Quality standard

Quality statement 6: Inpatient rehabilitation for people with traumatic brain injury

Quality statement 6: Inpatient rehabilitation for people with traumatic brain injury

Quality statement

People who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties that continue 72 hours after a traumatic brain injury have an assessment for inpatient rehabilitation.

Rationale

Rehabilitation enables people with traumatic brain injuries to reach and maintain optimal functioning levels in areas such as intellect, sensory, physical and social behaviour. Traumatic brain injuries can affect many aspects of a person's life; therefore, it is important to assess the benefits of inpatient rehabilitation.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that inpatient rehabilitation assessments can be carried out for people who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from service protocols.

Process

Proportion of people in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury who have an assessment for inpatient rehabilitation.

Numerator – the number in the denominator who have an assessment for inpatient rehabilitation.

Denominator – the number of people who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers (district general hospitals, major trauma centres, trauma units and specialist neurological centres) ensure that systems are in place for people who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury to have an assessment of their need for inpatient rehabilitation.

Healthcare professionals ensure that they assess the inpatient rehabilitation needs of people who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury.

Commissioners ensure that service providers assess the inpatient rehabilitation needs of people who are in hospital with new cognitive, communicative, emotional, behavioural or physical difficulties continuing 72 hours after a traumatic brain injury. This may be achieved by asking services to audit current practice to show evidence of compliance.

People who are in hospital after a head injury that has damaged their brain and caused problems lasting 3 days or more with their memory, concentration or communication, or emotional or physical difficulties, have an assessment to find out whether a programme of rehabilitation while they are in hospital would help them recover.

Definitions of terms used in this quality statement

Traumatic brain injury

Traumatic brain injury is defined as a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new or worsening of at least 1 of the following clinical signs, immediately after the event:

  • any period of loss of or a decreased level of consciousness

  • any loss of memory for events immediately before or after the injury

  • any alteration in mental state at the time of the injury (such as confusion, disorientation or slowed thinking)

  • neurological deficits (such as weakness, loss of balance, change in vision, praxis, paresis or plegia, sensory loss or aphasia) that may or may not be transient

  • intracranial lesion.

[SIGN's guideline on brain injury rehabilitation in adults]