Concussion Service - ACC

1 July 2019 Concussion Service Operational Guidelines - version 3 Page 1 of 64 Concussion Service Operational Guidelines This guide is to be read in conjunction with ACC s Standard terms and conditions and the Concussion Service Specification 1 July 2020 Version 3 This is a living document and will be updated as required the latest version is available on July 2019 Concussion Service Operational Guidelines - version 3 Page 2 of 64 Contents Contents 1. Introduction to Concussion services .. 6 2. Purpose .. 6 3. Philosophy .. 6 Individual needs.

2 6 Interdisciplinary team .. 6 Relationships .. 7 4. Service objectives .. 7 5. Useful contact numbers .. 7 6. Concussion Service Forms .. 8 7. Responsibilities .. 8 Supplier responsibilities .. 8 Client responsibilities .. 10 ACC responsibilities .. 10 8. Communication protocols .. 11 Relationship expectations .. 11 Communicating instead of reporting .. 11 9. Service End to End Process .. 12 Service Item Codes .. 14 Table 1 Use of Service item codes for the different activities in the Service .. 14 10. Client eligibility .. 15 Table 2 - Client eligibility criteria .. 15 Clinical diagnosis - severity of injury .. 15 Table 3 - Severity of the TBI at the acute stage.

3 15 11. Service Delivery .. 16 Referral .. 16 The referral form .. 16 Letters of referral .. 17 Who cannot refer? .. 17 Accept or decline .. 17 Initial purchase order .. 17 Table 4 - Initial purchase order codes (note: only the TBI21 and TBI29 will be shown on the initial purchase order) .. 17 Investigation of clinical and psycho-social background of client .. 18 July 2019 Concussion Service Operational Guidelines - version 3 Page 3 of 64 Investigation and Triage .. 18 Process map 2 - Investigation and Triage pathway .. 19 Gathering of Clinical Notes .. 19 Case Reviews .. 20 Diagnosis.

4 20 Providing Education (TBI21) .. 21 Table 5 - Education (TBI21) must cover, but not be limited to, the following items: .. 21 Triage .. 22 Table 6 Triage activity .. 22 Assessing risk to recovery .. 22 Assessment of Therapy Needs .. 23 Planning Rehabilitation .. 23 Use of time Number of hours required .. 23 Service Timeframes .. 24 Table 7 - Timeframes and responsibilities for delivering the Service .. 24 Therapy .. 24 Key worker/coordinator .. 24 Interdisciplinary Teams .. 25 Specialist paediatric 26 Notifying ACC of client progress .. 26 Clinical notes and records kept by the interdisciplinary team .. 26 ACC may request clinical notes.

5 27 If a detailed report is requested by ACC .. 27 Sharing of Client Clinical Information .. 27 Referrals to Other Specialists for Assessment (TBI25) .. 27 Links with Community Service Providers .. 27 12. Service Administration .. 28 Service location .. 28 Clinic setting .. 28 Situations where it may be appropriate to provide services in a community setting .. 28 Remote or Distance Rehabilitation - TeleRehab .. 28 Maximum duration for delivery of Service .. 29 Timeframes .. 29 July 2019 Concussion Service Operational Guidelines - version 3 Page 4 of 64 Table 8 Completing ACC884 setting out services and hours required.

6 29 Service time .. 29 Maximum funding limit .. 30 Purchase orders .. 30 Completing or extending the Service .. 30 Other ACC services .. 31 Client non-attendance .. 31 Invoicing the Client for non-attendance .. 32 Service exit due to non-attendance .. 32 Client exit .. 32 Post- Service Client support .. 32 Exclusions .. 32 13. Invoicing ACC .. 33 Reimbursement of costs when requesting a copy of Client Clinical Notes .. 33 Invoicing for services .. 33 Travel costs .. 35 14. Quality services .. 37 Qualifications, Experience and Supervision Requirements for Service Providers .. 37 Table 9 Qualifications criteria of the members of the Interdisciplinary Team.

7 37 Approval of Service Providers .. 41 ACC Approval required for the following Service Providers: .. 42 Qualified Trainees .. 42 Allied Health Trainee health professionals .. 43 Psychology Student/Interns .. 43 Medical 43 15. Supplier and Service Performance .. 43 Supplier Performance Measures .. 44 Table 10 - Supplier performance measures .. 44 16. Health and Safety .. 45 Working with clients who may pose a health and safety risk .. 45 Communication regarding care indicated clients .. 46 Stopping an assessment .. 46 Reporting health and safety risks and incidents .. 46 17. Resolving issues (escalation process) .. 46 July 2019 Concussion Service Operational Guidelines - version 3 Page 5 of 64 18.

8 48 Appendix 1: Risk to recovery assessment matrix .. 48 Appendix 2: Neuropsychological assessment guidelines .. 56 Appendix 3 - Useful Resources for Children and Young People with Concussion .. 62 Version Control - Log of Changes to the Concussion services Operational Guidelines .. 63 July 2019 Concussion Service Operational Guidelines - version 3 Page 6 of 64 1. Introduction to Concussion services Concussion is the most common type of Traumatic Brain Injury (TBI) and refers to mild to moderate TBIs (MTBI). MTBI is a technical term used more commonly in general medical contexts.

9 However, the term Concussion is still commonly used in sports medicine and is used here to describe this Service . Concussion is frequently defined as a head injury with brief loss of brain function and can also cause physical, cognitive, and emotional symptoms. There does not have to be an observed loss of consciousness. The Concussion Service is based on rehabilitation best practice and recognises the bio-psycho-social model. The Service works holistically and is flexible to best meet the rehabilitation needs of the Client while recognising the legal responsibilities of ACC and the Supplier. The Concussion Service (CS) is an interdisciplinary Service consisting of triage, assessments and therapy to support Clients to recover from a mild to moderate traumatic brain injury and return to everyday life.

10 The Concussion Service also aims to prevent long-term consequences by identifying Clients at risk of persisting symptoms and providing them with effective interventions and education. Education is also provided to clients to reduce the incidence of re-injury. 2. Purpose The purpose of the Service is to: Support Clients recovery and prompt return to their everyday life, including work or school; Reduce the incidence of long term consequences, such as persisting Concussion symptoms, by identifying Clients likely to develop long term consequences and provide them with education and effective interventions.