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It is estimated that less than 20% of best practices are ever applied because it takes both dedicated funding and effort to be able to effectively plan and sustain implementation activities. The implementation program for ABI works to build best practices in pilot locations, clinics and rehabilitation environments in order to create provincial standards for ABI care. It also evaluates the implementation of our guidelines and standards of care through measurement of outcomes, performance and efficiency, as well as evaluating outcomes for people with ABI.

 

Implementation Projects

Catalyst Grants

ONF provides catalyst funds to programs working on improving the degree of implementation of the adult concussion and moderate-to-severe TBI guidelines. There are periodic calls for applicants through the year and the final grant amount will depend on the number of successful applicants. There is a selection committee and process for reviewing the applications.

Learn more about our current funding opportunities.

Ongoing and completed projects are listed below. As projects are completed, a detailed summary of the project, a casebook, and relevant resources will be posted in the completed projects section. To learn more about any completed project, please click on the project title.

Ongoing Projects

Concussion

Asking the Question: Addressing Sexuality in Acquired Brain Injury: The targeted outcome of this project was to implement a process to help clinicians initiate discussions about sexuality with patients/caregivers.

Making the Most of Every Waking Moment: Fatigue Management After Concussion/ mTBI Project Lead - Arden McGregor About the Project: The purpose of this project is to implement a standardized curriculum for clinicians to use in the management of persistent fatigue and sleep-wake disturbances post concussion. Catalyst funds will be used to compile therapy guides/manuals and implement the standardized curriculum in clinic.

Transition to Virtual Care
Project Lead -Shannon Kenrick-Rochon
About the Project: The purpose of this project is to implement an amended assessment strategy for persistent concussion patients with blended virtual and in-person assessment, inclusive of an interprofessional approach. The blended approach will minimize travel for patients and maximize reach of the program while maintaining positive assessment outcomes.
Clinical Practice Guideline Targeted:Guideline for Concussion/Mild Traumatic Brain Injury and Prolonged Symptoms: 3rd Edition

Shifting to Virtual Care: The adaptation and implementation of clinical practice guidelines for the diagnosis and management of concussion
Project Lead-Roger Zemek & Nick Reed
About the project: The purpose of this project is to adapt the ONF clinical practice guidelines for concussion for virtual care by creating/evaluating an implementation toolkit/user-guide to support healthcare professionals to learn ‘how’ to use the adapted virtual guidelines. The goal is to increase the capacity of healthcare professionals to deliver evidence-based concussion care virtually for clients who cannot be seen in-person (geography, personal preference, pandemic etc.)
Clinical Practice Guideline Targeted: 1. Living Guideline for Diagnosing and Managing Pediatric Concussion
2. Guideline for Concussion/Mild Traumatic Brain Injury & Prolonged Symptoms (3rd Edition, for adults over 18 years of age)

Implementation of a Standardized Exercise-Test (Buffalo Treadmill Protocol) Informed Process for Prescribing Sub-System Threshold Exercise (STE) in Early Concussion
Project Lead - Mark Bayley
About the project: The purpose of this project is to standardize exercise prescription for concussion patients using the Buffalo Treadmill Testing Protocol. A standardized training toolkit will be developed to enable clinicians to calculate return to exercise and activity level for patients.
Clinical Practice Guideline Targeted: Guideline for Concussion/Mild Traumatic Brain Injury and Prolonged Symptoms: 3rd Edition Section 12. Rest and Return to Activity

Early recognition and referral of children and youth to specialized care who present at high risk for prolonged concussion recovery in acute and primary care settings
Project Lead - Stephanie McFarland
About the project:The purpose of this project is to improve implementation of the 5P high-risk clinical screen to prioritize and streamline those most likely to benefit from specialized care within the <4 weeks of injury. The goal is to create a streamlined, impactful and sustainable partnership model between Holland Bloorview and Sick Kids Hospital to ensure uptake of the 5P tool in the emergency department and pathway to Holland Bloorview services over time.
Clinical Practice Guideline Targeted: 2.1b: Note common modifiers that may delay recovery and use a clinical risk score to predict risk of prolonged symptoms (Evidence Level: A). 2.9: Consider early referral (prior to 4-week post-injury) to an interdisciplinary concussion team in the presence of modifiers that may delay recovery. (Evidence Level: A).

Supporting youth experiencing prolonged post-concussion symptoms: Pilot implementation of standardized measures to foster mental health
Project Lead - Christine Provvidenza
About the project: The purpose of this project is to improve the assessment of mental health and family functioning in clients experiencing persistent concussion symptoms. Improved assessment will support client mental health and family functioning during follow-up therapy sessions, as well as external referrals, leading to improved mental health management, supports, and coping skills.
Clinical Practice Guideline Targeted: Domain 8 (Recommendations 8.1 and 8.2) Living Guideline for Diagnosing and Managing Pediatric Concussion

Moderate-Severe

Comprehensive Data Collection of ABI clients
Project Lead - Leah Swann
About the project:The purpose of this project is to implement institutionalized data collection for Traverse Independence clients who are active in the Outreach and Transitional Living Program. All staff will be educated and trained on the data collection process and will support clients to complete the required assessments, questionnaires, and forms.
Clinical Practice Guideline Targeted: INESSS-ONF Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to severe Traumatic Brain Injury. A1 - Principles for Organizing Rehab Services A 1. 11 “In order to support the continuous quality improvement of their services, traumatic brain injury rehabilitation programs should monitor key aspects of their processes and efficiency.

Brain Injury Enhanced Case Coordination Project
Project Lead - Kamilah Francis
About the project: The purpose of the project is to implement case coordination for applicants to the ABI Outreach program in North Eastern Ontario, identifying clients’ immediate needs and discussing goal setting. Case coordination will allow for clients to access services in a more timely manner and improve community re-integration.
Clinical Practice Guideline Targeted: INESSS-ONF Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to severe Traumatic Brain Injury.
D. Promoting Reintegration and Participation D2. Community Rehabilitation D2.1 Individuals with ongoing disability after TBI should have timely access to specialized outpatient or community-based rehabilitation to facilitate continual progress and successful community re-integration.

Brain Injury and the Law - A Functional Support Initiative
Project Lead - Melissa Vigar
About the project:The purpose of this project is to implement one-on-one legal support for ABI survivors (suspected or diagnosed) involved in the justice system. Training will be provided for support persons (social work students) who will then use the knowledge to provide functional support to Legal Professionals and ABI survivors. The goal is for persons with ABI to be more successful when navigating the justice system, resulting in a reduction of missed appointments/court dates, an increase in supporting documentation, and a clearer understanding of the process.
Clinical Practice Guideline Targeted: INESSS-ONF Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to severe Traumatic Brain Injury.
Traumatic brain injury (TBI) rehabilitation programs should conduct or collaborate on information and education activities aimed at increasing public/community awareness and understanding of the needs and special challenges of individuals with TBI.

Redevelopment of Neurorehabilitation: Assisting Recovery and Function in Everyday Life Following Brain Injury (Level 1)
Project Lead - Ruth Wilcock
About the project: The purpose of the project is to redevelop the OBIA Neurorehabilitation: Assisting Recovery and Function in Everyday Life Following Brain Injury (Level 1) training program in order to educate participants how to understand and apply the Ontario Neurotrauma Foundation Clinical Practice Guidelines in their everyday practice with clients.
Clinical Practice Guideline Targeted: INESSS-ONF Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to severe Traumatic Brain Injury.
All CPG recommendations that can be worked on in the community will be the focus of the implementation activities, with the exception of those related to Medical/Nursing Management, Spasticity, and Medications. neurorehabilitation practice. Please note, guidelines related to medications are covered in Advanced Brain Injury Rehabilitation (Level 2).

Development of a Multi-Media Substance Misuse Screening and Education Package for Persons with TBI
Project Lead - Carolyn Lemsky
About the project:The purpose of this project is to implement the Screening Brief Intervention and Referral for people requiring intervention for substance use after brain injury. Healthcare professionals will be provided with education materials, along with a toolkit and training on implementing the intervention in their practice.
Clinical Practice Guideline Targeted: INESSS-ONF Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to severe Traumatic Brain Injury.
S.2.1: Management for co-occurring substance use disorders and brain injury should be concurrent (not sequential). Substance-use-related goals and interventions should be integrated within the traumatic brain injury rehabilitation plans. (INESSS-ONF, 2015) S.2.4. Secondary prevention of substance use disorders after traumatic brain injury (TBI) should be undertaken in the form of education and information. Materials should be provided to all individuals with TBI and their families in both written and verbal formats. This information should be provided in a timely manner, ideally beginning just after post-traumatic confusion has cleared, and continue across the continuum of care. (INESSS-ONF, 2015)

Completed Projects

Providence Care Hospital - Kingston

ABI and Addictions/Mental Health Collaborative: The targeted outcome of this grant was to establish a successful and sustainable mechanism for addressing the needs of clients with moderate to severe TBI and a comorbidity of mental illness and/or addiction.

Toronto Rehabilitation Institute UHN - Toronto 

Telephone Follow-up: Supporting Community Transition Post ABI Rehab: The targeted outcome of the project was to refine and implement a sustainable telephone follow-up process in the ABI Inpatient Services at Toronto Rehab, UHN.

West Park Healthcare Centre - Toronto

Acquired Brain Injury and Sexuality: The targeted outcome of the project was to educate ABI patients, caregivers, and families on sexuality post-ABI. The grant was used to develop educational content as well as the internal capacity to provide this education in group or one-on-one sessions.

Health Science North - Sudbury

Implementing contextualized assessment and intervention approaches for the inpatient rehabilitation of adults with cognitive-communication impairments post-TBI: The targeted outcome of the project was to implement contextualized assessment and intervention approaches for the inpatient rehabilitation of adults with cognitive-communication impairments post-TBI, while simultaneously avoiding over-reliance on standardized tests.

Sunnybrook Health Sciences Centre - Toronto

Improving Concussion Education at Sunnybrook Health Sciences Centre - Examining the Efficacy of a Self-Management Education Group for Adults with Concussion: The targeted outcome of this project was to implement self-management group education sessions for adults with prolonged symptoms beyond the post-acute stage of recovery. 

Hull-Ellis Concussion Clinic and Research Clinic UHN - Toronto 

Effective Assessment and Treatment of Fatigue Post-Concussion in the Acute Stages: The targeted outcome of this project was to standardize the management of fatigue by clinicians and provide standardized education related to persistent fatigue to patients.

Dale Brain Injury Services - London

Implementing ONF-INESSS Pain Management Clinical Practice Guidelines in a Community-Based Organization Providing Support to Adults with an Acquired Brain Injury: The targeted outcome of this project was to introduce a robust pain management program for clients at Dale Brain Injury Services. 

Ottawa Hospital Research Institute - Ottawa 

Using Patient-Centred Guidelines as Part of Summary Sheet Instructions for Outpatients at a Post-Concussion Clinic: The targeted outcome of this project was incorporate condensed sections of the Patient Guidelines, individualized based on specific symptoms, into an after-visit summary that patients receive. 

Concussion North Ltd - Barrie 

Improving Access to Medical Care in Concussion Patients at High Risk for Developing Persistent Symptoms: Utilization of a Physician Assistant within a Physician-Supervised Interdisciplinary Concussion Center

The specific outcome of the project was to reduce the wait time for patients to access specialized concussion support by bringing a physician’s assistant into the clinic.

Unity Health St. Michael's Site - Toronto 

The specific outcome was to develop and implement a digital tool that uses results of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) to generate customized written education materials for patients.

University of Waterloo - Waterloo 

(Department of Kinesiology in Partnership with the Centre for Community, Clinical and Applied Research Excellence [CCARE])

Advancing Concussion Care through Education, Scientific-Evidence and Community Support (ACCESS): The targeted outcome of this project was to bridge the gap between research and practice to create community awareness around best practices in identifying and treating sport-related concussions by creating educational videos.

NeuroMatters Newsletter

NeuroMatters is the source for news and information about research and best practices in injury prevention, care and treatment of spinal cord injury, acquired brain injury.

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