EDITORIAL PANEL: Chad T. Rodgers, MD, FAAP | Elena M. Davis, MD, MPH | Shannon Edwards, MD | William L. Mason, MD | J. Gary Wheeler, MD, MPS
Resource Update for
Traumatic Brain Injury Patients
TERRI IMUS, RN, BSN, and KIM LAMB, MS
Each year, approximately 25,000
Arkansans are treated in
emergency departments for a
traumatic brain injury (TBI). 1 Of
those injuries, about 400 are moderate
to severe. Within a year following
their incident, 22% of TBI patients
are readmitted to the hospital. 2 The
high level of hospital readmissions is
frequently due to the number of TBI
survivors who live in rural or medically
underserved areas of the state.
The Centers for Disease Control
and Prevention (CDC) defines a TBI as
a disruption in the normal function
of the brain that can be caused by a
bump, blow or jolt to the head or a
penetrating head injury. 3 Nationwide,
approximately 2.5 million Americans
a year experience a TBI-related injury
serious enough to visit an emergency
department. 4
Treatment of TBI survivors in
Arkansas significantly changed
with the development of the
Arkansas Trauma System (ATS) in
2009. 5 The Arkansas Department of
Health assumed management of
the ATS and its related programs
in 2010. Reporting TBIs to the ATS
became law in 2010. 6 Public and
private health and social agencies
and attending physicians are now
required to enter newly-identified,
moderate-to-severe TBIs into a statewide
registry — the Arkansas Traumatic
Brain Injury Registry (AR TBI).
The AR TBI Registry was launched
in 2013 with the help of the Brain
Injury Alliance of Arkansas and the
Arkansas Spinal Cord Commission.
It is managed by the University
of Arkansas for Medical Sciences
(UAMS) under the administration
of the Institute for Digital Health &
Innovation (IDHI).
Since 2013, the AR TBI Registry
has documented 2,450 moderate-to-severe
TBI injuries in Arkansas.
Plans are to expand the registry
to include acquired brain injuries
that are not hereditary, congenital,
degenerative or induced by birth
trauma 7 and mild brain injuries,
known as concussions. Data gathered
from follow-up services and the
AR TBI Registry enable other agencies
and organizations to plan TBI
prevention and recovery efforts.
Providing services and support
to all TBI survivors could potentially
improve the quality of life for
thousands of Arkansans. Individuals
documented in the TBIR receive
follow-up care, including resources
and guidance to help them return to
work or school and attain the highest
possible level of independence.
Follow-up care includes discussions
with adult survivors, their caregivers
and family members who can
provide a unique perspective about
survivors’ needs.
In 2018, UAMS received grant
funding from the Administration for
Community Living Traumatic Brain
Injury State Partnership Program
(SPP). The SPP grant has helped
improve resources and care via a
statewide advisory board, state
plan, developing a trust fund/
waiver program and outreach to
TBI survivors in underserved and
rural areas. The advisory board
workgroup meets quarterly to learn
about legal concerns, provider
reimbursement funds, housing
assistance and private fundraising.
The SPP grant provided funding
to develop a statewide plan. Data
for the plan is collected on the TBI
website, 8 surveys of survivors and
stakeholders, and discussions with
treatment staff. Once complete, the
statewide plan will provide goals and
recommendations to provide case
management, increase access to
rehabilitative services, and develop a
trust fund and/or waiver program to
36 • The Journal of the Arkansas Medical Society www.ArkMed.org