Clinical pathways in head injury: improving the quality of care with early rehabilitation.

PURPOSE To improve the management of all hospital admissions with head injuries, including mild and moderate by developing a clinical pathway and a head injury team. METHODS A head injury team was set up to take over the care of all admissions with head injury and to manage appropriate referrals and discharges. A key role was to facilitate communication between the different services involved in head injury care, arrange follow-up, support relatives and to educate healthcare staff. RESULTS In the first year, the team took over the care of 196 admissions of whom 128 attended for 3-month follow-up with 66% having a good outcome. Patients and relatives feedback was excellent with an average score of 4.8/5 on overall satisfaction rating. Other centers in the United Kingdom are aiming to set up similar pathways, and the team has presented on head injury pathways extensively. CONCLUSIONS A clinical pathway can improve the quality of care for all admissions with head injury and enhance the role for rehabilitation at an early stage.