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Research Article  |   June 1996
Development of Critical Paths for Postacute Brain Injury Rehabilitation: Lessons Learned
Author Affiliations
  • Beatriz C. Abreu, PhD, OTR, FAOTA, is Director of Occupational Therapy, Transitional Learning Community at Galveston, 1528 Postoffice Street, Galveston, Texas 77550, and Clinical Associate Professor, University of Texas Medical Branch, Galveston, Texas
  • Gary Seale, MS, is Director of Community Re-entry, Transitional Learning Community at Galveston, Galveston, Texas
  • Joyce Podlesak, RN, is Director of Continuous Quality Improvement, Transitional Learning Community at Galveston, Galveston, Texas
  • Leila Hartley, PhD, is Director of Staff Development, Transitional Learning Community at Galveston, Galveston, Texas
Article Information
Neurologic Conditions / Traumatic Brain Injury / Research
Research Article   |   June 1996
Development of Critical Paths for Postacute Brain Injury Rehabilitation: Lessons Learned
American Journal of Occupational Therapy, June 1996, Vol. 50, 417-427. doi:10.5014/ajot.50.6.417
American Journal of Occupational Therapy, June 1996, Vol. 50, 417-427. doi:10.5014/ajot.50.6.417
Abstract

One important tool for case management is critical path analysis. This article explains four critical pathways developed by an interdisciplinary team for a postacute brain injury rehabilitation program. The heterogeneity of the brain injury population mandates the need for systematic coordination of direct care services. Yet, variations in the neurobehavioral consequences of brain injury necessitate differing goals and treatment tracks for individual clients. The critical pathways in this setting define and describe the procedures and services to be rendered from admission to discharge to achieve optimal goals for four treatment program tracks: Return to Work, Return to School, Functional Independence, and Neurorehabilitation. The tracks reflect a hierarchy of expectations for information processing and functional performance. Critical pathways provide a tool for enhancing communication among service providers and external case managers and for determining the extent to which a client’s course of treatment compares with a clinical standard considered to be ideal. This article compares the four critical pathways, provides representative case samples, and discusses lessons learned in the development and implementation process.