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TBI Program Validation Fact Sheet (Adobe PDF)
TBI Fact Sheet (Adobe PDF)
TBI Brochure (Adobe PDF)

The Rehabilitation and Reintegration Division (R2D), in collaboration with the Defense Veterans Brain Injury Center (DVBIC) established a validation program for all Army Medical Department (AMEDD) Medical Treatment Facilities (MTFs) that provide care for Soldiers with mild, moderate, severe or penetrating Traumatic Brain Injuries (TBIs). This validation program was designed to establish standards of care for Soldiers with TBI and to ensure that services, physical facilities, and staffing levels are consistent across the Army MTFs based on the level of care provided at the facility.

Program categories are based on the scope and depth of care offered. The validation is divided into four categories:

• Category 1:  Providing inpatient and outpatient care for the full spectrum of TBI severity (mild, moderate, and severe).
• Category 2:  Providing inpatient and outpatient care for mild and moderate TBI.
• Category 3:  Providing outpatient medical and rehabilitative care for Soldiers with mild and mild-moderate TBI.
• Category 4:  Providing outpatient medical care for Soldiers with mild TBI and refer for additional services as needed.

In efforts to enhance the quality of care being provided to our Soldiers and to make sure the facilities are delivering care with all the necessary guidance and tools, the TBI validation program was established. This validation program came as a recommendation from the TBI Task Force Report, released 17 January 2008. The Director of the Health Policy and Services Directorate is the validating authority.

The program management requirements for validation are divided into two phases: the initial validation and the full validation. The initial validation is awarded upon submission and verification of completion of Phase 1 requirements, while the full validation is awarded upon submission and verification of the implementation for the full program.

The criteria for the MTFs are divided by functional program areas in management, education, assessment, treatment, metrics.

Staff is being added at most large MTFs to support TBI care. The funding for this staff resource is from the supplemental funds that were provided to the Army in 2007 and 2008. Based on mission, current staff available, and projected TBI patient population the following teams were developed:

Detection and Initial Treatment Teams

Augmented Teams at high troop density sites. The staff, which consists of 6-14 personnel, are typically made up of a Primary Care Provider, Behavioral Health Provider, Nurse Case Manager, Administrative Staff, Licensed Practical Nurse, and Program Liaison.

Rehabilitation Teams

Augmented Teams at sites with high numbers of patients with TBI. Rehabilitation team typically consists of 5-8 personnel, such as a Physical Medicine Rehabilitation Physician, Neurologist, Psychiatrist, Speech Language Pathologist, Physical Therapist, Physical Therapist Assistant, Occupational Therapist, and Occupational Therapist Assistant.

Regional Medical Center Team

Augmented Teams at 6 medical centers. RMC Team that consists of 8-17 personnel i.e., TBI Inpatient Program Director, Physical Medicine and Rehabilitation Physician, Neurologist, Nurse Practitioner or Physician Assistant, Neuropsychologist, Physical Therapist, Occupational Therapist, Speech Language Pathologist, Clinical Nurse Specialist, Social Worker, Rehabilitation Nurse, Pharmacist, Recreation Therapist, Counseling Psychologist, Psychiatrist, TBI Program Administrator, and TBI Program Liaison.

Surge Teams

Goal-Ensure TBI care is available at sites with limited organic TBI assets.

• Detection and Initial Treatment Team members include Primary Care Provider, Behavioral Health Provider, Nurse Case Manager, Licensed Practical Nurse, and Administrative Staff.
• Rehabilitation Team members include Speech Language Pathologist, Physical Therapist, Physical Therapist Assistant, Occupational Therapist, and Occupational Therapist Assistant.

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) DCoE was created in November 2007 to be the open front door of the Department of Defense for warriors and their Families needing help with psychological health and traumatic brain injury issues. The following links connect to TBI related material on the DCoE website. The majority of the TBI material available from DCoE was developed with input from TBI experts in the Army, Navy, Air Force, Marine Corps, Department of Veterans Affairs and a national network of military and civilian agencies, community leaders, advocacy groups, clinical experts, and academic institutions.

• DCoE Resources for Warriors- http://www.dcoe.health.mil/ForWarriors/TBIInformation.aspx
• DCoE Resources for Families- http://www.dcoe.health.mil/ForFamilies/TBIInformation.aspx
• DCoE Resources for Healthcare Professionals- http://www.dcoe.health.mil/ForHealthPros/TBIInformation.aspx

The most important tool for rehabilitation is education. The Proponency Office for Rehabilitation and Reintegration (PR&R) has worked closely with subject matter experts in the area of traumatic brain injury to produce these patient education tools. The content matter was originally developed by Womack Army Medical Center, located in Ft. Bragg, NC, and has been reviewed by clinicians and various healthcare personnel to ensure the most accurate and beneficial information is provided to our Soldiers.

These education tools cover exercises and techniques that patients can use to assist with their rehabilitation from injuries associated with TBI. In addition to instructions for patients to aid in their recovery, there are also supporting visual images. These tools are only to be used under the guidance of a health care provider.

Introduction to Traumatic Brain Injury (TBI) - VIDEO BELOW

If you are unable to view the video above you may download a local copy to your computer.

The Defense and Veterans Brain Injury Center (DVBIC) has a number of education products available to providers caring for service members or veterans who have sustained a TBI. Some materials are intended for providers to personally review with patients, while others are appropriate for use in a “waiting room” area and can be collected by patients as needed. We also have awareness campaign/promotional materials to help promote the DVBIC website with the aim of encouraging patients, Families, and providers to learn about our resources.

Learn more by visiting the DVBIC Education Materials page at http://www.dvbic.org/Providers/DVBIC-Educational-Materials.aspx.

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