MAXIMIZING VOCATIONAL OUTCOME AFTER BRAIN INJURY - INTEGRATION OF MEDICAL AND VOCATIONAL HOSPITAL-BASED SERVICES

Objective: To describe a medical and vocational case-management system that has been implemented at the Mayo Medical Center in Rochester, Mi nnesota, to decrease the time between onset of brain injury and succes sful community reintegration. Design: Barriers to employment are ident ified and targeted as part of a system that integrates medical center- and community-based services. Material and Methods: The success of th e project will be determined by several sources, including the Mayo-Po rtland Adaptability Inventory, a vocational rating scale, and traditio nal measures of vocational success (for example, level of independent living, job type and setting, rate of pay, and the type and cost of vo cational supports being used). Overall study outcomes will be compared against benchmarks derived from the literature on vocational outcome after brain injury. Results: Preliminary data are encouraging that pro ject goals are attainable. The medical case-management system has decr eased the amount of time between injury and initiation of vocational a nd other rehabilitation services. During the first year, 67 persons wi th brain injury began receiving vocational services through the projec t, and 34% are in community-based nonsheltered work or training progra ms. Second-year data will reveal whether the goal of 70% placement wit hin 9 months after admission to the project can be maintained.