Making a Difference with Brain Injury

Research

The TAC/ISCRR partnership

Professor Alex Collie

CEO, ISCRR

ISCRR is a collaboration with its base at Monash, formal links with the TAC and Worksafe and an expert research network spanning multiple universities.

2

Transport Accident

Commission

ISCRR HQ

N=20

Monash-based research network

N=50-60

Worksafe Victoria

Our mission …

• To collaboratively develop, execute and translate the highest quality research which helps the TAC and WorkSafeoptimise their outcomes and those of their clients.

Fewer and less severe injuries and diseases

Financial sustainability

Greater health, vocational and

social outcomes

The best possible client

experience

Our Approach

Conventional research funding approach

ISCRR approach

Researcher – driven agenda Collaborative / end-user driven agenda

Emphasis on discovery of new knowledge

Outcome oriented, focus on implementation of knowledge and

behaviour change

Objective = publication of findings Objective = use of findings

Often independently conceived and managed

Strong emphasis on partnership and collaboration

Activity across broad range of subject areas

Activity restricted to defined subject areas (TAC priorities)

TRAUMA RESEARCH IN VICTORIA

Trauma Research Investment by the TAC in Victoria

•Occasional project funding

Pre-1999

•Victorian Trauma Foundation

•Pre-hospital / acute care

1999-2006

•Victorian NeurotraumaInitiative

•Biomedical, Acute care & Rehab

2005-2010

•ISCRR

•Rehabilitation and Lifetime Care

2011-2015

• >$100m invested over 15 years from 2000• Brain and Spinal Cord injury focus• Broad range of research supported:

• Biomedical / ‘blue sky’ research• Pre-hospital and acute care• More recent focus on community rehabilitation and lifetime care

• Range of partners involved

TAC has been the largest supporter of applied brain injury research in Australia.

• Motor vehicle accidents are the most common mechanism of moderate / severe brain injury.

• TAC provides funding for lifetime care and support for those injured on a no-fault basis. (~$3.5m per seriously injured client)

• Research can improve health and social function for people with TBI and reduce costs to the insurance scheme.

Strategic investment in trauma care can make a big difference….

Reduction in odds of in-hospital death following road transport related major trauma in Victoria.

Gabbe B et al. Annals of Surgery 2015: 261(3); 565-572.

Strategic investment in trauma care can make a big difference….

Reduction in disability adjusted life years (and associated health costs) per case in Victoria. Gabbe B et al. Annals of Surgery 2015: 261(3); 565-572.

Trauma Research Investment by the TAC in Victoria

•Occasional project funding

Pre-1999

•Victorian Trauma Foundation

•Pre-hospital / acute care

1999-2006

•Victorian NeurotraumaInitiative

•Biomedical, Acute care & Rehab

2005-2010

•ISCRR

•Rehabilitation and Lifetime Care

2011-2015

• >$100m invested over 15 years from 2000• Brain and Spinal Cord injury focus• Broad range of research supported:

• Biomedical / ‘blue sky’ research• Pre-hospital and acute care• More recent focus on community rehabilitation and lifetime care

• Range of partners involved

NEUROTRAUMA STRATEGY 2011 - 2015

Partnership approach

12https://neurodevnet.wordpress.com/2015/05/01/research-partners-research-users-and-research-impact/

Neurotrauma Research Strategy 2011 - 2015

Priority 1. Models of lifetime care

14

• Attendant Care

• Accommodation

• Community Integration

Person

Lifetime care research (SmILE program)

15

RIPL evaluations

TAC has invested $30m to design and deliver

new accommodation for clients with high and

complex care needs.

Abbotsford, Lilydale, Frankston, Glenroy.

Pre- and post-occupancy evaluations underway.

Results so far have led to changes to design brief

and support model.

17

Research Leads:Ms Libby Callaway, Monash SPHCMs Kate Tregloan, Monash MADA

Design strategies to improve client accommodationoptions and outcomes

• Objective: – To investigate how architectural design strategies can influence the

quality, performance and efficiency of new and retrofitted accommodation for TBI residents

• Rationale: – There is a client group with unmet needs - individuals with high and

complex care needs who have the potential to live more independently but who currently lack suitable accommodation options.

• Deliverables:– Best practice design manuals and procurement guidelines to support

home modifications and new builds funded by the TAC.

18

Research lead:Prof Nigel Bertram, MADA, Monash University

19

Priority 2. Improving Rehabilitation and Disability Management

• Challenging Behaviours

• ‘Slow-stream’ rehabilitation

21

Caulfield ABI rehab centre

22

Caulfield ABI rehabilitation centre

23

• New 42 bed inpatient and community rehab service for ABI.

• Opened in Sept 2014.

• 18 month project thru 2013/14 developed the evidence base for the model of care, based on international best-practice.

• Follow up project is evaluating the care model using an ‘audit and feedback’ / continuous improvement approach.

• Researchers embedded in the unit, working directly with staff and clients.

In total, under the Neurotrauma Strategy….

• $19.1m invested

• 45 projects initiated

– 29 with brain injury focus of which 11 complete

• Research activity continuing through 2018

24

INDEPENDENT REVIEW OUTCOMES

Key findings

• “The ISCRR Neurotrauma Research Program has developed a formidable suite of applied research that is expected to have a profound impact.”

• “The program has been successful, resulting in changes to client treatment methodology, strong client outcomes and benefits to the TAC”

• “Realising benefits from research within a five-year timeframe is extremely challenging.….”

Strategic Project Partners, December 2014

http://www.iscrr.com.au/research/programs/neurotrauma/neurotrauma-docs/neurotrauma-indp-review-summary.pdf

Estimated quality of life impact

27 Based on 8 projects evaluated for client quality of life impacts

Estimated financial impact

28Based on 6 projects evaluated for financial impact (total invested value $3.4m)

Case studies of impact calculation

29

THE FUTURE?

Trauma Research Investment by the TAC in Victoria

•Occasional project funding

Pre-1999

•Victorian Trauma Foundation

•Pre-hospital / acute care

1999-2006

•Victorian NeurotraumaInitiative

•Biomedical, Acute care & Rehab

2005-2010

•ISCRR

•Rehabilitation and Lifetime Care

2011-2015

• >$100m invested over 15 years from 2000• Brain and Spinal Cord injury focus• Broad range of research supported:

• Biomedical / ‘blue sky’ research• Pre-hospital and acute care• More recent focus on community rehabilitation and lifetime care

• Range of partners involved

Possible focus areas for the future?

• Implementing existing evidence

• Creating new evidence

• Maintaining critical data infrastructure

• Engaging the ABI community

33

Get in touch…

W: iscrr.com.au

E: alex.collie@monash.edu

@ISCRR

@axcollie