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Journal of the Australasian Society for the Study of Brain Impairment

Clinical Implementation to Optimise Outcomes

This collection of Brain Impairment papers focuses on Clinical Implementation to Optimise Outcomes. We chose this topic for a special collection to highlight ways to address the often slow and inconsistent implementation of new evidence into the delivery of care, support, and rehabilitation services for people with brain conditions. Research has shown it may take ~15 years for evidence to have an impact on clinical practice. Brain injury clinicians can actively contribute to closing this gap by providing invaluable insights into potential challenges faced and ensuring that the design and implementation approaches address organisational context. This Collection of papers outlines the processes, frameworks, barriers, and facilitators of effective clinical implementation. They showcase high-quality examples of clinical implementation projects in a range of populations, settings, and cultures across the lifespan. In each of the Collection papers, implementation efforts were guided by established knowledge translation or implementation science frameworks, often applied in novel ways to suit specific contexts faced by brain injury clinicians. We hope these papers can usefully inspire ongoing efforts to implement evidence-based interventions and service models to optimise outcomes for people with conditions affecting the brain.

Collection Editors
Dana Wong (LaTrobe University, Melbourne, Vic., Australia)
Natasha Lannin (Monash University, Melbourne, Vic., Australia)
Sharon Kramer (Monash University, Melbourne, Vic., Australia)

Last Updated: 13 May 2024

Despite evidence supporting skills retraining during post-traumatic amnesia (PTA) following traumatic brain injury (TBI), utilisation of this intervention in clinical practice in Australia is unclear. Following training in the intervention, occupational therapists reported improved confidence and competencies, and 2 years later, a key facilitator of implementing the intervention into clinical practice was the benefit to the patients. Despite this, barriers such as time and resourcing require consideration to facilitate best-practice rehabilitation for individuals in PTA.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Helping patients navigate changes in sexual functioning and wellbeing after traumatic brain injury is an important aspect of recovery often overlooked in health care. This study tackles the hesitancy around discussing sexuality by identifying barriers and enablers and co-designing solutions with a healthcare team. This exploration revealed the importance of addressing institutional and environmental barriers to tackle the discomfort in addressing sexuality and to achieve sustainable behavioural change within healthcare teams.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Children and young people with acquired brain injury (CYP-ABI) and their families experience long-term impact on their well-being and participation in activities at home, school and in their community. They have substantial unmet needs and face multiple barriers, with a lack of awareness and understanding, support for parents and cross-sector collaboration being key. The findings are informing intervention development and recommendations for improving service provision to ensure the needs of CYP-ABI and their families are met and they experience improved health and well-being.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

IB23091Developing consensus-based clinical competencies to guide stroke clinicians in the implementation of psychological care in aphasia rehabilitation

Caroline Baker 0000-0001-8605-5181, Brooke Ryan, Miranda L. Rose, Ian Kneebone, Shirley Thomas, Dana Wong and Sarah J. Wallace

People with aphasia after stroke can have difficulty with conversations, healthcare decisions, relationships and returning to work. Aphasia can have negative impacts on psychological and mental health, such as depression and anxiety. Stroke clinicians report a lack of knowledge and skills in how to best support communication and psychological care needs. Consumers with lived experience of aphasia and expert clinicians contributed to the identification of a preliminary list of clinical competencies to guide clinician skill development.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

IB23094Adapting TeachABI to the local needs of Australian educators – a critical step for successful implementation

Marnie Drake 0000-0003-2651-1223, Shannon E. Scratch, Angela Jackman, Adam Scheinberg, Meg Wilson and Sarah Knight 0000-0002-9908-2231

This paper details the adaptation process forTeachABI-Australia, a nationwide digital resource for educators addressing acquired brain injury (ABI)-related learning needs. Australian educators found TeachABI acceptable but recommended modifications to improve cultural and environmental fit, highlighting the importance of tailoring professional development resources to local contexts.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Behaviour change is common and distressing after acquired brain injury (ABI); however, clinicians report a lack of training to address this. An intervention guidebook and podcast series were co-designed as training resources in PBS+PLUS, a behaviour support intervention. Participants with ABI, family members, and clinicians reported on many benefits of being involved in this co-design process and on the high utility of co-designed PBS+PLUS resources. Findings highlight the importance of involving stakeholders when implementing research into clinical settings.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

IB23101Heads Together Online Peer Education (HOPE): co-design of a family-led, video-based resource for families affected by paediatric acquired brain injury

Marnie Drake 0000-0003-2651-1223, Taylor Jenkin 0000-0003-2567-4514, Kate Heine, Penelope Analytis, Michael Kendall, Adam Scheinberg and Sarah Knight 0000-0002-9908-2231

Heads Together Online Peer Education (HOPE) is an online video resource that provides information and early support to families following childhood acquired brain injury (ABI). This study explored parents’ and rehabilitation clinicians’ experiences of using HOPE, and whether they found HOPE enjoyable and user-friendly. These results will help guide how we provide HOPE to families following childhood ABI within rehabilitation.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Going home after a stroke is a significant milestone in the stroke recovery journey; however, stroke survivors have unmet needs in relation to discharge planning processes. Our survey found that healthcare professionals working in stroke care experience challenges in coordinating care between services, resulting in inconsistent practice. Our study suggests that clearer guidance and support is needed to improve communication between hospital-based clinicians and primary and community care providers, which will benefit outcomes for stroke survivors.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017–2022), outlining activities to date.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.