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Clinical Outcomes: Why and How We Show Our Work

By Victoria Harding, PhD, CCC/SLP, MBA, Vice President of Development

Individuals recovering from brain injury, their families, and their funders are guided by many support professionals, programs, and services which can improve physical and cognitive abilities, help adjust to disability, and actively participate in their community. The features and benefits of neurorehabilitation programs are important, but there are additional considerations. Environments of care, caring and skilled staff, compassionate clinicians, peer support, safety, and effective communication are all additional details of a quality program. But truly, the goal of a neurorehabilitation program is to support each person served to achieve a measurable outcome, and demonstrating significant improvement in functioning by the time of discharge from the program.

Approximately ten years ago, NeuroRestorative changed outcomes’ collection, organization, and reporting structure. Resources were invested into establishing a team dedicated to a national system-wide outcomes program. The goal was to provide a meaningful understanding of the necessary ingredients about the persons and programs that influence positive gains and contributes to each person’s “life work” following a brain injury. Our team researched many measures but focused on the Mayo-Portland Adaptability Inventory – 4 (MPAI-4) and the Supervision Rating Scale. These instruments provide a system-wide assessment of disability and supervision needs as the individual progresses toward independence after brain injury. Measuring progress and outcomes also assists in meeting our obligations to follow an evidence model of care for our funders. Examples of improvements include:

• Monitoring each individual’s gains and prevent regressions using real data
• Transparency of clinical results
• Forecasting an individual’s recovery
• Comparing programs across the country to monitor quality
• Measuring the durability of our outcomes
• Using our data to answer important research questions, advocate and educate