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Severely brain injured patients still in coma should be referred to a specialist ABI unit where their continued acute care may be supplemented by an interdisciplinary rehab. teamCZC'Transfer to RehabilitationPatients requiring post-acute inpatient rehabilitation should be transferred to a specialist post-acute rehabilitation unit as soon as they are medically stable and fit to participate in rehabilitation. !Inpatient Rehabilitation ServicesLRegional Acquired Brain Injury Unit Thompson House Maine Villa Spruce House $Regional Acquired Brain Injury Unit.Opened May 2006. 25 Beds Flexibility of accommodation Integrated outpatient service Early transfer from acute units Working relationships with other providers Interdisciplinary team structure 20+ Years a coming1982. Medical Rehabilitation. Report of a Working Party. 1991. Sloan Report. 1994. Business Case for R.R.U. submitted to Management Executive. 1996. Social Services Inspectorate. Symposium and Workshop on TBI. 1998. RMSC Report on ABI Rehab.Z  Regional Strategy. 1997-2002. Dept. should undertake to resolve with Boards the provision of Rehabilitation services for persons with T B I. Development of locally sensitive hospital and community services and establish a Regional Rehabilitation Unit. Priorities for Action 2001/2002Boards and Trusts should finalise a Business Case for a Regional TBI Unit by December 2001. Agreement that Greenpark should lead development of Business Case. Sept. 2001 Outline Case submitted Dec. 2001 Capital funding announced.,J u3$Thompson House HospitalDown and Lisburn Trust Young disabled unit Slow stream neurorehabilitation 6-8 Brain injury rehab beds. Low level consciousness patients Shares base with community brain injury team, 'l4% Maine Villa Stand alone within psychiatric unit Locked facility 10-12 beds Challenging behaviour No female patients Linked to Mourne project Limks with community team>K  5& Spruce HouseNew build on acute hospital site Slow stream rehabilitation and respite Limited therapy input 6-8 brain injury beds Links to community team Potential step down facilityRehabilitation Service NetworksThese networks should include; Specialist regional service to meet the needs of more complex cases and provide specialist training and guidance for other professionals involved in the care of patients with ABI. Local hospital and community rehabilitation teamsZ Rehabilitation Service NetworksG Patients can be transferred between different services without any bureaucratic delays. There is close communication between local hospital, community and regional services to provide a seamless continuum of care. Patients with complex needs are able to regain access to specialised services as their needs dictate.HH "Rehabilitation Service NetworksSocial services to provide continued support for the individual and their family within the home setting. Voluntary agencies providing support, information and activities. Specialist brain injury vocational rehabilitation services.Rehabilitation Service NetworksStrategic Health Authorities should ensure that a managed network of specialised rehab. services is planned over a geographical area with collaborative commissioning of regional services.E l6' A Network?1R A B I U Thompson House Maine Villa Spruce House OR A B I U Mourne project Community Brain injury rehab teams in each Area Board ?!,Timing, intensity and duration of treatment.7Following acute ABI patients should; Be transferred as soon as possible to a rehabilitation programme of appropriate intensity to meet their needs. Receive as much therapy as they need, can be given and find tolerable. Be given as much opportunity as possible to practise skills outside formal therapy sessions.8Z8,\ )",Timing, intensity and duration of treatment.YAfter the post-acute phase, continued rehabilitation in the community should move progressively from formal therapy to a guided and supported resumption of chosen activities over months and years. There should be recognition of the need for life-long contact to meet the changing clinical, social and psychological needs of patients and carers.ZZZR)Discharge PlanningInpatient rehabilitation should continue while the patient requires the facilities, skills and therapeutic intensity of a specialist rehabilitation unit in order to make progress or while thee hospital environment is needed in order to maintain safety. Patients may be transferred back to the community once any specialist rehabilitation and support needed can be continued in that environment without delay.Z*Continuing care and supportPatients with significant ABI should have long term access to an individual or team with experience in management of ABI. Care services should be provided by skilled workers trained in the needs of ABI patients Patients with complex needs after ABI should have joint assessment by health and social services, with ongoing review and re-assessment Access to regional services is needed to supplement local service provision.Z Outpatient/Community Services RABIU Mourne Project Down & Lisburn B.I.T UCHT B.I.T. N & W Belfast. B.I.T. S & E Belfast. B.I.T NHSSB CABIRS. SHSSB. A.B.I.T. WHSSB. B.I.TVocational RehabilitationCEDAR Foundation. Vocational and pre-vocational rehabilitation services in each of N.I. Area Health Boards Reconnect. Provision of services for persons in Greater Belfast Area.Z  No man is an Island, entire of itself, every man is a piece of the Continent, a part of the main& & & & . Any man s death diminishes me, because I am involved in Mankind, and therefore never send to know for whom the bell tolls; It tolls for thee. John Donne Meditation XVII Z#Carers and families Rehabilitation services should be alert to the likely strain on families/carers and, in particular the needs of children in the family Patients and their families/carers should be considered with regard to treatment and care options and should be involved in planning of the patient s specific rehabilitation programme, negotiating appropriate goals, and in decisions regarding their care.>IT H$Carers and familiescFamilies of patients with ABI should be offered timely; Information and education about ABI, and local and national services and support groups. Referral to social services regarding their own needs. Assistance with the benefits system. Support and counselling, which should be available long-term, provided by professionals experienced in ABI management.dZd `%Carers and families And where appropriate; The opportunity to learn skills, techniques and routine necessary to maintain rehabilitation games. Information about the process of compensation for personal injury and approved sources of information concerning legal assistance."ZZSupport Organisations Headway Belfast. Social Reintegration and Family Support Services. Headway Ballymena. Headway Londonderry Headway EnnisRone Headway Southern Region.,L  + Unresolved IssuesMinor Brain Injury Patients managed within DGH Children with ABI Transition services Step down units Community care Long term neurobehavioural management~ .#Future challengesReview of Public Administration Combined hospital and community Trusts Reduction in number of Trusts Locality based commissioning Service network development European expansion,!European matters.Increase in size of European Union Accession states / economic migration Language Culture No family network Longer term placement Long term support 2 ` 33PP` 3333` ___MMM` 13` 333fpKNāvI` j@v۩ῑ΂H` Q_{>?" dd@,?n<d@ `7 `2@`7``2 n?" dd@   @@``PR    @ ` ` p>> l d   (    <pI" F    TLd" F    <O"U_ F    T Sd">& F    NW"P F    <["p F    S ~]?d?"" F    6\ "U  T Click to edit Master title style! !$  0b "   RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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A Northern Perspective. JOHN MC CANNn aaMac Hard Disc:Users:johnmccann:Desktop:Microsoft Office X:Templates:Presentations:Designs:BlendscFrank Kernohans11n@a@4@P՜.+,0     On-screen Show  JOHNMCCANNh) .TimesArial WingdingsBlendsMicrosoft Word DocumentDRehabilitation after Acquired Brain Injury. A Northern Perspective.Slide 2 DemographicsAcquired Brain InjuryDefinitions of RehabilitationEpidemiology of A B IN.I. Audit 2003Admissions to hospital.Background Documentation(Principles and organisation of servicesPrinicples and organisation.Transfer to RehabilitationTransfer to Rehabilitation"Inpatient Rehabilitation Services%Regional Acquired Brain Injury Unit.20+ Years a coming Slide 17 Priorities for Action 2001/2002Thompson House Hospital Maine Villa Spruce House Rehabilitation Service Networks Rehabilitation Service Networks Rehabilitation Service Networks Rehabilitation Service Networks A Network?-Timing, intensity and duration of treatment.-Timing, intensity and duration of treatment.Discharge PlanningContinuing care and supportOutpatient/Community ServicesVocational Rehabilitation Slide 33Carers and familiesCarers and familiesCarers and familiesSupport OrganisationsUnresolved IssuesFuture challengesEuropean matters. Slide 41  Fonts UsedDesign TemplateEmbedded OLE Servers Slide Titles)&_Ⱥ Frank KernohanFrank Kernohan  !#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root EntrydO)Pictures2CCurrent UserSummaryInformation(PowerPoint Document("DocumentSummaryInformation8