The transformational STEPS to Rehabilitation
Our client, a 50-year-old man, endured a life-altering traffic accident in 2023 that resulted in catastrophic physical injuries, including cranial injuries and skull fractures. In addition, he has faced the impact of a traumatic brain injury, leading to deep psychological and neurological impairment.
The client is a father of three children, ranging in age from 6 to 19, with the middle child being on the autistic spectrum. His wife, a dedicated NHS worker, found herself unable to work due to the overwhelming stress following her husband's accident and the effects on family life. As a result, the family has been grappling with the profound challenges posed by the accident and has struggled to cope with the resulting upheaval in their lives. In addition, the client’s elderly parents and in-laws experienced poor health, including a cancer diagnosis.
Sarah Novakovic has been appointed as the Case Manager to spearhead the client's rehabilitation journey. With a history of successful collaboration with STEPS Rehabilitation, Sarah is well-positioned to understand the benefits the facility can offer to her client. Leveraging her familiarity with STEPS, Sarah has been central to orchestrating a tailored and effective rehabilitation program that addresses the client's specific needs, ultimately guiding him towards a path of recovery and renewed independence.
Sarah Novakovic – Bush & Co Case Manager
With over a decade of experience in hospital settings and more than 15 years in the insurance and case management industry, Sarah brings a wealth of expertise to her role as a case manager. Her clinical background in surgery and intensive care within the NHS, including at Birmingham City Hospital and Sandwell and West Birmingham Hospital NHS Trust, has honed her specialisation in case management for clients with acquired brain injury, major trauma, complex orthopaedic injury, and the management of complicating factors such as pain management, spinal cord injury/mechanical ventilation, and poly-trauma/internal injuries.
Consistently receiving outstanding feedback from clients and instructing parties, Sarah is praised for her professionalism, attentiveness, and expertise and is adept at providing crucial psychological support to both clients and their families following catastrophic injury, a skill very much needed in this case.
Sarah's blend of clinical skills and experience in rehabilitation and injury case management equips her to effectively oversee the recruitment, coordination, and review of therapeutic and care teams to drive rehabilitation programs and ensure successful outcomes for her clients.
STEPS Rehabilitation
STEPS Rehabilitation is a leading provider of specialist rehabilitation services, dedicated to helping individuals regain independence and improve their quality of life. Its team of experienced professionals offers an integrated approach to rehabilitation that addresses both the physical and psychological aspects of injuries, including physiotherapy, occupational therapy, speech therapy, and cognitive rehabilitation.
They are committed to providing personalised care and support to individuals recovering from a wide range of conditions, including stroke, brain injury, spinal cord injury, and neurological disorders. At STEPS Rehabilitation, clinical professionals are passionate about empowering clients to achieve their rehabilitation goals and lead fulfilling lives.
Identifying client needs
Following the accident, the client's hospital stay was limited to just 2-3 weeks before he was scheduled for discharge, with little support in place to aid in his transition. Additionally, he was presenting signs of post-traumatic amnesia, struggling to recall essential information such as details of family names and other fundamental elements of his life. Concerns raised by his wife and a nurse from Headway, highlighted the severity of his condition, prompting the need for immediate and comprehensive intervention.
Sarah identified the client needed an extensive and coordinated rehabilitation programme upon conducting the Initial Needs Assessment, as he was unable to actively engage in the assessment and displayed numerous indicators signalling the urgent need for comprehensive intervention to address the profound physical and psychological trauma he had endured.
Addressing client needs
The initial task involved articulating the advantages of STEPS to the client and his family, emphasising how the client's compromised physical and mental state would greatly benefit from the diverse treatments available. Furthermore, it was crucial to convey that the limited neurological support available through the NHS underscored the critical need for the specialised care and resources provided by STEPS.
As the case manager, Sarah then prepared costings for two distinct rehabilitation programs: one centred on community-led rehabilitation and the other involving residential care at STEPS. Her recommendation was for the client to follow an initial 4-week rehabilitation programme at STEPS.The programme incorporated a cross-disciplinary approach integrating vital services such as physiotherapy, neuropsychology, speech and language therapy, dietician consultations, hydrotherapy, as well as additional specialised support.
Sarah received positive support from the insurer regarding her recommendation, ultimately securing an agreement to extend the rehabilitation program for an additional 4 weeks. The insurer was also receptive to expanding the support to include sleep studies after it was discovered that the client was suffering from apnoea, demonstrating a shared commitment to addressing the client's evolving needs. Throughout the rehabilitation, the insurer has remained engaged and has regularly participated in multi-disciplinary discussions regarding the client’s progress.
Among the key interventions at STEPS was the role the psychologist played in assisting the client to comprehend the nature of their brain injury and in reclaiming many of the cognitive functions that had become challenging since their accident. This support included aiding the client in retaining basic information, establishing regular eating habits, and remembering to take prescribed medication, ultimately facilitating significant progress in the client's rehabilitation journey.
STEPS took charge of coordinating all therapy schedules throughout the client's rehabilitation journey and worked closely with community teams both before and immediately after his discharge. This collaboration involved the sharing of detailed reports encompassing clinical observations from multiple therapies, including critical elements of neurorehabilitation, streamlining the transition of care, and saving valuable time.
The road ahead
The rehabilitation has now transitioned to a multi-disciplinary community team, where continued occupational therapy and support to address ongoing cognitive impairments is essential. Additionally, long-term pain management is a critical focus as the client continues their journey toward sustained recovery and improved quality of life.
It is anticipated that maxillofacial surgery may be required in the future, necessitating the input of a specialist consultant to assess the extent of treatment needed. Given the client's prior engagement in a senior sales position, concerns have arisen regarding his capacity for high-level decision-making following the accident. As a result, an assessment from a vocational case manager will be essential at a later stage to evaluate his ability to resume such responsibilities.
In summarising her work as the case manager so far and the role STEPS has played, Sarah comments:
There is no question the interventions provided by the team at STEPS have been critical to the successes the client has experienced in their rehabilitation so far. The profound complexity of the client's needs, added to the limited care plan in place following his initial discharge from hospital, necessitated a comprehensive rehabilitation programme and STEPS have been able to provide specialist care in all areas.