experiences to date and identifies some facilitators and barriers encountered that may impact the role's ongoing sustainability. Details of components of the planned full Process Evaluation of Healing Right Way related to the ABIC role and the partnerships surrounding it are also provided. In combination with the trial's ultimate results, this detail will assist in future service planning and provide a model of culturally secure care for stroke and brain injury services that can also inform other sub-acute and primary care models.

Highlights

Acquired brain injury, as a result of stroke and traumatic brain injury, affects Australia’s First Peoples at a significant rate (Esterman et al, 2018, Katzenellenbogen et al, 2018, Katzenellenbogen et al, 2016, You et al, 2015) and the impact is felt by individuals, families and communities (Armstrong et al, 2015, 2019a, 2019b)
Eight Aboriginal Brain Injury Coordinator (ABIC) positions have been created to reflect the eight sites/hospitals involved in Healing Right Way
The unique role of the ABIC is creating a new model of culturally secure care for Aboriginal people following a brain injury, with some positive feedback from participants to date

Summary

Introduction

As a result of stroke and traumatic brain injury, affects Australia’s First Peoples (hereafter referred to as Aboriginal people) at a significant rate (Esterman et al, 2018, Katzenellenbogen et al, 2018, Katzenellenbogen et al, 2016, You et al, 2015) and the impact is felt by individuals, families and communities (Armstrong et al, 2015, 2019a, 2019b). Aboriginal brain injury survivors and their families have recommended: i) better access to more (and understood) information about brain injury and its consequences, including practical information about supports available after discharge from hospital and ii) community support in navigating rehabilitation services and the recovery ‘journey’ especially during the first six months after the event (Armstrong et al, 2015, 2019a, 2019b) Both brain injury survivors and family members have emphasised the need for and importance of the role of an Aboriginal health professional in providing culturally secure care after brain injury.

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