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Down Lisburn Trust Community Brain Injury Team

Down Lisburn Trust Community Brain Injury Team. Better Access to Brain Injury Rehabilitation B.I. Conference Dublin, September 2006. Background to CBIT Aims and objectives of service improvement Outcomes How change was achieved Challenges Future . Background to CBIT.

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Down Lisburn Trust Community Brain Injury Team

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  1. Down Lisburn Trust Community Brain Injury Team Better Access to Brain Injury Rehabilitation B.I. Conference Dublin, September 2006

  2. Background to CBIT • Aims and objectives of service improvement • Outcomes • How change was achieved • Challenges • Future

  3. Background to CBIT

  4. Background • 1997 - Community Brain Injury Service • CARF accreditations 2003/2006, Chartermark x3, Investors in People x2 • Public Servant of the Year Team Award • Waiting list problems &service flow pathway • Processes not optimal • Trust support

  5. DLT- CBIT Context • First team in Northern Ireland • Developed in response to local study of need • Uses interdisciplinary model of assessment, goal planning and case co-ordination • Grown from core therapeutic expertise and knowledge base, funded from Disability savings in 1997. • In 2003 EHSSB additional Health and Wellbeing Investment monies allowed development of model

  6. CBIT – Results /Outcomes Focus • Key Results: • Rehabilitation Goals set with individual persons served and % attained over rehabilitation period. • Satisfaction of persons with outcomes achieved • Brain Injury Community Re-integration Outcome questionnaire {BICRO} as a measure • Access to service within desired timeframes see – Service Improvement Project {CARF Accreditation examines standards in Business Practices, Rehabilitation processes and Brain Injury Program specific standards here Home & Community}

  7. Resource 1997 Clinical Co-Ordinator-0.5 Neuro-Psychologist -0.6 Speech &Language Therapist 0.3wte Social Worker 0.4wte Physiotherapist 0.3wte Occupational Therapist 0.6 wte Admin support 0.5wte Resource 2006 Team Leader 0.3wte Neuro-Psychologist1.5wte Speech & Language Therapist 0.4 wte Social Worker 0.5 wte Physiotherapist 0.4 wte Occupational Therapist 1wte Rehabilitation Nurse 0.8 3 x Rehabilitation Assts 1.8wte Admin Support 0.8 wte Community Brain Injury Team

  8. Aims and Objectives

  9. Aim of project • To improve access to the Community Brain Injury Service • Objectives: • To reduce waiting time from referral to first face-to-face contact from 5 weeks to 10 days. • To reduce waiting time from first face-to-face contact to start of intervention from 51 weeks to 12 weeks. • To reduce waiting time from 170 weeks to a maximum of 52 weeks • To achieve a high level of client and carer satisfaction with quality of information given on entry to the service.

  10. Outcomes

  11. Objective 1: New referrals are seen within 10 days.

  12. Objective 2: Clients are planned within 12 weeks of screening

  13. Objective 3: Length of time waiting is below 52 weeks

  14. Longest wait reduced to 46 weeks ( 1 client ) Next longest wait is 5 weeks Reduction from 170 weeks to 5 weeks

  15. How change was achieved

  16. How.. • Overcoming inertia • Streamlining referral process • Segmented time - screening, assessment • Waiting list validation/management

  17. Information - letters, folders, reception staff • Streamlining CBIS - 3 options of service • Fast track service - specific, intensive • DNA/CNA procedure

  18. Professional service users • Regular, short project meetings • Additional hours • Representation at higher level in Trust

  19. Challenges

  20. Challenges • Project Manager left post • Social worker leaving post • Team working relationships • Thompson House Hospital renovations • Time commitment • Service user satisfaction -methodology • New Trust Community Stroke Team • Review of Public Administration – A4C

  21. Lessons learned

  22. Lessons learned • Process mapping - lengthy but necessary! • Demand and capacity - effective planning • Medical/Neuro assessment informs access to service • Waiting list review/validation - service process

  23. Lessons learned…. • Working groups - effective problem solving • Innovative practice doesn’t necessarily fit the service eg. partial booking • Discharge policy - a ‘must have’! • Keep it simple!

  24. Spread and Sustainability

  25. Spread and Sustainability Short term: • stringent processes within service • renewed motivational drive • Withdrawal of additional 6 hours per week which meets demands of administration and data collection

  26. Spread and Sustainability Long term: • Threat to service model due to RPA • Down Lisburn Trust CBIS will inform service delivery within RPA arrangements

  27. The future…..

  28. Future • Continue with Service Improvement • Service user consultation • Address bottleneck after planning stage • Liaise with Trust Community Stroke Team • Develop communication further with N.I.Regional BI Unit • Brain Injury Quality Conference 2007 • Promote service model within Public Administration arrangements

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