Perinatal Brain Injury: Improving Access to Care and Outcomes

Olga Morozova, MD, Patricia O'Berry, APRN Pediatric Rehabilitation Medicine

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Perinatal brain injury is a cause of the majority of developmental disabilities in young children. It is defined as occurring between the 22nd week of gestation and the 7th day of life. Early diagnosis and treatment are crucial in ameliorating the consequences of the injury. Close follow-up that is coordinated to meet the needs of the infant and family is necessary to create a treatment plan that includes early and intensive therapeutic interventions.²

Parents of children with special health care needs report frustration with care for their children that is uncoordinated and fragmented. The parents require additional support to provide safe and timely care for their child at the time of discharge from a hospital. This is especially important for a newborn who is in need of specialized care due to perinatal brain injury.¹

¹R Cady, et al. (2014). Attributes of advanced practice registered nurse care coordination for children with medical complexity. Journal of Pediatric Health Care 28(4), 305-312. Doi: 10.1016/j.pedhc.2013.06.005. ²G Cioni, et al. (2011) Perinatal brain damage in children: Neuroplasticity, early intervention, and molecular mechanisms of recovery. In O. Braddock, et al. (Eds.) Progress in Brain Research (pp. 139-154) New York: Elsevier. ³J Petitgout, et al. (2013). Development of a hospital-based care coordination program for children with special health care needs.

Journal of Pediatric Health Care 27, 419-425. Doi: 10.1016/j.pedhc.2012.03.005.

Barriers to follow up care³

Multiple subspecialists

Difficulty in obtaining timely and coordinated follow up appointments

Lack of information and access to providers

Address some of the concerns and stressors

Combine providers from Rehabilitation Medicine, Neonatal Neurology, Physical & Occupational Therapy in a single clinic

Improve access to care by a seamless integration of inpatient consultation with early outpatient follow up

Facilitate communication between the teams: Rehabilitation, Neonatal Neurology, Neonatology, PT, OT

Start parent education and counseling at bed side

Creation of Perinatal Brain Injury Clinic (program) in 2007 was designed to:

Our growth

Olga Morozova, MD

Taeun Chang, MD

Tammy Tsuchida, MD

Julie Smolinski, PT, DPT

Pat O’Berry, APN

Our Team

Aditi Kulkarni, OT