Polytrauma/TBI System of Care
Polytrauma System of Care Facilities
Persons having sustained a Traumatic Brain Injury (TBI) may require different levels of TBI specific and other supportive care throughout their lives. The typical treatment course begins with evaluation and acute rehabilitation and progresses to post-acute care in the community for ongoing sequelae.
As Veterans recover and transition closer to their homes, the Polytrauma System of Care (PSC) continues to provide a continuum of integrated care through 5Â Polytrauma Transitional Rehabilitation ProgramsÂ (PTRP), 23Â Polytrauma Network SitesÂ (PNS), 86Â Polytrauma Support Clinic Teams (PSCT), and 39Â Polytrauma Points of Contact (POC), located at VA medical centers across the country.
For patients who are unable to return home, long term care settings, such asÂ assisted living,Â medical foster homeÂ or nursing home care, may be required. Care is provided in the least restrictive setting possible. Ongoing follow-up assessment of the TBI survivor is key to preventing or managing a secondary disease or condition that might develop from the TBI.
Facility Type and Locations
PRCs are located at the VA medical centers in Minneapolis, MN; Palo Alto, CA; Richmond, VA; San Antonio, TX; and Tampa, FL. The PRCs serve as regional referral centers for acute medical and rehabilitation care, and as hubs for research and education related to polytrauma and TBI. They provide a continuum of rehabilitation services that include: specialized "emerging consciousness" programs, comprehensive acute rehabilitation care for complex and severe polytraumatic injuries, outpatient programs, assistive technology evaluation and training, and residential transitional rehabilitation programs (PTRP).
Polytrauma Network Sites (PNS) provide post-acute rehabilitation for Veterans and active duty Service Members with polytrauma and TBI who reside within their VISN catchment area. This includes inpatient rehabilitation for those transitioning closer to home, comprehensive outpatient TBI evaluations, a full range of outpatient therapy services; evaluations for durable medical equipment (DME) and assistive technology, access to other consultative specialists, and follow-up care and case management for ongoing rehabilitation needs. There is one PNS in each VISN, except VISN 8 & 17 which have two. In VISNs with a PRC, the PRC facility also operates as the PNS.
Polytrauma Support Clinic Teams (PSCT) provide interdisciplinary outpatient rehabilitation services in their catchment areas for Veterans and Service Members with mild and/or stable impairments from polytrauma and TBI. Services include comprehensive TBI evaluations, outpatient therapy services, management of stable rehabilitation plans referred from PRCs and PNSs, coordinating access to VA and non-VA services, and follow-up care and case management for ongoing rehabilitation needs.
A PPOC is identified in every VA facility that is not otherwise designated as one of the PSC components described above. The PPOC ensures that patients with polytrauma and TBI are referred to a facility and/or program capable of providing the level of rehabilitation services required. PPOCs commonly refer to the PNS and PSCTs within their VISN.Â A limited range of rehabilitation services are also available onsite at the PPOCs.
A structured residential program in a therapeutic, "real-world" setting with a focus on progressive return to independent living.