A Neurological Integrated Care Pathway

McCoy, Kathleen F.; Chan, Harriet

doi:10.21307/ajon-2017-117

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…An Aboriginal person with a relevant health or community care background will be employed 1 day/week at each of the trial sites as an ABIC. The role is based on the Neurological Nurse and Neurocare model of the Neurological Council of Western Australia (NCWA) 44 -a community neurological nursing service. The ABIC will see participants in hospital and up until 26 weeks post injury onset, providing education, support, liaison and advocacy services to participants and their families.…”

Section: Aboriginal Brain Injury Coordinatormentioning

confidence: 99%

Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury

et al. 2021

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IntroductionDespite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury.Methods and analysisDesign: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury.Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants.Primary outcome: Quality-of-life using EuroQOL-5D-3L (European Quality of Life scale, five dimensions, three severity levels) Visual Analogue Scale score at 26 weeks post injury. Recruitment of 312 participants is estimated to detect a difference of 15 points with 80% power at the 5% significance level. A linear mixed model will be used to assess the between-condition difference.Secondary outcome measures: Modified Rankin Scale, Functional Independence Measure, Modified Caregiver Strain Index, Hospital Anxiety and Depression Scale at 12 and 26 weeks post injury, rehabilitation occasions of service received, hospital compliance with minimum care processes by 26 weeks post injury, acceptability of Intervention Package, feasibility of Aboriginal Brain Injury Coordinator role.Evaluations: An economic evaluation will determine the potential cost-effectiveness of the intervention. Process evaluation will document fidelity to study processes and capture changing contexts including barriers to intervention implementation and acceptability/feasibility of the intervention through participant questionnaires at 12 and 26 weeks.Ethics and disseminationThe study has approvals from Aboriginal, university and health services human research ethics committees. Findings will be disseminated through stakeholder reports, participant workshops, peer-reviewed journal articles and conference papers.Trial registration numberACTRN12618000139279.

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Section: Aboriginal Brain Injury Coordinatormentioning

confidence: 99%

Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury

et al. 2021

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“…As noted above, the ABIC role grew out of Aboriginal brain injury survivors' and their families' recommendation for an Aboriginal health professional to assist in navigating services post hospital discharge. As a partner in the trial, the Neurological Council of Western Australia (NCWA) provided the model of care for the ABIC position, based on its Community Neurological Nurse and Neurocare positions (McCoy and Chan, 2015).…”

Section: Development Of the Aboriginal Brain Injury Coordinator Rolementioning

confidence: 99%

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

Armstrong

McCoy

Clinch

et al. 2021

Prim Health Care Res Dev

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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.

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“…The Coordinators are Aboriginal nurses or health workers who are based in the community but visit the hospital to meet the person and his or her family immediately after the stroke and then support them for the following 6 months. Based on a chronic care model and informed by local neurological nursing care programmes, the Aboriginal Brain Injury Coordinators provide educational information regarding stroke and subsequent rehabilitation/recovery, psychological support and advocacy services, keeping patients and their families in touch with local and remote services, telehealth facilities and the latest information regarding stroke rehabilitation treatment. This study is based on the Missing Voices study – a large state‐wide study conducted in Western Australia, encompassing epidemiological and qualitative interview data surrounding Aboriginal Australians’ experience of stroke, with a particular focus on individuals with communication disorders.…”

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confidence: 99%