Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA.
Division of Clinical Therapies and Inpatient Rehabilitation Program, Nationwide Children's Hospital, Columbus, OH, USA.
NeuroRehabilitation. 2023;52(4):585-596. doi: 10.3233/NRE-220196.
Care coordination aligns services and optimizes outcomes for children with traumatic brain injury (TBI), yet numerous obstacles can impede effective care coordination following a TBI.
The goal of this work is to identify barriers and facilitators to care coordination from the perspective of individuals who care for young people impacted by TBI (e.g., medical providers, educators, caregivers).
Twenty-one care providers participated in semi-structured interviews to gather their perspectives on systems of care coordination for youth with TBI and potential areas for improvement. Using reflexive thematic analysis, researchers identified key themes across interviews.
Three themes were identified: 1) gaps in knowledge; 2) poor collaboration and communication between systems and care providers; and 3) inadequate legislative and policy frameworks that fund and support pediatric TBI. Across themes, participants shared their experiences and ideas to improve each of these areas.
A structured, consistent, and coordinated system of care for pediatric TBI is critical to ensure optimal outcomes. Protocols that emphasize intentional and productive collaboration between healthcare settings and schools and education for all care providers are cornerstones in improving outcomes for children. Top-down action that develops policy and funding initiatives is needed to ensure equitable, consistent access to appropriate healthcare and educational supports.
医疗协调能使创伤性脑损伤（TBI）患儿的服务和结果达到最佳，然而，TBI 后仍存在许多障碍会阻碍有效的医疗协调。
本研究旨在从照顾 TBI 患儿的人员（例如医疗提供者、教育工作者、照顾者）的角度，确定 TBI 患儿医疗协调中的障碍和促进因素。
21 名护理人员参加了半结构化访谈，以收集他们对 TBI 青少年照护系统的看法，以及潜在的改进领域。研究人员使用反思性主题分析，从访谈中确定了关键主题。
确定了三个主题：1）知识差距；2）系统和护理提供者之间协作和沟通不良；3）立法和政策框架不足，无法为儿科 TBI 提供资金和支持。各主题中，参与者分享了他们的经验和想法，以改善这些领域。
为确保最佳结果，TBI 儿科护理需要建立一个结构化、一致和协调的护理系统。强调医疗保健机构和学校之间有目的且富有成效的合作以及对所有护理人员进行教育的协议，是改善儿童预后的基石。需要采取自上而下的行动，制定政策和资助计划，以确保公平、一致地获得适当的医疗保健和教育支持。
