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 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
Partnership approach
12https://neurodevnet.wordpress.com/2015/05/01/research-partners-research-users-and-research-impact/
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.
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.
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Research lead:Prof Nigel Bertram, MADA, Monash University
Priority 2. Improving Rehabilitation and Disability Management
• Challenging Behaviours
• ‘Slow-stream’ rehabilitation
21
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
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)
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