DEVELOPMENT OF CRITICAL PATHS FOR POSTACUTE BRAIN INJURY REHABILITATION - LESSONS LEARNED

One important tool for case management is critical path analysis. This article explains four critical pathways developed by an interdiscipli nary team for a postacute brain injury rehabilitation program. The het erogeneity of the brain injury population mandates the need for system atic coordination of direct care services. Yet, variations in the neur obehavioral consequences of brain injury necessitate differing goals a nd treatment tracks for individual clients. The critical pathways in t his setting define and describe the procedures and services to be rend ered from admission to discharge to achieve optimal goals for four tre atment program tracks: Return to Work, Return to School, Functional In dependence, and Neurorehabilitation. The tracks reflect a hierarchy of expectations for information processing and functional performance. C ritical pathways provide a tool for enhancing communication among serv ice providers and external case managers and for determining the exten t to which a client's course of treatment compares with a clinical sta ndard considered to be ideal. This article compares the four critical pathways, provides representative case samples, and discusses lessons learned in the development and implementation process.