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Lookup NU author(s): Dr Lisa Robinson, Dr Kate Hackett
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© 2019 John Wiley & Sons, Ltd.Rationale, Aims, and Objectives: The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. Methods: Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi-dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. Results: Fifty-eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7-item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long-term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. Conclusion: The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma.
Author(s): Robinson LJ, Stephens NM, Wilson S, Graham L, Hackett KL
Publication type: Article
Publication status: Published
Journal: Journal of Evaluation in Clinical Practice
Year: 2020
Volume: 26
Issue: 5
Pages: 1436-1447
Print publication date: 01/10/2020
Online publication date: 09/12/2019
Acceptance date: 22/11/2019
ISSN (print): 1356-1294
ISSN (electronic): 1365-2753
Publisher: Blackwell Publishing Ltd
URL: https://doi.org/10.1111/jep.13331
DOI: 10.1111/jep.13331
PubMed id: 31816667
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