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2020-21 ABI Catalyst Projects

The Ontario Neurotrauma Foundation provides catalyst funds to programs working on improving the degree of implementation of the adult/ pediatric concussion and adult moderate-to-severe TBI guidelines.  

Ongoing projects and their brief descriptions are listed in the dropdown menu under the Concussion and Moderate-to-Severe headings. As projects are completed, a detailed summary of the project, a casebook, and relevant resources will be posted on the Completed ABI Catalyst Projects webpage. Learn more about completed projects.

Concussion

Brainworks Rehabilitation 
Project Lead: Arden McGregor 

About this 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.

Complete Case Report

Resources
Survey Results


Sudbury Sport and Exercise Medicine Concussion Program 
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

Complete Case Report

CHEO & University of Toronto 
Project Lead(s): 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: Living Guideline for Diagnosing and Managing Pediatric Concussion Guideline for Concussion/Mild Traumatic Brain Injury & Prolonged Symptoms (3rd Edition, for adults over 18 years of age)

Complete Case Report

Hull-Ellis Concussion and Research Clinic, Toronto Rehab, University Health Network 
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

Complete Case Report

Resources
Screening Form
Exercise Prescription Form
Exercise Prescription Form with Physician’s Script
Symptom Evaluation
Recovery Ratings Guide for Physicians
Treadmill Test Data Collection Sheet
Physician Feasibility Survey

Holland Bloorview & SickKids Hospital 
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).

Complete Case Report

Holland Bloorview Kids Rehabilitation Hospital 
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

Complete Case Report

Moderate-to-Severe

Toronto Rehabilitation Institute UHN – Toronto 

About the project: 
The targeted outcome of this project was to implement a process to help clinicians initiate discussions about sexuality with patients/caregivers.

Complete Case Report

Traverse Independence 
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

A1. 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.

Complete Case Report

March of Dime Canada (NE Region)
Project lead: Kamilah Francis

About this 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.

Complete Case Report

Resources
Case Coordination Flow Chart
Case Coordination Feasibility Survey
Consumer Satisfaction Questionnaire
Additional Question for Intake – 12 Month Contact
Community Integration Questionnaire Testing Form


Brain Injury Society of Toronto 
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.

Complete Case Report

Ontario Brain Injury Association (OBIA) 
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).

Complete Case Report

Resources
Evaluation Survey
Evaluation Results Summary
Pre-Implementation Survey
Pre-Implementation Results Summary

Centre for Addiction and Mental Health (CAMH)
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)

Complete Case Report

2019-20 Projects

West Park Healthcare Centre

Project lead: Karl Gunnarsson – Kelley Anstey

About the project:
The goal of this project was to build system capacity to support individuals with the full range of challenging behaviour from agitation and confusion to aggression and violence.

Complete Case Report

Resources
30-Day Daily Data Collection Measure
Action Item Tracking Log Template
Draft Environmental Evaluation Tool
Final ONF Outcomes-post
Final ONF Outcomes-pre
Workshop Evaluation Form

JHC London, Parkwood Institute Main, Regional ABI Outpatient Services – London

Project lead: Andrea Lee

About the project:
The purpose of this project is to adapt, implement, and evaluate an existing brain injury intake, triage, and education process and to include mental health screening as a new part of the process.

Complete Case Report

Mind Forward Brain Injury Services – Mississauga

Project lead: Deborah Tang

About the project:
The targeted outcome of this project was to implement an educational workshop for individuals with brain injury to assist with memory compensation skills and errorless learning.

Complete Case Report

Resources
GAD-7 Assessment
Patient Health Questionnaire

Mind Forward Brain Injury Services – Mississauga

Project lead: Carolyn Lemsky

About the project:
The current project will make capacity building training (both didactic and case-based learning) available across Ontario for mental health and addictions settings to recognize and better manage the cognitive and neurobehavioural outcomes of traumatic brain injury.

Complete Case Report

Resources
Appendix B – Learning Outcome
Module and Course Evaluation
Registration and Pre-Learning
Post-Learning Assessment
3-Month Follow-up Assessment
6-Month Follow-up Assessment


CORPORATE ANNOUNCEMENT – February 2021(Click to learn more)
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