Investigating the model of community-based case management in the New South Wales brain injury rehabilitation program: a prospective multicenter study

Objective: To investigate a model of community-based case management (CM). Setting: New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP). Participants: All clinicians (N = 72) providing CM within 14 BIRP community rehabilitation teams. Design: A prospective, multicenter study. Main Measures: A purpose-designed survey. Methods: Participants from the 12 adult and 2 pediatric services (8 located in metropolitan areas, 6 in rural areas) completed a 3-part survey investigating their organizational context, clinical approach, and CM interventions. Between-groups analyses explored differences among individual services, as well as differences based on age (adult vs pediatric) and location (metropolitan vs rural). Results: All services provided a direct service model of CM. The underlying principles were uniform across services (more direct than indirect service provision; with more client-related than administrative-related tasks; more holistic than service-led in defining client needs; with decision making equally directed by staff and clients; and undertaking a more comprehensive than minimalist range of tasks). CM interventions included the provision of individual support, family support, advocacy, and community development alongside assessment, monitoring, referral, and liaison tasks. There were little differences in practice based on age or location. Conclusion: The NSW BIRP has drawn upon the results to produce a model of service for CM.