Moderate to severe traumatic brain injury (TBI) results in difficulties in thinking, behaving, feeling, moving, and sensing that can have a devastating impact on an individual’s ability to function independently at home and in the community. Comprehensive interdisciplinary inpatient rehabilitation can maximize function and reduce complications. Currently, a wide range of rehabilitation interventions are used, however, clinicians still struggle with answering the question: “Which intervention approach is best for my patient?”
Funded through the National Institutes of Health, National Institute of Neurological Disorders and Stroke, the Comparing Treatment Approaches to Promote Inpatient Rehabilitation Effectiveness for Traumatic Brain Injury (CARE4TBI) Study, aims to close this evidence gap by leveraging the infrastructure of the National Institute on Disability, Independent Living and Rehabilitation Research’s TBI Model Systems, as well as recent advances in data capture through electronic medical records (EMR), and in advanced statistical methods to study rehabilitation strategies. Jennifer Bogner, PhD, and Cynthia Beaulieu, PhD, at Ohio State University Wexner Medical Center and Erinn Hade, PhD, at New York University Langone Health are co-leading this pragmatic observational study of nearly 1,600 participants to be recruited through 15 TBI Model Systems sites, located across the United States in varied health systems and communities.
Andrew Packel, PT, NCS, is making an important contribution to this project by representing Moss to the multicenter, multidisciplinary team responsible for identifying and designing new data forms and response sets to be added to the standardized EMR. The aim is to capture data chronicling treatment and recovery during the natural course of a patient’s hospitalization.
Using the standardized data captured during inpatient stays, the impact of different approaches to rehabilitation therapy on patient outcomes will be evaluated relative to their effectiveness in improving the person’s ability to care for themselves and to function at home, at work/school, and in the community by 1 year post-injury. Mr. Packel, working with the clinical frontline staff on Moss’ inpatient TBI unit, will provide input to the project regarding suggested EMR changes to capture this important clinical information accurately and efficiently. At the same time, they will work to make sure that the recommended changes integrate well into Moss’ current EMR to enhance daily documentation of care by the numerous therapists on the unit.
Mr. Packel is joined in this project by Amanda Rabinowitz, PhD, and Mary Ferraro, PhD, OTR/L, as well as bioinformaticist Lisa Peck who make up the team responsible for conduct of the project at Moss. Dr. Ferraro is the lead Occupational Therapist and a member of the Executive Committee that oversees the project design and implementation. The varied rehabilitation disciplines (physical therapy, speech therapy, therapeutic recreation) are represented in all the working groups of the project.
This research project has the potential have a major impact on clinical care for TBI. As Dr. Ferraro notes, “this project has engaged clinicians and EMR developers to standardize elements of clinical documentation. This observational study will be a huge advance for broader data collection and analysis of TBI inpatient rehab practices.”
This article was adapted from an article originally published in The MossRehab Traumatic Brain Injury Model System’s Spring 2022 Edition of Brain E-News.