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Brain injury case management

The clinical usefulness of data analysis

Cathy Warne of StanleySmith Case Management discusses how it can be crucial in effective rehabilitation

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Through the capture and analysis of data, clients and teams can be supported in ways that are often hugely difficult without the collection of such information. 

Cathy Warne, clinical support case manager at StanleySmith Case Management, details the importance of data collection and effective analysis in rehabilitation 

 

Whereas in the early years of case management decisions were based on intuition and judgement calls, or time-consuming analysis from paper records, now we are very much a profession embracing the power of digital. 

We have systems that enable quick and easy-to-complete electronic forms, which can be updated and shared with key people instantly. Rather than wading through the traditional paper-based records, this is immediate, with notifications you can act on as soon as they arrive. 

And with this instant digital information comes hugely valuable data. The quantifiable information that allows you to see what works and what doesn’t; how a client responds to rehabilitation; the progress they’re making; the performance of teams and what more they need. All supported by statistics, which are at our fingertips whenever we need them. 

But are we making best use of this data? While we all know it is there, are we analysing it regularly and thoroughly, to be able to make judgement calls based on factual evidence, and give the best possible rehabilitation potential to our clients?

At StanleySmith Case Management, we are keen adopters of data analysis. While I would not call myself a data analyst, nevertheless this scrutiny of clinical information is a key part of my role as a clinical support case manager and something we see regularly – among both clients and our team – exactly how worthwhile it is to assess the data for the good of everyone involved. 

Supporting clients

Clients’ daily support records, incident reports and some therapy session records are, for many case managers, now routinely received digitally and shared instantly among those who need to see them. So, we really do have the data at our fingertips. 

I probably first became aware of the value of data collection about ten years ago, in capturing evidence to support a young man in his ambition to live independently. While this was not entrenched in routine practice at that time, the value of this – and its impact on informing the care experts and in turn supporting his litigation settlement – was hugely important to his whole family. 

There are have been many other cases over the years where the analysis of relevant data has proved really valuable to rehabilitation. As one example, I worked with a teenage girl who lived with behavioural difficulties and a mild learning disability as a result of brain injury. We saw the problems she experienced with sleep and the impact this had on her family, so devised a bespoke form capturing episodes of waking between the client first going to bed each night and rising for each day, which her mum completed daily over the course of a month, so we could gain the evidence to support our knowledge around the problem. 

The records kept by her mum – which we created primarily in a tick-box format, to make it as quick and easy to complete as possible – helped us to evidence what she had exhaustedly tried to communicate to the therapy and legal teams. As well as supporting more tailored care and recommendations, it also informed statutory service assessments, and may yet help with a continuing healthcare funding application. 

There is also the example of a young man, who we saw from support work notes had been experiencing some bowel-related issues after consuming certain food and drink, which then contributed to behavioural challenges. You can only ask the ‘right question’ to be able to pull out the right information through being aware of the challenge, so by this link being made known, we could then collect the data to support that, creating colourful and engaging charts to discuss with this man’s family and support team, so that changes could be reasoned, understood and followed through. 

By having this evidence in place, the impact can truly be life-changing for clients and families, who may have been battling particular issues for some time.

The award-winning StanleySmith team brings together a breadth of expertise

Support for the treating team

For clinical professionals, in supporting our clients to the absolute best of our abilities, we benefit greatly from having the opportunity to reflect and offload with colleagues. By taking the time to do this, we can support each other in being able to best support our clients.

At StanleySmith, the wellbeing of our team is paramount, and we are committed to their welfare and protecting them from burnout. As well as holding psychologist-led mentoring for case managers, we often provide psychologist-led reflection and development sessions for teams supporting clients, which gives the opportunity to share experiences and offload in a supported environment. We have seen the value this brings to us as individuals and as a team in being able to be at our very best in doing our jobs. 

And data also has a place in this process. As well as discussion, the collection of evidence and statistics to support change is also very important, in matters ranging from staff development and progress, through to CQC-informing information. But it can also be applied in more ways. 

As an example, a clinical psychologist and case manager sought evidence around the psychology input for a man whose brain injury resulted in behavioural difficulties that led to him being well known to police. Through creating a survey/questionnaire for team members, they were able to clarify that the team did find the psychology input very helpful and supportive – giving reassurance for the professionals involved that the strategy being taken was effective. 

Additionally, data gathering is effective in gauging happiness and wellbeing of team members more generally, and that is a very important process to undertake. We have recently sent out questionnaires to our support workers, and their views are crucial in us being able to gather and assess the data to see what is working and what we could do better.

Effective analysis

While it may be seen as more of an admin role than something for a case manager, there is great importance for a clinical focus in shaping the questions that are asked on the forms and analysing this kind of information. 

In my role, I personally look at data in the context of my role and with my clinical background. My years of experience of working in this field mean I understand the clinical and claims process, and how they work together for the good of the client, and data should be captured and assessed in support of that. 

With deep knowledge and experience, you can shape the questions and format accordingly, to ensure the information you gather is entirely relevant to the client or/and the wider team and their best interests. By understanding the clinical implications, you can anticipate that and contribute meaningful suggestions and solutions.

I am very pleased to see data now becoming more widely adopted in case management, and I would encourage those who do not use it – or don’t use it to best effect – to look at how they can do so. 

The addition of evidence-based statistics into the rehabilitation process can be invaluable, as I have seen now for over a decade, and can support clients, families, teams and individual team members to feel heard and for change to be made in ways which previously may not have been possible.  

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