Each year, more than 20,000 Danes are diagnosed with a brain injury, the majority after a haemorrhage or blood clot in the brain. In eastern Denmark, the most serious brain injuries are referred to the Department of Highly Specialised Neurorehabilitation/Traumatic Brain Injury, which holds some of Denmark's best specialists in the area.
However, the journey back to normal life after a severe brain injury is long, and much of the rehabilitation process is run by the municipalities. Therefore, Rigshospitalet is now establishing a function to support and develop municipal rehabilitation.
"We’ve set up a two-year project in collaboration with four municipalities: Helsingør, Brøndby, Slagelse and Guldborgsund.
Together, we’re now in the process of organising a programme for competence development in which municipal nursing staff and therapists can take competence development courses with us immediately after the summer holiday," said Hanne Munk, who is a senior therapist at the Department of Highly Specialised Neurorehabilitation/Traumatic Brain Injury. She elaborated:
"Furthermore, we’re setting up a task force that initially will enable the four participating municipalities to draw on a team of specialists from the department if they experience difficulties with rehabilitation for a patient.
If the municipal staff find themselves in a situation where they can’t get anywhere with a patient with swallowing difficulties, for example, our team can either go out to the municipality, or they can see the patient at our outpatient department: whatever’s best.
Then our specialists will advise them about how they can work on precisely the challenges they are facing in the specific situation. This will benefit the individual patient, and I hope it will also generate knowledge that can spread further in the municipal team in the future".
Hotline welcomed
The initiative is being supplemented by a telephone hotline open for healthcare professionals from all municipalities, as well as general practitioners in all of eastern Denmark. They can ring the hotline with any patient issues: trivial or serious. The lines opened in late March 2019, and the service was welcomed by the municipalities.
Lyngby-Taarbæk Municipality has a large rehabilitation unit with 40 beds. Occupational therapist Camilla Elvig and physiotherapist Martin Suhrke look forward to drawing on the skills of the experts from Rigshospitalet:
"Even though we have a relatively large department, with a broad professional expertise and many opportunities for advice among colleagues, it will be good to be able to call a team of experts and ask for specific advice," said Camilla Elvig and Martin Suhrke continued:
“It’ll be extremely relevant, if it can be as specific and close to the individual scenario, as possible. For example, if you could talk with the physicians and therapists who worked with patients before they were discharged and transferred to us.
But I can also see the relevance of the cross-disciplinary training course, because even though we have broad expertise here at the centre, there are also more specialised treatment options we could benefit from knowing more about.”
National model
The task force from Rigshospitalet will be set up with a grant from the Danish Health Authority of DKK 2.2 mill. A similar service based at the Hammel Neurocenter in Jutland will also be established so that municipalities from the whole of Denmark can draw on the same knowledge.
"Overall, we can see that there is a great difference between the municipal rehabilitation services. This is of course linked to the correspondingly large differences between municipalities. We’re collborating on projects with Hammel Neurocenter so that we can establish a relevant nationwide service to share knowledge and upskill staff,” said Hanne Munk.
Facts about the Department of Highly Specialised Neurorehabilitation/Traumatic Brain Injury
- The department receives around 100 patients a year, all of whom undergo individual programmes.
- A total of ten different specialist groups working with rehabilitation at the department.
- Patients are typically admitted after road accidents or other accidents, asphyxia after a heart attack, infectious diseases of the brain and severe blood clots or haemorrhage.
- Even though patients are all very seriously injured on arrival, around 40% of them are ultimately discharged to their own homes.