1. 1 Governor’s Task Force on Brain Injury November 6, 2013 Governor’s Task Force on Brain Injury November 6, 2013 Bryan Andresen MD Eugene-Springfield, OR

2.  Sacred Heart Med Center, Eugene-Springfield  Trauma Services  Inpatient neurology unit  In-patient rehab unit: Oregon Rehabilitation Center  Community Rehabilitation Services of Oregon  Agenda--TBI

3.  Level 2 trauma center  Calendar yr 2012 ◦ 140 patients admitted with TBI as Dx ◦ Disposition  45% Home  17% rehab  16% exp.  11% SNF  6% Home health Sacred Heart Med Ctr Trauma Services

4.  Advanced Primary Stroke Center ◦ Neurohospitalist ◦ Endovascular surgery ◦ 600-700 stroke patients/year SHMC-Neurology

5.  Oregon Rehabilitation Center ◦ Eugene-University District ◦ 18 beds ◦ 275-300 admissions/year ◦ Started 1976 ◦ Full rehab team  Rehabilitation physician  Rehab nurse  Physical/Occupational/Speech and Language therapy  Neuropsychology  Social worker/Care manager SHMC Inpatient Rehabilitation

7.  Program Objectives  individualized treatment plan with the patient and their family. We work with patients on:  Cognitive and functional abilities to facilitate the return to home or other community setting  Mobility and self-care skills  Neuropsychological testing  Behavioral programs for acute stages of recovery  Language and communication skills  Community mobility, resources and re-entry  Assessment of adaptive equipment needs  Supportive counseling for adjustment issues Oregon Rehab Ctr--TBI

8.  Number Served 51  Age Average Age 53 Age Range 18 to 84  Male/Female Ratio: 66%/34%  Average Length of Stay, Days 13.4 ORC-TBI Outcomes 2012

9.  Discharge setting: ◦ Home Setting (Percent) 42 (82.%) ◦ Long Term Care 6% ◦ Sub-Acute & Rehab 4% ◦ Acute 8% ORC-TBI

10.  Physical therapy ◦ Mobility/balance/vestibular ◦ Seating and wheelchair  Occupational therapy ◦ Self care ◦ Cognition  Speech therapy ◦ Cognition ◦ Language ◦ Swallowing  Neuropsychology SHMC—outpatient rehab

11.  Founded 1992.  Outpatient program  Who served: ages 13-64  Mild/moderate ABI  Medical and vocational programs  Assessments ◦ Cognitive screening ◦ Neuropsychological ◦ AD/HD ◦ Community based situational assessment ◦ Psychological ◦ Job site Community Rehabilitation Services of Oregon (CRSO)

12.  Med Rehab ◦ Cognitive rehabilitation ◦ Case management ◦ Psychotherapy ◦ Support Group-monthly  Vocational Rehab ◦ Situational assessments ◦ Job retention/work placement coordination Community Rehab Services of Oregon

13.  Private medical insurance  Automobile insurance  Worker’s comp  Vocational rehab ◦ Caseworker typically performs intake interviews at CRSO Funding sources

14.  1. Medical rehab  2. Vocational Assessment  3. Neuropsychological Assessment  4. Team meeting  5. Situational assessment  6. Team meeting  7. Job Search  8. Job placement  9. Follow-along  J Head Trauma Rehab, 2003. data collected by grant through Dept of Ed and OVRS Ideal process (rare!)