Whose Outcome is it Anyway? Outcome and Brain Injury Case Management

Lowry, Jessica; Wakeham, Thomas; Norman, Alison Van; Dean, Jackie; Holloway, Mark; Needham-Holmes, Ben; Clark-Wilson, V; Feltham-White, Philippa

doi:10.31389/jltc.107

Cited by 4 publications

(7 citation statements)

References 52 publications

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“…In addition to communication, studies also identi ed the importance of good working relationships between the client and case manager as a vital aspect of case management (25,36,39,42,49). Fitzsimmons (49) in their case study of 10 people with severe ABI, concluded that effective intervention was dependent upon the working relationship of case manager and client.…”

Section: Key Components Of Case Management Practicementioning

confidence: 99%

“…This ensures that family members are knowledgeable of brain injury, can make well-informed decisions, and act as an advocate for their loved one (54). However, in addition to providing information for family members, Lowry et al, (25) and Holloway et al, (24) contend that the case management role also involves working holistically to support the families of clients.…”

Section: Key Components Of Case Management Practicementioning

confidence: 99%

“…Of these, 3 were reviews, 12 were opinion pieces, and 20 were empirical research studies. Included studies spanned from 1988 (23) to 2022 (24,25). Twelve out of the 35 studies were published before the year 2000, 10 papers were published between 2001 and 2012, while 13 were published within the last 10 years (2013-2023).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Case management for acquired brain injury: A systematic review of the evidence base.

Leonard,

Linden,

Holloway

2023

Preprint

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Background Brain Injury Case management involves coordinating and organising services and systems around brain injured clients and their families. Case managers may come from diverse professional backgrounds but have expert understanding of the unique and often complex needs of people with acquired brain injury. In what is the largest review on this topic to date, we sought to explore the international evidence base in relation to case managers and acquired brain injury. Methods Searches were conducted with seven databases, using a search strategy based on key terms relating to “case management” and “brain injury”. Eligible studies included peer reviewed publications, with books and magazine pieces excluded. All studies were screened and independently extracted by two reviewers. The quality of empirical studies was assessed by the Mixed Methods Assessment Tool (MMAT), with the appropriate Joanna Briggs Institute (JBI) checklists used for systematic reviews and text and opinion studies. Given the diversity of the evidence reviewed, findings were presented narratively. Results Electronic searches identified 2,062 studies, of which 35 were deemed eligible to be included in this review. Of these, 3 were reviews, 12 were opinion pieces, and 20 were empirical research studies. The majority came from the USA (n = 15) and the UK (n = 10), with other studies originating from Australia (n = 8) and Canada (n = 2). Narrative synthesis of included studies highlighted the challenges of measuring and evaluating the impact of case management for brain injury, vital aspects of case management, such as good communication and relationships with clients, supporting the wider family, and expertise relating to brain injury. Findings also indicated that case managers must work across the continuum of care, working with their clients’ long term, possibly across acute, to post-acute and into community services. Conclusions The relative infancy of the case management profession creates certain challenges, however it also provides an ideal opportunity to shape its future in a way that is beneficial for the client, family and healthcare providers. Case managers have already made significant developments to the profession since its conception, however, future progression requires collaboration between academics, clinicians and case managers, to produce better outcomes for clients and their families.

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Section: Key Components Of Case Management Practicementioning

confidence: 99%

Section: Key Components Of Case Management Practicementioning

confidence: 99%

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Case management for acquired brain injury: A systematic review of the evidence base.

Leonard,

Linden,

Holloway

2023

Preprint

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“…Rehabilitation is said to be a future-orientated process which looks to maximise function, physically, cognitively and socially, through restoration, compensation and adaptation while minimising medical complications and disability (Wressle, Oberg & Henriksson, 1999;Kischka, 2004;Gutenbrunner, Ward & Chamberlain, 2006;Meyer et al, 2011;Lowry et al, 2022). However, in severe brain injury, complete recovery is rare, and so, in many cases, despite often prolonged periods of rehabilitation, these people remain impaired and need significant care and support from others in the long term.…”

Section: Brain Injury Rehabilitationmentioning

confidence: 99%

Poster Boys and the Rehabilitative Dream: Using a Temporal Lens to Explore Severe Brain Injury Rehabilitation

Latchem-Hastings

2023

Journal of Long Term Care

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The future comes into the present and acts upon the now. Understanding how engagement with the future shapes today and how actions taken in the now affect a time yet to come is important in understanding and improving brain injury rehabilitative practice.Objective: This paper examines the way in which futures of different types of braininjured residents residing in long-term neurological care settings are imagined by health and care professionals and the role a 'rehabilitative imaginary' has in how residents' futures are imagined or go unimagined.Methods: Over 500 hours of ethnographic observations and 49 interviews with staff members in two neurological rehabilitation and long-term settings in England were analysed using situational analysis, drawing out key rehabilitative narratives presented here.Findings: Residents were primarily categorised by their abilities to rehabilitate successfully (or not) and their futures imagined (or not) in line with their rehabilitative journey. Key residents who successfully rehabilitated and fulfilled a rehabilitative ideal were held up as 'poster boys' (or girls), providing a positive advertisement for the organisation, engendered dedication to the specialism of neurological rehabilitation and reinforced rehabilitation-as-process.Limitations: Data was collected in two English care settings. Applicability to international care settings is unknown. Extraneous factors restricting health care professionals' future imaginings were not explicitly studied. Implications:The paper concludes by considering the implications of rehabilitative imaginary-fuelled narratives in these settings. It argues that predominant rehabilitative narratives bracket out how and if the futures of those unable to rehabilitate successfully are imagined by health care professionals and questions whether non-imagining leads to inaction around those not rehabilitating. Potential organisational and structural reasons for constrained health care professionals' imaginings is discussed, and broader applicability of the reification of particular patient types in other areas of health care is considered.

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“…Evaluation of the various models of CM for people with complex health conditions, such as brain injury, is lacking (including for people with traumatic brain injury [6,[10][11][12][13]. The evidence suggests that case management for people with brain injury is needed even though it represents a high cost.…”

Section: Introductionmentioning

confidence: 99%

A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?

Lukersmith

Salvador‐Carulla

Chung

et al. 2023

IJERPH

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Case management developed from a generalist model to a person-centred model aligned with the evidence-informed evolution of best practice people-centred integrated care. Case management is a multidimensional and collaborative integrated care strategy where the case manager performs a set of interventions/actions to support the person with a complex health condition to progress in their recovery pathway and participate in life roles. It is currently unknown what case management model works in real life for whom and under what circumstances. The purpose of this study was to answer these questions. The study methods used realistic evaluation framework, examined the patterns and associations between case manager actions (mechanisms), the person’s characteristics and environment (context), and recovery (outcomes) over 10 years post severe injury. There was mixed methods secondary analysis of data extracted via in-depth retrospective file reviews (n = 107). We used international frameworks and a novel approach with multi-layered analysis including machine learning and expert guidance for pattern identification. The study results confirm that when provided, a person-centred case management model contributes to and enhances the person’s recovery and progress towards participation in life roles and maintaining well-being after severe injury. Furthermore, the intensity of case management for people with traumatic brain injury, and the person-centred actions of advising, emotional and motivational support, and proactive coordination contribute to the person achieving their goals. The results provide learnings for case management services on the case management models, for quality appraisal, service planning, and informs further research on case management.

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Whose Outcome is it Anyway? Outcome and Brain Injury Case Management

Cited by 4 publications

References 52 publications

Case management for acquired brain injury: A systematic review of the evidence base.

Case management for acquired brain injury: A systematic review of the evidence base.

Poster Boys and the Rehabilitative Dream: Using a Temporal Lens to Explore Severe Brain Injury Rehabilitation

A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?

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