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Traumatic Brain Injury Program

Brain Injury Rehabilitation Program - Craig Hospital

Craig Hospital has been providing long term acute care (LTAC), rehabilitation, and research for patients with brain injuries since 1956, making it one of the most experienced brain injury rehabilitation programs in the country.  Most of our patients with brain injury are due to traumatic brain injury (TBI), but on a case-by-case basis we also treat young people who have other types of atypical acquired brain injury (ABI), such as cerebral vascular accidents (CVA), aneurysm, cerebral arteriovenous malformation (AVM), hypoxic ischemia, or anoxia.  Craig provides a comprehensive system of care for patients with brain injury- from the initial days after injury, through inpatient and outpatient treatment, home and community based services, and long term follow-up.  Craig is equipped to provide care for newly-injured patients and works with a wide range of acute medical issues. Early referral is encouraged.  The staff is experienced in treating adolescent and adults (16-65 typically) with moderate to severe brain injuries, with all levels and types of medical, physical, cognitive, and behavioral challenges. 

Early Intervention After Brain Injury

Craig Hospital has a close relationship with many trauma centers in the region. A preadmission clinical evaluation is provided by Craig Hospital staff at those trauma centers immediately after the injury to facilitate early intervention.

Direct collaboration with Swedish Medical Center gives Craig Hospital direct access to state of the art diagnostic, laboratory, surgical and subspecialty services. Craig Hospital also provides medical direction at the Centura- St. Anthony's Central Neurotrauma Unit. Both Swedish and St. Anthony's are Level One Trauma Centers.

This continuity of care, together with the experience and specialization of the staff and of the Craig Hospital facility itself, results in a comprehensive system for traumatic brain injury treatment.

The Interdisciplinary Team

The inpatient Traumatic Brain Injury Program is the foundation on which a comprehensive system of care for brain injury has been built. Upon admission to the Traumatic Brain Injury Program, each patient and family is assigned to an interdisciplinary team of experienced clinicians. Initial evaluations are conducted by each team member and the patient, family and clinicians begin to set rehabilitation goals. Leading the Brain Injury team is Dr. Weintraub who has been the B.I. Medical Director since 1986.  He and his CNS physician partners provide full-time primary medical care.

The inpatient clinical staff on the traumatic brain injury teams are experts in treating the early stages of recovery from a brain injury. Therapists average 13 years at Craig. Each inpatient team has the patient and family at the center, and includes rehabilitation nurses, rehab techs and behavior attendants, neuropsychologists, speech and language pathologists, physical therapists, occupational therapists, therapeutic recreation specialists, respiratory care, a school tutor, driving evaluators, dieticians, a community reintegration specialist, patient and family service counselors, a broad based medical consulting staff, insurance adjustors, and case managers.

Craig Hospital's Model of Brain Injury Rehabilitation

Craig Hospital's model of traumatic brain injury rehabilitation is based on a continuum of care. A treatment plan is built on an understanding of the patient's neurological diagnosis and prognosis, as well as the relationships between the injury and behavior. Additionally, the treatment plan is reviewed and adapted within the context of the patient's personality, goals, resources and environment, and the community to which the patient and family will be discharged. Team rounds are held weekly to review a patient's progress and goals. A family conference is held monthly, and case planning and behavioral meetings are held as indicated. Together this interdisciplinary team strives to maximize physical, cognitive, behavioral, and emotional functioning and to prevent/minimize chronic disability.

The length of inpatient stay is highly individualized, depending on the severity of the injury and the rate of improvement. Typically, length of stay ranges between 30-90 days, depending on diagnosis, severity of injury, rehabilitation goals, and medical complications.

The Inpatient Rehabilitation Units

The physical design of the inpatient program is centered around two units on a single floor at Craig Hospital. All clinical services and even the dining facilities are in close proximity to the patients' rooms. This design increases efficiency and creates a safe, supervised and structured environment. The West Unit is designed to closely monitor patients for safety, while still allowing them access around the unit. The unit is monitored with cameras and a bracelet monitoring system but it is not locked. Patients who require a locked facility are referred elsewhere.

The units also have two therapy gyms, as well as smaller, less stimulating therapeutic areas, including the "T-Zone", a self contained supervised activity room, and "Quiet rooms" in which individual therapy or co-treatments (more than one therapeutic discipline providing treatment simultaneously) can be provided without distraction. In addition to direct nursing care, a team of behavior attendants (BAs) provide individualized structure and assistance to the patients, as needed. The goal is to provide the least restrictive environment possible. As patients progress, they may move to the East Unit, where they will continue to gain independence and begin the transition home, while still having access to acute hospital care.

Therapy Classes

Most therapy is provided on a one to one basis by licensed therapists. These therapists have only five patients on their total caseload at any one time. In addition, to provide multisensory stimulation, a variety of group classes are provided by the interdisciplinary team.
These classes include:

  • Mat Class: group exercises for people in the early stages of mobilization
  • SMAT class, for people working on higher level balance and coordination
  • Fit Class for strengthening and conditioning
  • Speech Group, working on conversational activities
  • Skills Class, which is an educational lecture group
  • Project Group, doing procedural and hands on group activities
  • Cooking Group
  • Horticultural Group
  • In house Direct TV Educational programs

Family Inclusion and Involvement

Brain injury rehabilitation involves not only the patient, but the patient's family and support system. For this reason, we welcome families, and there are no restrictive visiting hours. Families are encouraged to stay in our on-site Family Apartments - the first thirty days at no charge. Families are also urged to observe and participate in therapy sessions and to attend educational programs on traumatic brain injury. The Department for Patient and Family Services exists to provide families with counseling, assistance with insurance issues and help in applying for benefits.

For patients and families living locally, structured pass programs are provided to allow the patient to go home for short periods as trial runs for discharge home.

Therapeutic Outings

Craig is located in a residential neighborhood suburb of Denver, with easy access to nearby restaurants, shopping, parks and outdoor activities. We take advantage of the beautiful Colorado climate by getting outside for therapy. A variety of therapeutic outings are provided for patients involving each of the therapeutic specialties (Physical Therapy, Occupational Therapy, Therapeutic Recreation and Speech Therapy.) Families are encouraged to go along.

The therapeutic recreation program is vitally important in providing applied reality based therapy at Craig and in the community. The quality of the recreational opportunities is unparalleled, providing patients and families with experiences to stay emotionally and physically healthy. Additionally, The Digby Friendship Center exists on campus for families to host social gatherings in a homelike atmosphere.