Results of a Codesign Process: A Cognition Screening Pathway for Inpatient and Outpatient Settings for Patients Who...

Background/Objectives: Cognition plays a major role in prosthetic rehabilitation success. The ability to identify patients who may have difficulty understanding and adapting to the rehabilitation process is beneficial for clinicians and patients to allow for targeted and appropriate therapy. The research aim was to codesign a process that facilitates routine cognitive screening into the amputee inpatient journey. Methods: A convenience sample of sixteen medical and allied health practitioners from one local health district undertook a codesign process over 10 months from March to November 2023. A combination of virtual and face-to-face data collection occurred. Each of the codesign meetings was audio recorded, following which transcription occurred. Transcripts were reviewed using thematic analysis-based techniques to capture themes and consensus within the group. Results: Two pathways were established for use within one local health district, allowing clinicians to measure the cognition of patients in both inpatient and outpatient settings either before or after they underwent amputation. The newly established pathways provide step-by-step guidance for clinicians, such as how to address contraindicators for testing and providing guidance for subsequent neuropsychological testing. The Montreal Cognitive Assessment (MoCA), both paper based and electronic based, was selected as the cognitive screening tool for implementation. Conclusions: Utilizing codesign as a method for generating a cognitive screening pathway for amputees was successful. The pathways generated should be reviewed for suitability for application in other health settings.