Characterization, Evaluation, and Implementation of Innovative TBI Intensive Evaluation and Treatment Programs (IETP)

NIH RePORTER · VA · I50 · · view on reporter.nih.gov ↗

Abstract

The Veterans Health Administration, Physical Medicine and Rehabilitation (PM&R) National Program Office developed five specialty Polytrauma Rehabilitation Centers (PRC) to provide comprehensive rehabilitation services for persons with traumatic brain injury (TBI). To date effective dissemination and implementation of extant and emerging findings into clinical care for individuals with TBI remains limited– specifically those with mild TBI (mTBI), restricting the VA’s ability to maximize efforts to deliver care across the PRCs as a continuous learning healthcare system. One program has yielded high visibility and high consumer demand – TBI Intensive Evaluation and Treatment Program (IETP), an innovative modality for delivering evidence-based care in a residential, inpatient format. IETP programs provide bundled evidence-based assessment, treatment, referral, and case management practices in concordance with existing guidelines for mild TBI and common co-occurring comorbidities. To date, there has been no formal characterization or evaluation of the IETP residential program modality to understand facilitators and barriers to spread the unique elements that create higher consumer demand (for the successful program at one site) across the system of care. The goal of the PM&R National Program Office is to facilitate the implementation of the high consumer demand IETP at a single site to all VA PRCs. The short-term goal of this partnered evaluation is to fully characterize the innovative modality (TBI-IETP), quantify outcomes, and understand the facilitators and barriers to spread the program across the system of care. The long-term goal is to fully implement the effective components of the program across the PM&R system of care at all five of the PRCs. This three-year concurrent mixed-method partnered evaluation initiative will employ a Community Based Participatory Approach to conduct the following aims: Aim 1: Describe TBI-IETP services and state of implementation of these services in each of the five PRCs to identify opportunities for adaptation and scale. In Aim 1, we will use qualitative observations, semi-structured interviews and focus groups to describe PRC members and DoD representatives’ experiences and suggestions for implementing TBI-IETP; and patient’s experiences and needs with TBI-IETP. Findings will identify TBI-IETP core aspects and identify implementation readiness. Aim 2: Characterize the relationship between patient characteristics, clinical services and outcomes for TBI-IETP patients with traumatic brain injury across multiple outcome domains, including trajectories of recovery. In Aim 2 we will use primary data collection from TBI-IETP participants at each site to best characterize long-term outcomes and patient satisfaction with treatment, and secondary data to quantitatively characterize patient level and care system level data. Findings will evaluate the clinical impact of TBI-IETP components. Aim 3: Develop and deliver an impl...

Key facts

NIH application ID
10415392
Project number
1I50HX003441-01A1
Recipient
JAMES A. HALEY VA MEDICAL CENTER
Principal Investigator
Jolie N. Haun
Activity code
I50
Funding institute
VA
Fiscal year
2022
Award amount
Award type
1
Project period
2021-10-01 → 2024-09-30