TY - JOUR
T1 - Minimum Competency Recommendations for Programs That Provide Rehabilitation Services for Persons With Disorders of Consciousness
T2 - A Position Statement of the American Congress of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research Traumatic Brain Injury Model Systems
AU - Giacino, Joseph T.
AU - Whyte, John
AU - Nakase-Richardson, Risa
AU - Katz, Douglas I.
AU - Arciniegas, David B.
AU - Blum, Sonja
AU - Day, Kristin
AU - Greenwald, Brian D.
AU - Hammond, Flora M.
AU - Pape, Theresa Bender
AU - Rosenbaum, Amy
AU - Seel, Ronald T.
AU - Weintraub, Alan
AU - Yablon, Stuart
AU - Zafonte, Ross D.
AU - Zasler, Nathan
N1 - Funding Information:
This position statement was developed under the American Congress of Rehabilitation Medicine Evidence and Practice Committee (ACRM EPC), which is supported by unrestricted grants from CARF International and Paradigm. Neither Commission on Accreditation of Rehabilitation Facilities International nor Paradigm were involved in any phase of the development of this statement. The recommendations and supporting text included in this article were developed through a collaboration between the ACRM and grantees of the National Institute on Disability, Independent Living, and Rehabilitation Research ( NIDILRR ). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government. Neither ACRM nor NIDILRR provided any funding to support this work. Portions of this article were presented at the annual meetings of the ACRM (2014) and the International Brain Injury Association (2016, 2017).
Funding Information:
This position statement was developed under the American Congress of Rehabilitation Medicine Evidence and Practice Committee (ACRM EPC), which is supported by unrestricted grants from CARF International and Paradigm. Neither CARF International nor Paradigm were involved in any phase of the development of this statement.The recommendations and supporting text included in this article were developed through a collaboration between the ACRM and grantees of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government. Neither ACRM nor NIDILRR provided any funding to support this work.
Publisher Copyright:
© 2020 American Congress of Rehabilitation Medicine
PY - 2020/6
Y1 - 2020/6
N2 - Persons who have disorders of consciousness (DoC) require care from multidisciplinary teams with specialized training and expertise in management of the complex needs of this clinical population. The recent promulgation of practice guidelines for patients with prolonged DoC by the American Academy of Neurology, American Congress of Rehabilitation Medicine (ACRM), and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) represents a major advance in the development of care standards in this area of brain injury rehabilitation. Implementation of these practice guidelines requires explication of the minimum competencies of clinical programs providing services to persons who have DoC. The Brain Injury Interdisciplinary Special Interest Group of the ACRM, in collaboration with the Disorders of Consciousness Special Interest Group of the NIDILRR-Traumatic Brain Injury Model Systems convened a multidisciplinary panel of experts to address this need through the present position statement. Content area-specific workgroups reviewed relevant peer-reviewed literature and drafted recommendations which were then evaluated by the expert panel using a modified Delphi voting process. The process yielded 21 recommendations on the structure and process of essential services required for effective DoC-focused rehabilitation, organized into 4 categories: diagnostic and prognostic assessment (4 recommendations), treatment (11 recommendations), transitioning care/long-term care needs (5 recommendations), and management of ethical issues (1 recommendation). With few exceptions, these recommendations focus on infrastructure requirements and operating procedures for the provision of DoC-focused neurorehabilitation services across subacute and postacute settings.
AB - Persons who have disorders of consciousness (DoC) require care from multidisciplinary teams with specialized training and expertise in management of the complex needs of this clinical population. The recent promulgation of practice guidelines for patients with prolonged DoC by the American Academy of Neurology, American Congress of Rehabilitation Medicine (ACRM), and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) represents a major advance in the development of care standards in this area of brain injury rehabilitation. Implementation of these practice guidelines requires explication of the minimum competencies of clinical programs providing services to persons who have DoC. The Brain Injury Interdisciplinary Special Interest Group of the ACRM, in collaboration with the Disorders of Consciousness Special Interest Group of the NIDILRR-Traumatic Brain Injury Model Systems convened a multidisciplinary panel of experts to address this need through the present position statement. Content area-specific workgroups reviewed relevant peer-reviewed literature and drafted recommendations which were then evaluated by the expert panel using a modified Delphi voting process. The process yielded 21 recommendations on the structure and process of essential services required for effective DoC-focused rehabilitation, organized into 4 categories: diagnostic and prognostic assessment (4 recommendations), treatment (11 recommendations), transitioning care/long-term care needs (5 recommendations), and management of ethical issues (1 recommendation). With few exceptions, these recommendations focus on infrastructure requirements and operating procedures for the provision of DoC-focused neurorehabilitation services across subacute and postacute settings.
KW - Best practices
KW - Brain injuries
KW - Coma
KW - Health services
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2020.01.013
DO - 10.1016/j.apmr.2020.01.013
M3 - Comment/debate
C2 - 32087109
AN - SCOPUS:85082651601
SN - 0003-9993
VL - 101
SP - 1072
EP - 1089
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 6
ER -