Understanding ALC and Facilitating Access to Rehab for ABI Patients who Require Observers
The patient transitions working group is conducting an investigation to better understand the issues associated with ABI patients who are identified as being in need of an alternate level of care across acute care, rehab and complex continuing care programs. Through this process, the group is collaborating to problem-solve and facilitate access for ABI patients that are experiencing difficulty with transition.
Participating organizations are being asked to gather data about what contributes to an ALC stay for ABI patients (medical, physical, cognitive, and behavioural). We have a specific interest in understanding the behavioural challenges that impact ALC stays, even for those that are not referred to the Network because it is expected they will be declined.
Each week, the Toronto ABI Network facilitates a half-hour teleconference for participating members, in which the Network provides a bird’s eye view of the state of the waitlists for the rehab facilities. Every organization is asked to provide the following information which is then summarized and forwarded to all participants after the weekly teleconference.
Acute care:In addition to collecting the data on the ABI-ALC patients, another goal of the teleconference is to provide an opportunity for discussion and problem-solving about challenging patient transfers/discharges. The content of this discussion is recorded and themes and key issues are summarized to support the identification of service gaps which can then be used to support system planning.
Rehab and CCC units:
- How many ABI ALC patients are currently in your facility on all acute units?
- How many have been referred to post-acute care? (inpatient rehab, residential, do not include those referred to LTC)
- What are their reasons for waiting? (medical, behavioural, psychiatric)
- How many ABI-ALC patient have you not referred?
- What are the reasons for not referring? (medical, behaviours, psychiatric)
- How many days have they been waiting with an ALC status?
- How many ABI-ALC designated patients are currently in your rehab units waiting for post-rehab transfer?
- What are they waiting for? (LTC, assisted living, home)
- How many ABI-ALC designated patients are currently in your CCC units waiting for post-rehab transfer?
- What are they waiting for? (LTC, assisted living, home)
- What are the reasons for waiting? (medical, behavioural, capacity issues)
- How many days have they been waiting with an ALC status?
Observer Pilot
This working group is also looking at implementing an Observer Pilot to look at cost sharing the resources of an observer for patients waiting for inpatient regular stream ABI rehab who previously could not be transferred due to use of an observer/sitter. Preliminary information suggests this approach can benefit both clients, in getting access to rehab earlier, and the system by reducing costs and enhancing patient flow. Organizations involved are working with the Network to finalize details for how the pilot will run and we are targeting implementation of the pilot in the New Year.
Neurological Strategy Consultations
It is estimated that over one million Ontarians are living with a neurological condition today. These are conditions that span every age and stage of life. They are often progressive and at present, not curable. For individuals, families, communities and our province overall, the health, social and economic costs of neurological conditions are enormous. Historically, neurological conditions have been considered on a condition-specific basis, not as a category of illness with commonalities. Health charities have advocated individually to government with limited success.
In 2008, health charities representing Canadians with a variety of neurological conditions came together to form a coalition. While not precluding work by individual coalition members, Neurological Health Charities Canada (NHCC) was borne of the recognition that the needs of the millions of Canadian families dealing with the many chronic diseases, injuries and conditions affecting the neurological system can also be supported through cooperative effort.
Over the past year, the NCHH has been working with the Health System Strategy Division (HSSD) of the Ontario Ministry of Health and Long-Term Care to identify common issues facing Ontarians with neurological conditions. Both parties have agreed to work together to explore strategies and develop options aimed at developing an Ontario Neurological Strategy.
The relationship between the HSSD and the NHCC is a partnership – one that will be managed by a joint working committee and documented for learning and reflection. The HSSD has committed funding and human resources to support the development of the strategy; and the NHCC has committed to overall project leadership and coordination, including the provision of direct stakeholder feedback. The executive director of the Toronto ABI Network has been invited to participate in the province-wide consultations occurring throughout October and November.
The purpose of this project is to develop a set of recommendations that would form the basis of an integrated Ontario Neurological Strategy. These recommendations will support the achievement of government priorities (health, social and economic) by identifying opportunities to leverage existing resources and new investments to improve services and supports for Ontarians with neurological conditions. This project will support the creation of a comprehensive multi-ministry neurological strategy for Ontario. Acquired brain injury is specifically included within this strategy.
If the strategy is implemented, the anticipated benefits will be:
- To Ontarians living with neurological conditions:
- Reduction in the impact of disability enabling individuals to participate more fully in life
- Improved access to services and support
- Greater equity in services and support provision.
- To the Government of Ontario:
- Improved services and supports for individuals with neurological conditions and their care partners through strategic investments that build on existing programs and services and leverage linkages with identified government priority activities
- Identified short and longer term targets to assist in the evaluation of the impact of the strategy
- Optimized health care resource utilization
- Improved coordination of care.
The Joint Working Group (JWG) is chaired by Kent Bassett-Spiers, CEO, Ontario Neurotrauma Foundation (as a member of the NHCC) and the JWG membership consists of representatives from NHCC as well as the MOHLTC.
For further information on NHCC please go to www.neurohealthcharities.ca
A Psychiatric Primer for Physicians
The Toronto ABI Network is pleased to be hosting a workshop to educate physicians about the effects of acquired brain injury.
The Road Map to Acquired Brain Injury: A Psychiatric Primer for Physicians
April 14, 2010The course objective is to enhance the knowledge of physicians in the assessment and management of behavioural, psychiatric, and cognitive impairments associated with acquired brain injuries.
Angus Glen Golf Club
Markham, Ontario
Workshop speakers will include a panel of noted local professionals ~ Drs. Shree Bhalerao, Minella de Souza, Abe Snaiderman and David Wheler ~ and will be moderated by Dr. Chanth Seyone.
Presenters will:
- provide an overview of the neuropsychiatric, psychosocial and behavioural implications of acquired brain injury;
- identify basic components of psychiatric assessment;
- review bio-psychosocial treatment for the psychiatric complications of ABI patients;
- introduce the medical/legal interface for traumatic brain injury; and
- explore the challenges in managing ABI patients within a community practice.
Interested parties are requested to complete and return the registration form. Enrollment will be limited and on a first-come, first-served basis.
Planning for this workshop has been a collaborative effort of the speakers, the Toronto ABI Network and York Simcoe Brain Injury Services (YSBIS). YSBIS is a partnership between York Central Hospital and the March of Dimes.
Data on Referrals Received
The Toronto ABI Network manages referrals for acquired brain injury services in the Greater Toronto Area. Referrals for inpatient service are triaged through the Network office to the first available bed that is appropriate to the individual's needs. The Network also facilitates the process of referring to community-based ABI providers. The following information reports only on patients/clients referred through the Network office and is not intended to reflect incidence data.
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* This chart provides information only for those clients who provided consent to report data in aggregate form. Furthermore, client demographic data is only counted the first instance where a person was referred to the Network. Those people being referred subsequently for other services are not reported again in this chart.
Toronto/GTA includes: Toronto Central LHIN, Central LHIN, Central East LHIN, Central West LHIN, and Mississauga-Halton LHIN.
Events Listing
The events listed here are provided for your information and are not necessarily being organized by the Toronto ABI Network. If you are interested in further details about any of the events below, please contact the appropriate individual identified in the event listing.
December 4, 2009
Half-day workshop:
Congratulations! You're an Expert! From Report Writing to the Courtroom
Location: Four Points Sheraton, London, Ontario
FOR FURTHER INFORMATION:
Contact: Brain Injury Association of London & Region
Phone: 519-642-4539
Email: info@braininjurylondon.on.ca
All proceeds from this workshop help support the programs offered by the Brain Injury Association of London & Region.
January 25, 2010
St. Michael's Hospital Health Service & Continuing Education, Faculty of Medicine, University of Toronto, present:
Brain Matters:
Traumatic Brain Injury and Mental Health ~ Overview, Impact and Management
Location: 89 Chestnut Street Conference Centre, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Jeff Loudermilk, St. Michael's Hospital
Phone: 416-864-6060 ext. 6481
Email: loudermilkj@smh.toronto.on.ca
March 1, 2010
GTA Rehab Network, along with its planning partners, presents:
Best Practices Day 2010:
Inquiry, Innovation and Integration
Location: The Sutton Place Hotel, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Conference Services, Toronto Rehab
Phone: 416-597-3422 ext. 3693
Email: conferences@torontorehab.on.ca
March 10-14, 2010
International Brain Injury Association presents:
Eighth World Congress on Brain Injury
Location: Hyatt Regency Crystal City Hotel, Washington, DC
FOR FURTHER INFORMATION:
Contact: International Brain Injury Association
Phone: 703-960-6500
Email: mjroberts@internationalbrain.org
Web: www.internationalbrain.org
March 22-26, 2010
Baycrest-Berkeley presents the 20th annual Rotman Research Institute Conference:
The Frontal Lobes
Location: Metro Toronto Convention Centre, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Paula Ferreira, Baycrest
Phone: 416-785-2500 ext. 2363
Email: pferreira@baycrest.org
Web: www.baycrest.org/Events/default_14171.asp
April 14, 2010
Toronto ABI Network, in partnership with York Simcoe Brain Injury Services, presents:
The Road Map to Acquired Brain Injury ~ A Psychiatric Primer for Physicians
Location: Angus Glen Golf Club, Markham, Ontario
FOR FURTHER INFORMATION:
Contact: Robert Jessop, Toronto ABI Network
Phone: 416-597-3422 ext. 3726
Email: jessop.robert@torontorehab.on.ca
November 2010
Toronto ABI Network presents:
Toronto ABI Network Conference 2010
Location: Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Robert Jessop, Toronto ABI Network
Phone: 416-597-3422 ext. 3726
Email: jessop.robert@torontorehab.on.ca
This listing provides details of events taking place within a few months of the newsletter’s release date. For a more comprehensive list of events of interest to the ABI community, please see the conference listing on our website.
In Brief
Call for Abstracts for Best Practices Day conference
- Have you been involved in initiatives that improved patient care, system flow, or service delivery?
- Have you developed programs, tools, or partnerships that your peers in rehab could learn from?
- Do your research findings help rehab professionals make better decisions about system planning, service delivery, or patient care?
The GTA Rehab Network ~ along with its planning partners in Kingston, London, Ottawa, Sudbury and Thunder Bay ~ invite rehabilitation researchers, clinicians, policy and management professionals and students to share best practices, research and innovation through the Call for Abstracts for Best Practices Day 2010.
On March 1, 2010, the GTA Rehab Network's 10th annual Best Practices Day will focus on the role of inquiry, innovation and integration for both the system and the patient journey through the rehabilitation process.
Authors are invited to submit abstracts for either poster or podium presentations. All rehabilitation-related abstracts will be considered. The deadline for submissions is November 16, 2009.
Find out more about Best Practices Day 2010 and how you can submit an abstract for this event.
Planning underway for Network's 2010 conference
Planning is well underway for the next Toronto ABI Network Conference which will be held in the fall of 2010. Members of the conference planning committee have been meeting since July to plan and organize the event. The details are still being worked out but we are almost ready to make an announcement on the date, location and program. Make sure you receive information about this event by adding your email to our ABI Events List.
Resources available following forum on ABI and homelessness
The Toronto ABI Network partnered with COTA Health and the City of Toronto, Homelessness Partnership Initiatives to put together a workshop aimed at increasing the awareness of brain injuries in those working with the homeless population.
Based on the published study by Dr. Stephen Hwang citing the prevalence of brain injury in the homeless population, Dr. Carolyn Lemsky of Community Head Injury Resource Services and ABI case managers from COTA Health led the session which was designed to assist in identifying brain injuries in their clients, understand its impact and enhance their ability to support this unique population.
The workshop was video recorded. You may view workshop presentations online on the Toronto ABI Network website or you may purchase a DVD of the presentations for later viewing offline.
Brain Matters conference focusing on TBI and mental health
St. Michael's Hospital Mental Health Service is hosting an upcoming conference about traumatic brain injury and mental health. The conference, called "Brain Matters: Traumatic Brain Injury and Mental Health ~ Overview, Impact and Management" will be held at the 89 Chestnut Street Conference Centre in Toronto on January 25, 2010.
Neuropsychiatrist Dr. Jonathan Silver will give the keynote address, providing an overview of traumatic brain injury and its impact on patients and families. A panel presentation will follow which will explore the family and patient impact of mental health issues after TBI. Panelists will include Dr. Silver, Dr. Shree Bhalerao, Theresa Cook, Dr. Carolyn Lemsky and Dr. Chanth Seyone.
For more information, download the event flyer from our website: www.abinetwork.ca/downloads/flyer-brainmatters2010.pdf
Successful workshop provided strategies for brain injury family intervention
In October 2009, the Toronto ABI Network hosted the second two-day workshop of the Brain Injury Family Intervention (BIFI) for families of adults affected by ABI and the newly-modified version designed specifically for adolescents ages 13 to 19 years (BIFI-A).
Returning as facilitators were Caron Gan of Bloorview Kids Rehab, and Drs. Jeffrey Kreutzer and Taryn Stejskal of Virginia Commonwealth University. Assisted by Kathy Gravel and Rebecca Swift-Weir this exceptional program introduced to participants practical tools and a structured, manualized protocol for clinicians to use in their own practice.
The first day provided an overview focusing on the impact of brain injuries on families, intervention techniques and theoretical frameworks, how to effectively manage difficult cases and situations, and objectively evaluating change and therapeutic benefits. The second day, participants were divided into two groups to focus on interventions for adults with ABI and adolescents with ABI, respectively, where they were given the opportunity to focus on skill-building, drawing on family discussion, vignettes, role plays and interactive exercises.
For the second time offering this workshop, the event was sold out and very well received. In total, there are now 80 participants who have completed this two day workshop. This session’s participants have expressed a desire to reconvene now as a larger group to have further discussions on how to implement this model of intervention into their practice and to have the opportunity to raise any questions and problem solve around particularly challenging cases.
The Toronto ABI Network in currently reviewing the evaluations forms and will begin planning next steps including the possibilities of hosting another session for new participants and/or a follow-up session with the first two groups of participants.
Workshop about changes to auto insurance legislation sold out
On Thursday, September 10, 2009, Thomson, Rogers hosted an event outlining the proposed changes to the Ontario automobile insurance legislation. Over 250 people attended this one-day conference to learn about how the proposed changes will affect their ability to provide service and support for their patients.
All proceeds from this successful event were donated to the Toronto ABI Network. In turn, the Toronto ABI Network further donated one half of these proceeds to the Scott Southwell ABI Assistance Fund which provides financial assistance to individuals with an ABI, enabling them to participate more fully and meaningfully in the community and to reach their own personal development goals through education, training, devices, equipment or support services.