A System That Is TBI Optimized by Charles Watson
Posted on December 22, 2022
A system that is optimized for TBI must include a number of essential components, such as interaction between the health care system and the research sector as well as integration between the care and recovery stages. Moreover, bio-psycho-socio-ecological (BPSE) elements outside of the injury itself must be taken into account for comprehensive and tailored therapy for TBI. The diagnosis, first treatment, and even immediate survival after a TBI is influenced by BPSE variables, as well as the recovery, rehabilitation, and reintegration into work, family, and social life.
The last ten years of research have shown that BPSE variables should guide all stages of care. However, the existing method does not sufficiently address the biological origin of the damage and acute presentation, which are the main focuses of TBI care and management. Inequalities in risks, access to care, and outcomes following TBI that are related to racial, ethnic, socioeconomic, geographic, and other subsets of the population are also influenced by BPSE variables. It is no longer acceptable to continue ignoring how these factors affect results and care. Due to the significance of BPSE dimensions, it is also necessary to manage TBI care on a team basis and conduct research that aims to produce the best possible clinical results. The committee's proposed optimised TBI system must include a wide spectrum of partners and stakeholders due to the extent, scale, and heterogeneity of TBI.
The following are key components of a system that is properly optimised for TBI.
incorporates treatment, research, and prevention. The foundation of a TBI-optimized system is prevention. As few people as feasible need to receive care as a result of efforts to stop brain injuries from happening or lessen their severity.
is family- and person-centered. A system that has been optimised approaches patient needs holistically. Understanding and respect for the requirements and viewpoints of the individuals, families, and communities affected by TBI form the basis of the system. Such a system takes into account the requirements of all patients, paying special attention to those who are most susceptible to negative outcomes, and involves people with TBI and their families in both clinical care and research.
Person-centered care is defined as "the experience of transparency, individualization, acknowledgment, respect, dignity, and choice in all areas, without exception, connected to one's person, circumstances, and relationships in health care" (to the extent the informed, individual patient wishes it).
utilizes a strict system of classification. In order to identify and categorise TBI, an optimal system relies on an accurate framework, which helps to produce more precise and accurate diagnosis, prognostication, monitoring, and research.
gives everyone the best care possible. In an optimal system, clinical practise is informed by research findings from settings of real-world care, and research results and needs are fed back into clinical practise. The information and comprehension gained in this way enable the creation and dissemination of guidelines for best practises in healthcare that are supported by evidence and that are tailored to the needs of both patients and their families. A system that delivers the best care possible aims to identify and address racial and ethnic, geographic, socioeconomic, and other sources of imbalances in access to high-quality TBI care and outcomes.
provides smooth transitions throughout the care continuum. The linkages between each element of the TBI landscape are supported by an optimal system, creating awareness of the interdependencies and encouraging cooperation and communication.
develops responsibility and systemic quality improvement. In order to better serve the needs of patients and their families, an optimised system includes the capability of identifying and implementing quality indicators.
becomes a fully integrated learning system. Creating a system is essential but insufficient for optimising it for TBI; a learning system is required. The characteristics of a learning health system have been described in earlier National Academies papers. The effectiveness of such a system "is determined by the influence of the system on the health and lives of patients," and it "is reliant on the active engagement of all members of the system, from patients to doctors to health system officials." The ability to recognise the gaps and difficulties impeding better care and to collaborate across the system to overcome them is increased by a learning system for TBI.
includes leadership committed to bringing about change. Leaders and advocates who support the system's objective and vision comprise a TBI optimization, learning system. These leaders encourage, carry out, and maintain positive change.