The Statewide Brain and Spinal Cord Injury (BaSCI) Project

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Initiative Type
Service Improvement
Status
Deliver
Added
25 January 2023
Last updated
16 February 2023

Summary

The Statewide Brain and Spinal Cord Injury (BaSCI) project will implement key actions in the Statewide adult brain injury rehabilitation health service plan 2016-2026 and the Statewide adult spinal cord injury health service plan 2016-2026 to support standardised access to services and improve data collection to enable considered service monitoring and ongoing improvement. Additionally, models to improve access to specialist rehabilitation services will be implemented by participating Hospital and Health Services (HHSs) across the state. These will overcome existing barriers and boost service and system capability and capacity. 

Key dates
Jul 2021
Jun 2025
Implementation sites
Townsville HHS, Sunshine Coast HHS, Metro North HHS, Metro South HHS, Gold Coast HHS.
Partnerships
Six Hospital and Health Services

Aim

The Statewide BaSCI Project aims to improve health services and patient outcomes for people with acquired brain and/or spinal cord injuries in Queensland requiring adult specialist rehabilitation care.  By providing  timely access to safe and quality networked care that is closer to home patients will transition to the community in a supported way with improved outcomes and experiences. 
 

Benefits

  • Equitable and timely access to specialised brain and/or spinal cord injury rehabilitation, transition and outreach support services in Queensland, regardless of where a patient lives
  • Improved patient experience and outcomes 
  • Increased capacity and capability of specialist brain injury and spinal cord injury rehabilitation, transition and outreach services to provide optimal person-centred care and meet increasing service demand 
  • Reduced variation through improved coordination, consistency and standardisation of care processes within and between services
  • Enhanced data collection to demonstrate improved outcomes, efficiency and effectiveness
     

Background

Health services required for people with acquired brain injury (ABI) and spinal cord injury (SCI) are resource intensive being both highly specialised and costly to provide. This has resulted in ABI and SCI services being offered in single or minimal locations. This centralised service model may have a detrimental effect on the experiences and outcomes of patients and their families who do not live locally.  
The Statewide adult brain injury rehabilitation health service plan 2016-2026 and the Statewide adult spinal cord injury health service plan 2016-2026, seek to address such inequities, and consequently access and patient outcomes by broadening delivery of high-quality specialised rehabilitation services and skills in Queensland. Funding from the Commonwealth Community Health and Hospitals Program (CHHP) will enable Queensland Health to implement actions in the plans to improve adult brain and spinal cord injury rehabilitation services.  
 

Solutions Implemented

System level actions underway: 

  • Developing standardised access pathways for spinal cord injury and acquired brain injury across Queensland that are patient centred and based on clinical need
  • Improving data collection including development of ABI and SCI minimum data sets to support service planning, performance monitoring and continuous improvement 

QuickStart for Spinal Cord Injury
Due to the current issues with access and flow through the Spinal Injuries Unit at the Princess Alexandra Hospital, the Queensland Spinal Cord Injury Service (QSCIS) identified a need for an in-reach service to support patients with newly acquired SCI, and their referring team, while they wait. QuickStart is a new service model in Queensland that addresses the risk to safety and outcomes caused by long delays to admission by enabling early consultation and planning with a team of multi-disciplined specialists in SCI care. 
The project also includes delivery of an online education and resource library for clinicians working in general teams who may not have currency of practice with SCI.  
In partnership with QSCIS, several sites are also working to embed staff in the HHS to better link and integrate for an improved and networked service. 

Expanding Specialist Acquired Brain Injury Rehabilitation 
The Brain Injury Rehabilitation Service (BIRS) at Princess Alexandra Hospital has historically been the only identified specialist brain injury rehabilitation service in Queensland. BIRS offers services across the rehabilitation continuum to accepted patients including inpatient care at the Brain injury Rehabilitation Unit (BIRU), a specialised transitional rehabilitation service at ABI-Transitional Rehabilitation Service (TRS) and an outreach service through Acquired Brain Injury Outreach Service (ABIOS). 
The Statewide plan captured a need to build capacity and capability across the state to meet both the high demand for service and the consumer desire for care closer to home. Under the project a range of interventions relevant to local service context and community need are being implemented at the six (6) HHS identified in the plan: Townsville  (THHS), Sunshine Coast (SCHHS), Metro North (MNHHS), Metro South (MSHHS), Gold Coast (GCHHS) and Children's Health (CHHHS). 

These so far include but are not limited to: 
•    Neuro-Intensive Day Rehabilitation Service (SCHHS) 
•    new BIRU, STARs (MNHHS) 
•    expanded and coordinated comprehensive ambulatory models (THHS, MNHHS, GCHHS) 
•    culturally safe ABI service model for First Nations People (THHS) 
•    complex concussion clinics (THHS, SCHHS, MSHHS) 
•    community ABI rehabilitation models (MNHHS, MSHHS) 
•    local ABI service mapping and internal pathway redesign (THHS, SCHHS, MNHHS, MSHHS, GCHHS)

Evaluation and Results

A full evaluation of the implementation and outcomes of the Statewide BaSCI Project will be undertaken April - June 2025.

Early results of collected data show QuickStart for Spinal Cord Injury has significantly decreased the waiting time for access to specialist SCI care for patients with newly acquired injuries through early consultation, liaison and planning. Additionally, a proportion of referred patients have been successfully transitioned to the community from their referring facility, avoiding the need to travel for inpatient care and allowing them access to specialist expertise and support from QSICS while remaining close to their family and community.

Furthermore, the range of strategies being implemented to Expand Specialist Acquired Brain Injury Rehabilitation in Queensland have impacted the way patients are moving through the system and enabling provision of specialist care closer to home including earlier transitions to non-admitted models that support patients out of hospital following an ABI. 
 

Lessons Learnt

To date the role of partnerships between service providers is a critical enabling factor for the project. Continued investment in actions to build collaboration will be supported by the project. 
 

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Key contact

Louise O'Reilly
Principal Project officer
Healthcare Improvement Project
07 33289408
louise.oreilly@health.qld.gov.au

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