The continual development of brain injury case management is being held back by a lack of regulatory oversight and standardisation in approaches, according to a new study.
In the largest review to date of the evidence on case management and brain injury, results reveal that there is currently a lack of standardised outcome measures being utilised.
The researchers looked at studies from 1988 to 2022 that included both adults and children with acquired brain injury across four high- and middle-income countries.
The researchers found that there is currently a lack of evidence on the effectiveness of case management along with a large variation in the definition of case management, encouraging further research with studies providing a clear definition of the role.
Measuring success
The review of the studies, carried out by researchers at the School of Nursing and Midwifery, Queen’s University Belfast, revealed that there is currently a lack of evidence on the effectiveness or ineffectiveness of case management for brain injury due to low quality studies, a lack of evaluation of service provision, differences in research designs, variation in sample sizes, and variability of outcome measures.
Key components of case management practice
When looking at successful case management practice, the researchers found a number of elements considered key, including clear communication between managers, patients, and family members, effective relationships, trust building and adequate support.
Working across the continuum of care
Continuity of care was also highlighted by the researchers as vital for successful case management, including case managers working with patients long term across acute and post-acute care, and community services.
Training case managers to ensure extensive knowledge of available services and the needs of brain injury survivors was pinpointed as a key component of providing this care.
Recommendations
The authors make a number of recommendations based on their findings including establishing the consistent use of an agreed upon definition of case management to allow for the better comparison between studies, along with providing sufficient support and training for case managers to ensure they have the knowledge of the impact of acquired brain injury and available services.
Further, they note there is currently no recognised case management qualification, advocating for the standardisation and regulation of the role and the establishment of a professional qualification or registration.
In this regard, they highlight that the recently established Institute of Registered Case Managers in the UK will provide an official framework through which the profession can be recognised, encouraging that other countries establish a similar body as well as the creation of an international task force for setting standards and an international forum for knowledge sharing.
The authors conclude: “Case management is a relatively new profession, with developments largely being driven by case managers themselves.
“The rapid evolution of the profession can create challenges, such as lack of regulatory oversight and governance, and lack of standardisation in treatment approaches. Furthermore, case management is a diverse profession, in that case managers come from various disciplines, and work with diverse service user groups, which again produces challenges in the standardization of the profession and the outcomes used to measure its effectiveness.
“However, the relative infancy of this profession provides an ideal opportunity to shape its future in a way that is beneficial for the client, family and healthcare providers, and can flex, change, and develop as new knowledge about the impact of ABI [acquired brain injury] and the delivery of neurorehabilitation is created.
“The future shaping of case management requires collaboration between academic researchers and case managers, utilising the expertise of case managers, to generate research which ultimately produces better outcomes for clients and families.”
Read the full report here: https://www.tandfonline.com/doi/full/10.1080/02699052.2024.2438785#abstract
