Summary
Getting access to early rehabilitation after major trauma makes a significant difference to a person’s recovery. Rehabilitation can, in some cases, be lifelong. The major trauma rehabilitation work programme strives for early and equitable access to rehabilitation and making sure that services meet the needs of people with complex injuries. This reduces unwarranted variation in care for the most seriously injured New Zealanders.
The programme engaged sector experts and invited clinical teams to address local problems through a national collaborative. This work identified innovations and opportunities that are relevant to and worth sharing with the sector. The rehabilitation workstream continues to evolve, combining quality improvement projects, establishing consistent national data collections, engaging consumers and developing cross-health sector relationships.
In March 2019, the Accident Compensation Corporation (ACC) contracted Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) to provide support to the National Trauma Network (the Network), who identified trauma rehabilitation as an area of focus. Te Tāhū Hauora developed the quality improvement workstream of the programme. This work was intended to optimise the efficiency of rehabilitation and improve outcomes. The overarching goal was to give people with major trauma the greatest chance of returning to independence, with the best quality of life.
Early consultation confirmed that:
- levels of service were not consistent across the country
- access to services was not equitable across the country
- there was no certainty that services meeting the needs of trauma patients were available where needed.
Two quality improvement approaches were used in this work:
- co-design with consumers to identify and understand the issues and to design and implement solutions[1]
- working with local project teams to resolve problems and issues via a national collaborative.[2]
The project has focused on improving existing services and ensuring that patients and their whānau have better access to the right rehabilitation services at the right time.
Kat Quick is clinical lead for the project. Kat has over 19 years' experience in rehabilitation, both within Aotearoa New Zealand and in the United Kingdom’s national health service. She has a special interest in rehabilitation following major trauma, neurosurgery and traumatic brain injury. Her clinical experience ranges from acute to community settings. In 2022, Kat worked as an expert advisor for the World Health Organization’s package of interventions for rehabilitation in traumatic brain injury and has been involved in delivering complex service improvement projects.
If you have any questions, please contact project lead, Kat Quick, at: help@majortrauma.nz.
References
[1] Te Tāhū Hauora Health Quality & Safety Commission. Understanding co-design. URL: www.hqsc.govt.nz/consumer-hub/engaging-consumers-and-whanau/co-design/
[2] Institute for Healthcare Improvement. 2003. The Breakthrough Series: IHI’s collaborative model for achieving breakthrough improvement. IHI Innovation Series white paper. Boston, MA: IHI. URL: www.ihi.org.
April–December 2020 (scoping phase)
- Establishing expert advisory group
- Discovery workshop
- Ethics approvals for data
- Sector engagement
March 2021–June 2022 (national collaborative)
- Learning sessions 1–4
- Webinars 1–10
- Team site visits
- Coaching
- Evaluation survey
June 2022–March 2023 (promotion of outcomes)
- Evaluation reports
- Publishing case studies
- National and international presentations
- Social media promotion
- Podcast planning
April 2020–June 2023 (future opportunities)
- Data analysis (ACC and Australasian rehabilitation outcomes centre)
- Development of allied health workforce
- Collation of resources
- Strategic planning for rehabilitation work programme
Background
In March 2019, the Accident Compensation Corporation (ACC) contracted Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) to provide support to the National Trauma Network (the Network), who identified trauma rehabilitation as an area of focus. Te Tāhū Hauora developed the quality improvement workstream of the programme. This work was intended to optimise the efficiency of rehabilitation and improve outcomes. The overarching goal was to give people with major trauma the greatest chance of returning to independence, with the best quality of life.
Early consultation confirmed that:
- levels of service were not consistent across the country
- access to services was not equitable across the country
- there was no certainty that services meeting the needs of trauma patients were available where needed.
Two quality improvement approaches were used in this work:
- co-design with consumers to identify and understand the issues and to design and implement solutions[1]
- working with local project teams to resolve problems and issues via a national collaborative.[2]
The project has focused on improving existing services and ensuring that patients and their whānau have better access to the right rehabilitation services at the right time.
Kat Quick is clinical lead for the project. Kat has over 19 years' experience in rehabilitation, both within Aotearoa New Zealand and in the United Kingdom’s national health service. She has a special interest in rehabilitation following major trauma, neurosurgery and traumatic brain injury. Her clinical experience ranges from acute to community settings. In 2022, Kat worked as an expert advisor for the World Health Organization’s package of interventions for rehabilitation in traumatic brain injury and has been involved in delivering complex service improvement projects.
If you have any questions, please contact project lead, Kat Quick, at: help@majortrauma.nz.
References
[1] Te Tāhū Hauora Health Quality & Safety Commission. Understanding co-design. URL: www.hqsc.govt.nz/consumer-hub/engaging-consumers-and-whanau/co-design/
[2] Institute for Healthcare Improvement. 2003. The Breakthrough Series: IHI’s collaborative model for achieving breakthrough improvement. IHI Innovation Series white paper. Boston, MA: IHI. URL: www.ihi.org.
Timeline
April–December 2020 (scoping phase)
- Establishing expert advisory group
- Discovery workshop
- Ethics approvals for data
- Sector engagement
March 2021–June 2022 (national collaborative)
- Learning sessions 1–4
- Webinars 1–10
- Team site visits
- Coaching
- Evaluation survey
June 2022–March 2023 (promotion of outcomes)
- Evaluation reports
- Publishing case studies
- National and international presentations
- Social media promotion
- Podcast planning
April 2020–June 2023 (future opportunities)
- Data analysis (ACC and Australasian rehabilitation outcomes centre)
- Development of allied health workforce
- Collation of resources
- Strategic planning for rehabilitation work programme