This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schools where the trainings occurred, judged the use of the competencies to be informative and useful to their practice both immediately following the training and at a 5-month follow-up. The greatest gains in knowledge were noted by those participants self-reporting the least amount of knowledge pre-training. Participants also ranked the perceived value and relative importance of each of the ten competencies.

The study examined rates of possible brain injury among survivors of intimate partner violence. Of the 171 women screened, 91% indicated they had been hit in the head or strangled, and 31% reported it happened more than six times in their life. Only 35% of women who were hit in the head or strangled received medical treatment, and 64% reported losing consciousness or experienced a period of being dazed and confused. Organizations serving intimate partner violence survivors should routinely screen survivors for brain injury so they can obtain timely referrals for neurorehabilitation services to improve their quality of life.

Introduction: Nebraska Mission: Lifeline Stroke is a 4-year initiative to increase guideline-based treatment of acute stroke across the continuum of care. Guidelines advise post-stroke assessment by a multi-disciplinary team to guide discharge process and select ideal rehab setting. Purpose: To develop resources to facilitate the transition of Nebraskans with stroke to the most appropriate level of post-acute care. Methods: Healthcare Providers (HCPs) from various settings completed two surveys: hospital stroke rehab referral strategies and practices (N=23), and individual experiences related to stroke rehab (N=260). In addition, a literature review was conducted to find published guidelines and research on clinical decision making. Lastly, a focus group consisting of social worker/case managers was held to provide input on resources developed. Results: Hospitals (N=23) believe higher numbers of stroke patients should be referred to IRFs (42%) and stated that patients’ “health status” (91%), “opinions from hospital team members” (87%), and “opinions from patient, family, or caregivers” (78%) are most relevant in the decision process. Factors that impact referral process include: HCPs may not be familiar with all options for post-acute rehab care (17%) and patient or family/caregivers are not educated about options (30%). Most (57%) of HCPs surveyed and all focus group participants indicated discharge referral process could be improved with a standardized decision-making tool. Based on this input, two discharge planning guides were developed. The first assists HCPs in determining appropriate level of post-acute stroke care by comparing various types and settings in an easy-to-read format. The second is patient/caregiver focused and includes information to assist in decision-making process and a table comparing rehab settings. These guides have been disseminated through conference presentations, direct mailings, and web-based resources. Conclusions: Discharge tools with clear descriptions of options are necessary to assist HCPs and patients/caregivers in matching appropriate care with patient’s rehab needs. These care choices are key to patients achieving their highest level of independence.

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