Whose Outcome is it Anyway? Outcome and Brain Injury Case Management

Abstract

Context: The acquired brain injury (ABI) literature highlights various factors that can prevent successful community rehabilitation and hinder good long-term outcomes. Brain injury case management is a service model with the potential to overcome these barriers within rehabilitation and longer-term care and support, but there is minimal research surrounding the effectiveness of case management in ABI. Objectives: This study aims to gain a better understanding of outcomes in brain injury case management and what facilitates good outcomes when working with clients from the perspective of brain injury case managers. Methods: A mixed qualitative study using both conventional content analysis and thematic analysis. Twenty-eight brain injury case managers completed an online questionnaire about what constitutes a good outcome in brain injury case management. Of these, five took part in a follow-up interview. Findings: The analysis identified four themes related to brain injury case management outcomes; 1) A client-centred approach to outcome, 2) the role of the brain injury case manager, 3) monitoring outcome in case management, and 4) issues of funding. Limitations: Participation in the survey and interviews was somewhat low, largely due to conducting the study during the COVID-19 pandemic. The study only included brain injury case mangers and future studies should examine clients’ and family members’ perspectives. Implications: This study identified that brain injury case management is a holistic approach to rehabilitation and case coordination that requires further attention to develop evidence-informed practice. Appropriate holistic measures of quality of life and outcome need to be developed to support the evidence base for case management.

Keywords

• brain injury
• case management
• rehabilitation
• community support