Building and Sustaining Inpatient-Clinician Collaboration in Spinal Cord Injury Rehabilitation: A Case Example Using...

Area of Science:

• Rehabilitation Medicine
• Clinical Psychology
• Health Services Research

Background:

• Goal planning is integral to the biopsychosocial model of rehabilitation, particularly in spinal cord injury (SCI) settings.
• Current evidence on specific goal planning practices, interventions, and their impact in SCI rehabilitation is limited, with no established universal standards.
• The National Spinal Injuries Centre (NSIC) has utilized a specific goal planning program since 1989.

Purpose of the Study:

• To outline the standards and interventions used in goal planning at the NSIC.
• To assess the impact of a quality improvement project on inpatient care since 2016.
• To investigate current goal planning practices and rehabilitation measure usage internationally in SCI services.

Main Methods:

• Study One: Retrospective analysis of quality improvement project interventions and outcomes at the NSIC.
• Study Two: International survey of rehabilitation measure usage and goal planning practices among adult and pediatric SCI services.
• Data analysis of inpatient presence and multidisciplinary team involvement in goal planning meetings.

Main Results:

• A quality improvement project since 2016 has tracked interventions aimed at enhancing inpatient care.
• International survey data indicates that inpatient presence at goal planning meetings occurs in 75% (adults) and 76% (children and young people) of services.
• A high percentage of services (85% adults, 90% CYP) report 4 or more multidisciplinary team members present at goal planning meetings.

Conclusions:

• Structured quality improvement methodologies can yield significant gains in SCI rehabilitation.
• There is a clear need for the development of standardized approaches to goal planning in spinal cord injury rehabilitation.
• Current practices show variability, highlighting opportunities for improvement and standardization.