Completed Research Projects

The TAC’s current research investment model started in August 2018. Below are research projects that have been completed under this model. For more information please contact the Research and Evaluation team on research@tac.vic.gov.au.

Ageing

Project title	Key findings	Completion
T038 Ageing and Disability	This project used linked Victorian State Trauma Registry data to compare older client rehabilitation pathways and outcomes, healthcare utilisation, comorbidities and perspectives of recovery. Key Insights: 1. The rate of discharge to inpatient rehabilitation was higher for transport cases relative to non-transport cases, and increased with each age group. 2. Even when patients were managed in high-volume rehab centres, longer term functional and health outcomes varied markedly. Problems with mobility and self-care were prevalent with increasing age. 3. Subsequent hospital admissions were high in both transport and non-transport patients. 4. Proportion of people with pre-existing health conditions increases with increasing age. 5. There are additional complexities associated with managing recovery from injuries for older adults (age - prognosis for recovery, risk / fear of falling, Grief/loss / feeling a burden).	August 2020
T034 Ageing with life-long accident injuries	Two separate groups of people were identified by this research; those ageing with injury who may experience accelerated ageing, and those who are older at the time of injury whose pre-existing conditions may limit or delay their recovery. There is considerable evidence on the prevalence of age-related conditions for people with spinal cord injury and traumatic brain injury however but much of it is low-quality. Therefore, disentangling the effects of injury from the effects of ageing remains difficult. Beyond spinal cord injury there are few evidence-based resources available for the prevention and management of age-related conditions in people ageing with injury. There is a deficiency of injury-specific aged care providers in the community and residential aged care may not provide adequate support for people ageing with injuries due to their complex needs	August 2020

Project title

Key findings

Completion

T038 Ageing and Disability

This project used linked Victorian State Trauma Registry data to compare older client rehabilitation pathways and outcomes, healthcare utilisation, comorbidities and perspectives of recovery.

Key Insights:
1. The rate of discharge to inpatient rehabilitation was higher for transport cases relative to non-transport cases, and increased with each age group.
2. Even when patients were managed in high-volume rehab centres, longer term functional and health outcomes varied markedly. Problems with mobility and self-care were prevalent with increasing age.
3. Subsequent hospital admissions were high in both transport and non-transport patients.
4. Proportion of people with pre-existing health conditions increases with increasing age.
5. There are additional complexities associated with managing recovery from injuries for older adults (age - prognosis for recovery, risk / fear of falling, Grief/loss / feeling a burden).

August 2020

T034 Ageing with life-long accident injuries

Two separate groups of people were identified by this research; those ageing with injury who may experience accelerated ageing, and those who are older at the time of injury whose pre-existing conditions may limit or delay their recovery. There is considerable evidence on the prevalence of age-related conditions for people with spinal cord injury and traumatic brain injury however but much of it is low-quality. Therefore, disentangling the effects of injury from the effects of ageing remains difficult. Beyond spinal cord injury there are few evidence-based resources available for the prevention and management of age-related conditions in people ageing with injury. There is a deficiency of injury-specific aged care providers in the community and residential aged care may not provide adequate support for people ageing with injuries due to their complex needs

August 2020

Acquired Brain Injury

Project title	Key findings	Completion
H100 - Small Grants: CyberAbIlity: A co-designed web resource to help people with Acquired Brain Injury (ABI) stay safe from online scams	The project created an online cyber safety training program designed specifically for people with ABI. The interactive online training provides information about how scams work, how to avoid being scammed, how to emotionally recover and where to access support. To complement the online training resources, participants are able to create their own individually tailored cyber safety plan. The CyberAbility program is designed to reduce feelings of shame, by showing videos of real people with brain injury sharing their own scam experiences and learnings.	December 2021
H100 - Small Grants: ABI Regional Advocacy Peer support network ‘Leading a new life: let’s do it together’	The project developed three peer support groups and information resources for people living in regional areas with acquired brain injury (ABI). The project aimed to build connections and address isolation, knowledge, self-advocacy skills, confidence and strengthen links between rehabilitation units and local support services.	June 2021
T029 - Rehabilitation after catastrophic acquired brain injury: Evaluation of process and outcomes of a specialist ABI unit and its impact on long term quality of life and community participation	Evaluation of the ABI rehabilitation facility at the Caulfield Hospital. The facility offers rehabilitation to patients whom would ordinarily have been discharged to aged care or shared supported accommodation based on having low Functional Independence Measure (FIM) scores. The evaluation found client outcomes improved over time with rehabilitation and then further post discharge. The unit has streamlined where Victorian patients receive their rehabilitation; with two facilities (Caulfield & Epworth) now providing expert care.	May 2021
T024 - Multi-centre randomised controlled trials of early acute interventions (hypothermia , and erythropoietin) to improve outcomes after traumatic brain injury	A randomised controlled trial investigating the impact of Erythropoietin in Traumatic Brain Injury (EPO-TBI) on neurological outcome at 6 months post injury. A health economic analysis was the final phase of this project. The use of prophylactic hypothermia compared to controlled normothermia was not cost‐effective. There were no statistically significant differences between the intervention and control groups regarding costs, favourable neurological outcomes or quality of adjusted life years (QALY) at 6 months post injury.	June 2021
T030 - Reducing behaviours of concern (BoC) following traumatic brain injury - Intervention and Evaluation	Positive Behaviour Support + PLUS (PBS+PLUS) is a person-driven and collaborative intervention incorporating four fundamental principles: “Person driven. Learning together. Uniting supports. Skill building”. The PBS+PLUS intervention resulted in a significant reduction in BoC in the intervention group, including sexual behaviour, verbal aggression, physical aggression against others, inappropriate social behaviour and perseverative behaviours. Improvements were maintained over 8 months post-intervention. Participants achieved 92% of the 182 individualised goals set during the PBS+PLUS intervention period. Family/carer confidence in managing behaviours significantly improved and this was maintained at follow up. This in turn may be associated with a reduction in care support needs, use of antipsychotic and anti-convulsant medication, and alcohol use. However, the study could not conclude that PBS is better than other existing interventions.	August 2020
T018 - A sensory modulation intervention in an adult acquired brain injury population to reduce behaviours of concern	Behaviours of concern (BoC) are a common consequence of acquired brain injury (ABI). This research comprised a pre-post study of sensory modulation interventions for people with ABI and qualitative interviews with occupational therapists. Results indicated that delivery of sensory modulation interventions is feasible in a community adult ABI population to reduce the number and frequency of BoC. The occupational therapists indicated that their ability to provide the intervention was enabled by training and ongoing support.	October 2019

Assistive Technology

Project title	Key findings	Completion
T037 - Contemporary disability practice horizon scanning program	The horizon scan identified new and emerging trends in innovative contemporary disability practice over two years. In year one, a grey literature scan, stakeholder interviews, and survey of individuals were conducted. Fourteen innovations were shortlisted and 6 underwent deep dive analysis across these topics; assistive technology, service delivery and therapeutic modalities. In year two of the project, the scan identified 116 relevant innovations and categorised these into 5 themes; exoskeletons, virtual reality, mobility aids, employment and single topic items.	May 2022

Bladder and Bowel

Project title	Key findings	Completion
T031 - Evaluation of the implementation of a new model of bladder management care at the Victorian Spinal Cord Services	A new model of bladder management care was implemented in August 2017. Transitioning the patient to perform intermittent self-catheterisation (ISC) was the cornerstone of the new model of care. This project aimed to compare the incidence of readmission to hospital for urinary tract infection (UTI) before and after the implementation of the new model of care. The evaluation found that the rates of emergency department (ED) presentation, readmission or any hospitalisation for UTI was lower following the introduction of the new bladder management model of care.	April 2022

Culturally and linguistically Diverse

Project title	Key findings	Completion
T059 - Qualitative research exploring cultural diversity	This project explored the experience of 16 clients from Cultural and Linguistically Diverse (CALD) and/or Aboriginal and Torres Strait Islander (ATSI) backgrounds. Five key themes were identified; 1) lack of familiarity with the TAC prior to accident and significant barriers to engagement, 2) limited understanding of the TAC remit and frustration, 3) variable expectations of service delivery, 4) the important role of claims managers for these clients and 5) variable experience with interpreter services.	December 2021

Client Experience

Project title	Key findings	Completion
T044 - Client Insights Vulnerable Client Survey	91% of providers agree that telehealth has been a beneficial service to help TAC clients recover during Covid-19. Telehealth reduces access issues (33%) and was found to be a better alternative to nothing (25%). Utilisation is mostly out of necessity. The majority (70%) of providers would prefer to deliver their services mostly by face to face.	October 2020
T013 - ReMARK: A new approach to health research	The ReMARK project involved the collaboration of research funders, researchers and end users to develop seven guiding principles for everyone involved in health research: Inclusive, Authentic, Supportive, Accountable, Transparent, Discoverable, and Useful. In addition, the project resulted in the development of a paper prototype of the ReMARK process, which involves the following eight steps: 1. Scan, 2. Sort, 3. Review, 4. Frame, 5. Refine, 6. Select, 7. Callout, and 8. Commence. The process was piloted on the Scaffle platform.	June 2020
T036 - Client Insights Cross-sectional Survey	The cross-sectional client survey was part of a broader piece of work evaluating the success of the 2018 Rapid and Supported Recovery claims management models. Analyses of survey data indicates that the models are working well, however 20% of clients believe there’s still more the TAC can be doing, particularly around; lack of communication from the TAC, generally not feeling supported, being in need of additional services, and long waits for approval of treatments. Recommendations included refinements to the initial needs identification assessment and implementing additional follow-ups.	June 2020
T019 - Assessing the measurement properties of the Transport Accident Commission’s Life Back on Track (LBoT) measure	The TAC commissioned Monash University, Centre for Health Economics to conduct an independent assessment of the measurement properties of its Life Back on Track (LBoT) measure. This project consisted of complex statistical analysis using de-identified client research survey data, the development of mapping algorithms and a scan of relevant literature.	June 2019

Community and Social Participation

Project	Key findings	Completion
T032 - Maximising Social Connection and Building Relationships in the Community: Evaluation of a Multi-component Community Connection program (M-ComConnect) for people with severe TBI	M-ComConnect is an individualised intervention that aims to increase social activity and support community integration. The evaluation revealed the M-ComConnect program is a promising intervention. Immediate post-intervention results showed a positive effect on quality of life, wellbeing and community integration, and these changes were maintained at the 3 month follow-up. Wellbeing and community integration improvements were maintained at the 6-month follow-up, however, quality of life scores showed a significant reduction.	June 2021

Compensation

Project	Key findings	Completion
T003 - Bourke Street Evaluation Project	This study examined the TAC’s approach to claims management following the Bourke Street incident. This research provided recommendations across nine areas for building upon existing strengths and addressing some of the gaps in implementation of claims management after a large‐scale transport incident. The TAC have already implemented a number of adaptations to policy and procedures since the Bourke Street incident, and are currently in the process of considering further adaptations. The TAC’ response to the Bourke Street incident demonstrated good practice (as determined by international expert consensus), and has established a solid basis for responding to future large scale transport incidents.	December 2019
M195 - Review of the Joint Medical Examination (JME) process	Joint Medical Examinations (JMEs) were introduced by the TAC in 2014, and refined in 2016. The research aimed to understand the operation and impact of JMEs, and to identify opportunities for improvement. JMEs generate a range of benefits including a reduction in the number of assessments clients undergo, improvements in client experiences, and the potential to facilitate quicker access to benefits. This review identified a number of opportunities to improve the JME process, particularly with respect to client experience, the quality of medical evidence produced, and stakeholder engagement.	December 2019
T015 - Environmental scan of clinical panel models	The aim of this Evidence Review was to assist the TAC in developing a new way of working for the TAC’s Clinical Panel. Service and clinical models for client outcomes vary greatly based on their local context: no one right way was evident with the exception of a coordinated care approach. There is no optimal ‘one size fits all’ service model for using clinical experts in rehabilitation schemes and there is a distinct lack of measuring client outcomes. However, some organisations are beginning to think about how they do this objectively. A shift to a greater focus on de-medicalised psychosocial model is evident and this requires clinical practice behavioural change.	October 2018

Disability

Project	Key findings	Completion
H100 - Small Grants: Transforming Practice - Dental Health for People with Intellectual Disability and Acquired Brain Injury	Funding supported the development of an inter-disciplinary Community of Practice (CoP) to collaboratively identify knowledge gaps and build professional development resources for dentists. Key insights from the CoP included the barriers experienced by oral health professionals in providing treatment and their lack of understanding of disability, as well as the need for a cross-professional approach in providing oral healthcare to people with disability.	June 2021
H100 - Small Grants: Storytellers with lived experience strengthening opportunities for people with a disability to live independently	The project developed a suite of tools and resources which are now available on the Summer Foundation's Housing Hub to help empower people to make the transition to independence living. The 10 capacity building tools created include: a three-part podcast series about moving out of residential aged care, a three-part audio and written series about support, and a four-part video series about moving out of residential aged care to supported disability accommodation.
T005 - Building Capability to Support Client decision making	The Support for Decision Making Practice Framework created by Professor Bigby & Professor Douglas (2015) formed the basis of the project which aimed to build the capability of the Service Model Transformation Pilot team members in the Independence Division to apply the Framework in their interactions with clients, thereby delivering services consistent with contemporary disability practice. Training and mentoring was delivered by the researcher and via a structured online learning course that is being tailored to the TAC client context for broader training and embedding of practice across the Independence Division.	July 2020

Housing

Project	Key findings	Completion
T022 - Research to support the TAC Housing Strategy: Evaluation of Glenroy 2	Glenroy 2 is the 6th Residential Independence Proprietary Limited (RIPL) site for the TAC and was the first to feature a hub and spoke model. Researchers evaluated pre and post move expectations and experiences, and the health, independence, participation and quality of life outcomes of TAC clients. The hub and spoke model was found to enable more participation in choice making and home integration tasks. People with traumatic brain injury (TBI) and challenging behaviour were found to need specific accommodation support planning. People with high level spinal cord injury (SCI) were found to need lifetime support for some daily activities.	February 2022
T049 - Disability housing outcomes framework	The Disability Housing Outcomes Framework links the activities of both the built-form environment and in-home supports to understand how housing facilitates good outcomes for people across six core outcome areas: Daily Living, Health, Relationships and Community, Rights and Voice, Independence, and Stability and Safety. A preliminary pilot was conducted with seven organisations, including Specialist Disability Accommodation (SDA) and Supported Independent Living (SIL) providers who used the Framework in practice. The bespoke data collection tools aligned to the Framework were found to provide data that is meaningful for people with disability, practical for providers to implement, and able to inform decision-making. A full report, summary report, presentation and easy-read report were delivered.	July 2022
T010 - TAC Client Housing Strategy	This project explored emerging issues related to national and international housing developments, availability and feasibility of different housing models, and innovative models of housing, support, collaboration and partnerships. Numerous reports were produced which were used to inform development of the TAC’s client housing strategy.	September 2019

Mental Health

Project	Key findings	Completion
T001 - Screening for Prevalence of Illicit Toxins in Emergency Department Trauma (SPIT-T): An Observational Study	This project investigated the degree of illicit drug intoxication of victims of major motor vehicle accidents attending the two major trauma centres in Victoria. Over 12 months, 13% of 1312 cases tested positive to at least one illicit substance. They were a younger population, most likely injured in a motor vehicle and more likely to arrive overnight. The group was also more likely to re-present to hospital within 28 days (13.9% vs 5.4%).	April 2020
M204 - REcovery after Serious Trauma – Outcomes, Resource use and patient Experiences study (RESTORE) – linked data project	Age, compensable status, nature of injury, cause of injury, experiencing a recent hospital admission and reporting disability in the week prior to injury were all consistent predictors of outcome to 5 years post-injury. Notably, the association between age and outcome was not straightforward. In most cases, increasing age was a predictor of poorer outcome. However, increasing age was protective for anxiety and depression.	July 2020

Persistent Pain

Project title	Key findings	Completion
H031 - Electronic Persistent Pain Collaboration (ePPOC ) 2018-2021	Measures client outcomes (TAC and WorkSafe) for Network Pain Management Programs. At referral to a pain management program, clients had greater clinical severity and made consistently less clinically significant improvements. However, follow up results indicated that there was an increase in the proportion of clients who improved post discharge. Nearly 60% of clients used opioid medication. They were also more likely to be male, born in Australia, unemployed, and report greater pain/pain interference, depression and impaired self-efficacy. Back pain was associated with the highest use of opioids. A reduction in opioids during the program was associated with reductions in pain intensity, pain interference and improved mood and cognition scores at program conclusion and follow up.	June 2021

Rehabilitation

Project title	Key finding	Completion
H024 - Australasian Rehabilitation Outcomes Centre (AROC)	A national benchmarking system aiming to improve clinical rehabilitation outcomes in both the public and private sectors. Feedback from the industry indicates that during this last year both the outputs of AROC and the projects AROC has been involved with, added significant value to the sector. Information generated by AROC is increasingly being used by clinicians, hospital managers, payers and regulators to measure trends in clinical practice, and to improve outcomes in rehabilitation for patients.	September 2022
T009 - Development of a new health service delivery model for major trauma clients living in rural and remote Victoria	This project found General Practitioners and Physiotherapists are well distributed throughout R&R areas. Other Allied Health disciplines are less represented. Many R&R clients access clinicians in metropolitan areas and report greater travel times. R&R clients have more ongoing rehabilitation needs compared to metro survivors (81.6% vs 72.4%). Unmet needs exist in Gippsland and Grampians for mental health and cognition. Interestingly quality of care was rated similarly by R&R and metropolitan clients. Three types of outreach service delivery models exist; Face-to-face periodic visiting clinics, virtual clinics that use technology to provide interventions, and indirect outreach which provides mentoring to R&R practitioners.	February 2021

Return to Work

Project title	Key findings	Completion
T021 - Building and Testing Mainstream Employment Pathways for people living with Acquired Brain Injury	Co-design and trial of a new employment pathway (Employment CoLab) for people with acquired brain injury (ABI). Employment CoLab offered an effective team approach for seven people with ABI to gain and sustain open employment and wages. The small sample size and variation in data limited the ability to detect significant change and make comparisons to standard employment pathways.	March 2021

Spinal Cord Injury

Project title	Key findings	Completion
H100 - Small Grants: Victorian Accessible Beach Directory	The project aimed to improve access to beaches for people with spinal cord injury. Funding supported practical measures and media strategies. Advocacy was a key part of the project to ensure disability access is part of the assessment for capital works at Surf lifesaving clubs.	November 2021
H100 - Small Grants: Peer-led program for consumer engagement in spinal cord injury research	Funding supported creating a new role; the 'Consumer Engagement Lead' who then conducted a literature review of similar consumer engagement programs in Australia, launched a Consumer Advisory Network, built relationships with Victorian community-based spinal/disability organisations, strengthened links with other peer support organisations and international spinal organisations, and raised awareness of websites promoting clinical trials.	October 2021
H100 - Small Grants: Peer-led community based 'Skills for Independence' course for people with spinal cord injury in Victoria	This peer-led, community based course for Victorians living with a spinal cord injury (SCI) aimed to upskill existing AQA Victoria peer mentors and deliver a course. The funds contributed to improving the 'Discovering the Power in Me' coaching course and 'Manual Wheelchair Skills Delivered Differently' course.	June 2021
T028 - Immediate Cooling and Emergency Decompression (ICED) for the treatment of spinal cord injury: pilot, safety and feasibility studies	This sub-study of the Immediate Cooling followed by Emergency Decompression (ICED) project applied the Spinal Emergency Evaluation of Deficits (SPEED) assessment to a prospective cohort of patients with suspected cervical spinal cord injury (SCI) to examine whether brief and simple assessments of neurological function can rapidly determine the level and severity of cervical SCI. The SPEED assessment has been rapidly integrated into current paramedic practices. Rapid identification of patients with SCI facilitated direct patient admission to surgical centres and pre-hospital notification, minimising times to decompression.	December 2019
T008 - Spinal community integration programs: identifying best practice	The aim of the project was to identify best-practice service delivery and care models for spinal community integration programs (national and international). A number of elements were identified that should be considered for inclusion in a best practice program, and a number of gaps in service provision were identified, in addition to areas that warrant future research.	June 2019
T016 - Development of a framework integrating peer support activities at the Australian Quadriplegic Association (AQA) Spinal Injury Resource and Support Network (SPIRE)	SPIRE (Spinal Injury Resource & Support Network) is a peer-led, peer-facilitated and peer-resourced support network provided by AQA (Australian Quadriplegic Association) which is specifically designed to encourage, inform and assist people living with a Spinal Cord Injury. This project developed a framework to summarise activities in the current SCI peer-mentoring program in Victoria at AQA SPIRE, while also providing recommendations to facilitate future peer-mentoring program service improvements. Nine primary principles were identified, which will inform the ongoing development and improvement of peer-mentoring programs. The project also demonstrated the unique contribution of peer support, and the inherent value it provides to this specific population.	September 2019

Trauma and Acute Care

Project title	Key findings	Completion
T026 - Health economic analysis of Major Trauma Recovery Coordinator (MTReC) project with Alfred Health	This analysis was the final component of the Major Trauma Recovery Coordinator (MTReC) study which compared resource utilisation and costs, in the first 6-months of major trauma patients who received coordination services and those who did not. The MTReC role was not shown to be a cost-effective intervention for major trauma patients. Limitations with the study design and bias are likely to have contributed.	August 2022
T017 - Optimising Patient Outcomes Following trauma (BeFIT)	This project developed and piloted a new allied health model of care. The new model aimed to deliver an early, expanded, intensive, innovative, multidisciplinary model of allied health care designed to support improved recovery outcomes for trauma patients and provide a greater intensity of therapy to patients, delivered Monday through Sunday.	March 2022
T023 - Allied Health Trauma Workforce Model of Care	The TAC and Alfred Health partnered to modernise the Alfred Allied Health Trauma workforce and associated environment to enable early and intense therapy to commence in the acute environment in order to support improved recovery outcomes for Victorian trauma patients.	March 2022
T046 – Independent review of TAC-funded Data Registries	The review found that the Registries are high-functioning, high-quality and meet most characteristics of mature, high-functioning clinical quality registries. Impacts of the registries were examined with reference to patients, clinicians, researchers and government/policy. Opportunities to improve governance and reporting arrangements, measuring translation and impact, contract management and data sharing were identified.	October 2021
M202 - Trauma System – State-wide Capability Program	Trauma team training sessions using a mixture of prescribed pre-learning, didactic lectures, skill stations and simulated team based scenarios resulted in significant improvement in participant-reported outcomes in clinical confidence and real life team leadership.	July 2021
H032 - Major Trauma Recovery Coordinator (MTReC) Project	The absence of a consistent point of contact for coordination of care and information has been identified as a major deficit in care by trauma patients. Therefore, the TAC provided funding to The Alfred for two Major Trauma Recovery Coordinators (MTReC) for a 2-year period. The aim of this study was to explore the impact of the MTReC roles on patient experiences and outcomes. Results found no compelling and consistent evidence to continue funding the MTReC roles using the current model, and the discharge planning component of the role has subsequently been incorporated into the new allied health model of care for major trauma patients. Other recommendations included the provision of written information for patients in a consistent and appropriate format, improvements to the outpatient booking system and the development of a service map with respect to pain management and mental health services.	March 2020
M201 - Ambulance Victoria Heads up Display (HUD) decision-support technology usability and effectiveness evaluation	Evaluated the usability and effectiveness of HUD technology for paramedics. The project encountered difficulties that prevented a successful in-field clinical trial. The three main difficulties were: technical challenges related to software and hardware development, operational constraints such as willingness to wear the HUD, and limitations with existing digital infrastructure such as poor internet connectivity at remote locations.	June 2020
T020 - Supporting young people following major trauma	This study utilised a systematic review and environmental scan approach to provide a comprehensive evidence base of current approaches to health and disability assessment, planning, and management for young people aged 0-18 years who have sustained major traumatic injuries. Factors related to outcome were education, social relationships, and mental health. Longer school retention, completing secondary school, and undertaking further education were all positively associated with achieving key adult goals, such as living independently and gaining employment. Positive relationships were protective and related to improved outcomes. A diagnosis of mental illness placed young people at increased risk of poorer outcomes, including unemployment and lower levels of community integration.	July 2019
T011 - Acute allied health models of care	The aim of this Evidence Review was to determine whether allied health interventions provided to adults with a traumatic injury in an acute inpatient hospital setting improves health outcomes, and to examine the elements of interventions shown to be effective. For all of the small number of studies that reported significant gains in the intervention arm, a greater intensity of allied health treatment and therapy was utilised for the intervention group. However, the specifics of each intervention varied between studies, ranging from increasing the amount of therapy provided by a single allied health professional, to establishing large multidisciplinary teams and implementing structured care pathways. Most of the studies identified were NHMRC level III studies, giving a high risk of selection bias. Therefore, results should be interpreted with caution as the impact of the proposed interventions may have been overestimated.	February 2019
T025 - Leveraging Victorian State Trauma Registry (VSTR) and Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) outcomes Data	The TAC views client outcomes as a primary strategic objective, through the lens of clients getting their lives “back on track”. The TAC is exploring opportunities to better leverage outcomes data that have already been collected for TAC clients. One important potential source of existing outcomes data for TAC clients is the Victorian State Trauma Registry (VSTR) and Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) (“the registries”). Of the 157,215 claims provided by the TAC, 14,309 (9.1%) were captured in the registries. The coverage rates differed substantially based on claims management division; 4% of Rapid Recovery clients, 27% of Supported Recovery clients, and 86% of Independence clients. There were notable gaps in registry coverage of TAC clients, particularly children, non-hospitalised TAC claims, and injuries not routinely requiring admission to hospital. Despite these gaps, the key finding of this study was that a propensity score approach could be feasibly applied to the wider TAC claims data, with some caveats for claimants with extremely low registry coverage.	December 2019

Virtual Healthcare (Telehealth)

Project title	Key findings	Completion
T047 - Effectiveness of telehealth for hospitalised clients	A mixed methods study aiming to understand the experience and cost effectiveness of telehealth services for hospitalised TAC clients. Phase 1 found telehealth services created both challenges and opportunities for clients, providers and the TAC. Individual, technology, environment and support-related factors influenced the experience of telehealth. Opportunities to enhance the use and experience of telehealth were identified, some of which were in the TAC's sphere of influence. Phase 2 analysed TAC claims data matched to Victorian State Trauma Registry (VSTR) data for 1,390 clients. Seven percent of services were delivered by telehealth between March 2020 and August 2021. Psychology, network pain management and hospital rehabilitation were the most frequently delivered services via telehealth. Clients who used telehealth were more severely injured, more likely to have worked or studied prior to injury, and at 12 months post injury had a greater odds of higher disability, pain and anxiety/depression, compared to non-users.	August 2022

Completed Research Projects

Ageing

Project title

Key findings

Completion

T038 Ageing and Disability

This project used linked Victorian State Trauma Registry data to compare older client rehabilitation pathways and outcomes, healthcare utilisation, comorbidities and perspectives of recovery.

August 2020

T034 Ageing with life-long accident injuries

August 2020

Acquired Brain Injury

Project title	Key findings	Completion
H100 - Small Grants: CyberAbIlity: A co-designed web resource to help people with Acquired Brain Injury (ABI) stay safe from online scams	The project created an online cyber safety training program designed specifically for people with ABI. The interactive online training provides information about how scams work, how to avoid being scammed, how to emotionally recover and where to access support. To complement the online training resources, participants are able to create their own individually tailored cyber safety plan. The CyberAbility program is designed to reduce feelings of shame, by showing videos of real people with brain injury sharing their own scam experiences and learnings.	December 2021
H100 - Small Grants: ABI Regional Advocacy Peer support network ‘Leading a new life: let’s do it together’	The project developed three peer support groups and information resources for people living in regional areas with acquired brain injury (ABI). The project aimed to build connections and address isolation, knowledge, self-advocacy skills, confidence and strengthen links between rehabilitation units and local support services.	June 2021
T029 - Rehabilitation after catastrophic acquired brain injury: Evaluation of process and outcomes of a specialist ABI unit and its impact on long term quality of life and community participation	Evaluation of the ABI rehabilitation facility at the Caulfield Hospital. The facility offers rehabilitation to patients whom would ordinarily have been discharged to aged care or shared supported accommodation based on having low Functional Independence Measure (FIM) scores. The evaluation found client outcomes improved over time with rehabilitation and then further post discharge. The unit has streamlined where Victorian patients receive their rehabilitation; with two facilities (Caulfield & Epworth) now providing expert care.	May 2021
T024 - Multi-centre randomised controlled trials of early acute interventions (hypothermia , and erythropoietin) to improve outcomes after traumatic brain injury	A randomised controlled trial investigating the impact of Erythropoietin in Traumatic Brain Injury (EPO-TBI) on neurological outcome at 6 months post injury. A health economic analysis was the final phase of this project. The use of prophylactic hypothermia compared to controlled normothermia was not cost‐effective. There were no statistically significant differences between the intervention and control groups regarding costs, favourable neurological outcomes or quality of adjusted life years (QALY) at 6 months post injury.	June 2021
T030 - Reducing behaviours of concern (BoC) following traumatic brain injury - Intervention and Evaluation	Positive Behaviour Support + PLUS (PBS+PLUS) is a person-driven and collaborative intervention incorporating four fundamental principles: “Person driven. Learning together. Uniting supports. Skill building”. The PBS+PLUS intervention resulted in a significant reduction in BoC in the intervention group, including sexual behaviour, verbal aggression, physical aggression against others, inappropriate social behaviour and perseverative behaviours. Improvements were maintained over 8 months post-intervention. Participants achieved 92% of the 182 individualised goals set during the PBS+PLUS intervention period. Family/carer confidence in managing behaviours significantly improved and this was maintained at follow up. This in turn may be associated with a reduction in care support needs, use of antipsychotic and anti-convulsant medication, and alcohol use. However, the study could not conclude that PBS is better than other existing interventions.	August 2020
T018 - A sensory modulation intervention in an adult acquired brain injury population to reduce behaviours of concern	Behaviours of concern (BoC) are a common consequence of acquired brain injury (ABI). This research comprised a pre-post study of sensory modulation interventions for people with ABI and qualitative interviews with occupational therapists. Results indicated that delivery of sensory modulation interventions is feasible in a community adult ABI population to reduce the number and frequency of BoC. The occupational therapists indicated that their ability to provide the intervention was enabled by training and ongoing support.	October 2019

Assistive Technology

Project title	Key findings	Completion
T037 - Contemporary disability practice horizon scanning program	The horizon scan identified new and emerging trends in innovative contemporary disability practice over two years. In year one, a grey literature scan, stakeholder interviews, and survey of individuals were conducted. Fourteen innovations were shortlisted and 6 underwent deep dive analysis across these topics; assistive technology, service delivery and therapeutic modalities. In year two of the project, the scan identified 116 relevant innovations and categorised these into 5 themes; exoskeletons, virtual reality, mobility aids, employment and single topic items.	May 2022

Bladder and Bowel

Project title	Key findings	Completion
T031 - Evaluation of the implementation of a new model of bladder management care at the Victorian Spinal Cord Services	A new model of bladder management care was implemented in August 2017. Transitioning the patient to perform intermittent self-catheterisation (ISC) was the cornerstone of the new model of care. This project aimed to compare the incidence of readmission to hospital for urinary tract infection (UTI) before and after the implementation of the new model of care. The evaluation found that the rates of emergency department (ED) presentation, readmission or any hospitalisation for UTI was lower following the introduction of the new bladder management model of care.	April 2022

Culturally and linguistically Diverse

Project title	Key findings	Completion
T059 - Qualitative research exploring cultural diversity	This project explored the experience of 16 clients from Cultural and Linguistically Diverse (CALD) and/or Aboriginal and Torres Strait Islander (ATSI) backgrounds. Five key themes were identified; 1) lack of familiarity with the TAC prior to accident and significant barriers to engagement, 2) limited understanding of the TAC remit and frustration, 3) variable expectations of service delivery, 4) the important role of claims managers for these clients and 5) variable experience with interpreter services.	December 2021

Client Experience

Project title	Key findings	Completion
T044 - Client Insights Vulnerable Client Survey	91% of providers agree that telehealth has been a beneficial service to help TAC clients recover during Covid-19. Telehealth reduces access issues (33%) and was found to be a better alternative to nothing (25%). Utilisation is mostly out of necessity. The majority (70%) of providers would prefer to deliver their services mostly by face to face.	October 2020
T013 - ReMARK: A new approach to health research	The ReMARK project involved the collaboration of research funders, researchers and end users to develop seven guiding principles for everyone involved in health research: Inclusive, Authentic, Supportive, Accountable, Transparent, Discoverable, and Useful. In addition, the project resulted in the development of a paper prototype of the ReMARK process, which involves the following eight steps: 1. Scan, 2. Sort, 3. Review, 4. Frame, 5. Refine, 6. Select, 7. Callout, and 8. Commence. The process was piloted on the Scaffle platform.	June 2020
T036 - Client Insights Cross-sectional Survey	The cross-sectional client survey was part of a broader piece of work evaluating the success of the 2018 Rapid and Supported Recovery claims management models. Analyses of survey data indicates that the models are working well, however 20% of clients believe there’s still more the TAC can be doing, particularly around; lack of communication from the TAC, generally not feeling supported, being in need of additional services, and long waits for approval of treatments. Recommendations included refinements to the initial needs identification assessment and implementing additional follow-ups.	June 2020
T019 - Assessing the measurement properties of the Transport Accident Commission’s Life Back on Track (LBoT) measure	The TAC commissioned Monash University, Centre for Health Economics to conduct an independent assessment of the measurement properties of its Life Back on Track (LBoT) measure. This project consisted of complex statistical analysis using de-identified client research survey data, the development of mapping algorithms and a scan of relevant literature.	June 2019

Community and Social Participation

Project	Key findings	Completion
T032 - Maximising Social Connection and Building Relationships in the Community: Evaluation of a Multi-component Community Connection program (M-ComConnect) for people with severe TBI	M-ComConnect is an individualised intervention that aims to increase social activity and support community integration. The evaluation revealed the M-ComConnect program is a promising intervention. Immediate post-intervention results showed a positive effect on quality of life, wellbeing and community integration, and these changes were maintained at the 3 month follow-up. Wellbeing and community integration improvements were maintained at the 6-month follow-up, however, quality of life scores showed a significant reduction.	June 2021

Compensation

Project	Key findings	Completion
T003 - Bourke Street Evaluation Project	This study examined the TAC’s approach to claims management following the Bourke Street incident. This research provided recommendations across nine areas for building upon existing strengths and addressing some of the gaps in implementation of claims management after a large‐scale transport incident. The TAC have already implemented a number of adaptations to policy and procedures since the Bourke Street incident, and are currently in the process of considering further adaptations. The TAC’ response to the Bourke Street incident demonstrated good practice (as determined by international expert consensus), and has established a solid basis for responding to future large scale transport incidents.	December 2019
M195 - Review of the Joint Medical Examination (JME) process	Joint Medical Examinations (JMEs) were introduced by the TAC in 2014, and refined in 2016. The research aimed to understand the operation and impact of JMEs, and to identify opportunities for improvement. JMEs generate a range of benefits including a reduction in the number of assessments clients undergo, improvements in client experiences, and the potential to facilitate quicker access to benefits. This review identified a number of opportunities to improve the JME process, particularly with respect to client experience, the quality of medical evidence produced, and stakeholder engagement.	December 2019
T015 - Environmental scan of clinical panel models	The aim of this Evidence Review was to assist the TAC in developing a new way of working for the TAC’s Clinical Panel. Service and clinical models for client outcomes vary greatly based on their local context: no one right way was evident with the exception of a coordinated care approach. There is no optimal ‘one size fits all’ service model for using clinical experts in rehabilitation schemes and there is a distinct lack of measuring client outcomes. However, some organisations are beginning to think about how they do this objectively. A shift to a greater focus on de-medicalised psychosocial model is evident and this requires clinical practice behavioural change.	October 2018

Disability

Project	Key findings	Completion
H100 - Small Grants: Transforming Practice - Dental Health for People with Intellectual Disability and Acquired Brain Injury	Funding supported the development of an inter-disciplinary Community of Practice (CoP) to collaboratively identify knowledge gaps and build professional development resources for dentists. Key insights from the CoP included the barriers experienced by oral health professionals in providing treatment and their lack of understanding of disability, as well as the need for a cross-professional approach in providing oral healthcare to people with disability.	June 2021
H100 - Small Grants: Storytellers with lived experience strengthening opportunities for people with a disability to live independently	The project developed a suite of tools and resources which are now available on the Summer Foundation's Housing Hub to help empower people to make the transition to independence living. The 10 capacity building tools created include: a three-part podcast series about moving out of residential aged care, a three-part audio and written series about support, and a four-part video series about moving out of residential aged care to supported disability accommodation.
T005 - Building Capability to Support Client decision making	The Support for Decision Making Practice Framework created by Professor Bigby & Professor Douglas (2015) formed the basis of the project which aimed to build the capability of the Service Model Transformation Pilot team members in the Independence Division to apply the Framework in their interactions with clients, thereby delivering services consistent with contemporary disability practice. Training and mentoring was delivered by the researcher and via a structured online learning course that is being tailored to the TAC client context for broader training and embedding of practice across the Independence Division.	July 2020

Housing

Project	Key findings	Completion
T022 - Research to support the TAC Housing Strategy: Evaluation of Glenroy 2	Glenroy 2 is the 6th Residential Independence Proprietary Limited (RIPL) site for the TAC and was the first to feature a hub and spoke model. Researchers evaluated pre and post move expectations and experiences, and the health, independence, participation and quality of life outcomes of TAC clients. The hub and spoke model was found to enable more participation in choice making and home integration tasks. People with traumatic brain injury (TBI) and challenging behaviour were found to need specific accommodation support planning. People with high level spinal cord injury (SCI) were found to need lifetime support for some daily activities.	February 2022
T049 - Disability housing outcomes framework	The Disability Housing Outcomes Framework links the activities of both the built-form environment and in-home supports to understand how housing facilitates good outcomes for people across six core outcome areas: Daily Living, Health, Relationships and Community, Rights and Voice, Independence, and Stability and Safety. A preliminary pilot was conducted with seven organisations, including Specialist Disability Accommodation (SDA) and Supported Independent Living (SIL) providers who used the Framework in practice. The bespoke data collection tools aligned to the Framework were found to provide data that is meaningful for people with disability, practical for providers to implement, and able to inform decision-making. A full report, summary report, presentation and easy-read report were delivered.	July 2022
T010 - TAC Client Housing Strategy	This project explored emerging issues related to national and international housing developments, availability and feasibility of different housing models, and innovative models of housing, support, collaboration and partnerships. Numerous reports were produced which were used to inform development of the TAC’s client housing strategy.	September 2019

Mental Health

Project	Key findings	Completion
T001 - Screening for Prevalence of Illicit Toxins in Emergency Department Trauma (SPIT-T): An Observational Study	This project investigated the degree of illicit drug intoxication of victims of major motor vehicle accidents attending the two major trauma centres in Victoria. Over 12 months, 13% of 1312 cases tested positive to at least one illicit substance. They were a younger population, most likely injured in a motor vehicle and more likely to arrive overnight. The group was also more likely to re-present to hospital within 28 days (13.9% vs 5.4%).	April 2020
M204 - REcovery after Serious Trauma – Outcomes, Resource use and patient Experiences study (RESTORE) – linked data project	Age, compensable status, nature of injury, cause of injury, experiencing a recent hospital admission and reporting disability in the week prior to injury were all consistent predictors of outcome to 5 years post-injury. Notably, the association between age and outcome was not straightforward. In most cases, increasing age was a predictor of poorer outcome. However, increasing age was protective for anxiety and depression.	July 2020

Persistent Pain

Project title	Key findings	Completion
H031 - Electronic Persistent Pain Collaboration (ePPOC ) 2018-2021	Measures client outcomes (TAC and WorkSafe) for Network Pain Management Programs. At referral to a pain management program, clients had greater clinical severity and made consistently less clinically significant improvements. However, follow up results indicated that there was an increase in the proportion of clients who improved post discharge. Nearly 60% of clients used opioid medication. They were also more likely to be male, born in Australia, unemployed, and report greater pain/pain interference, depression and impaired self-efficacy. Back pain was associated with the highest use of opioids. A reduction in opioids during the program was associated with reductions in pain intensity, pain interference and improved mood and cognition scores at program conclusion and follow up.	June 2021

Rehabilitation

Project title	Key finding	Completion
H024 - Australasian Rehabilitation Outcomes Centre (AROC)	A national benchmarking system aiming to improve clinical rehabilitation outcomes in both the public and private sectors. Feedback from the industry indicates that during this last year both the outputs of AROC and the projects AROC has been involved with, added significant value to the sector. Information generated by AROC is increasingly being used by clinicians, hospital managers, payers and regulators to measure trends in clinical practice, and to improve outcomes in rehabilitation for patients.	September 2022
T009 - Development of a new health service delivery model for major trauma clients living in rural and remote Victoria	This project found General Practitioners and Physiotherapists are well distributed throughout R&R areas. Other Allied Health disciplines are less represented. Many R&R clients access clinicians in metropolitan areas and report greater travel times. R&R clients have more ongoing rehabilitation needs compared to metro survivors (81.6% vs 72.4%). Unmet needs exist in Gippsland and Grampians for mental health and cognition. Interestingly quality of care was rated similarly by R&R and metropolitan clients. Three types of outreach service delivery models exist; Face-to-face periodic visiting clinics, virtual clinics that use technology to provide interventions, and indirect outreach which provides mentoring to R&R practitioners.	February 2021

Return to Work

Project title	Key findings	Completion
T021 - Building and Testing Mainstream Employment Pathways for people living with Acquired Brain Injury	Co-design and trial of a new employment pathway (Employment CoLab) for people with acquired brain injury (ABI). Employment CoLab offered an effective team approach for seven people with ABI to gain and sustain open employment and wages. The small sample size and variation in data limited the ability to detect significant change and make comparisons to standard employment pathways.	March 2021

Spinal Cord Injury

Project title	Key findings	Completion
H100 - Small Grants: Victorian Accessible Beach Directory	The project aimed to improve access to beaches for people with spinal cord injury. Funding supported practical measures and media strategies. Advocacy was a key part of the project to ensure disability access is part of the assessment for capital works at Surf lifesaving clubs.	November 2021
H100 - Small Grants: Peer-led program for consumer engagement in spinal cord injury research	Funding supported creating a new role; the 'Consumer Engagement Lead' who then conducted a literature review of similar consumer engagement programs in Australia, launched a Consumer Advisory Network, built relationships with Victorian community-based spinal/disability organisations, strengthened links with other peer support organisations and international spinal organisations, and raised awareness of websites promoting clinical trials.	October 2021
H100 - Small Grants: Peer-led community based 'Skills for Independence' course for people with spinal cord injury in Victoria	This peer-led, community based course for Victorians living with a spinal cord injury (SCI) aimed to upskill existing AQA Victoria peer mentors and deliver a course. The funds contributed to improving the 'Discovering the Power in Me' coaching course and 'Manual Wheelchair Skills Delivered Differently' course.	June 2021
T028 - Immediate Cooling and Emergency Decompression (ICED) for the treatment of spinal cord injury: pilot, safety and feasibility studies	This sub-study of the Immediate Cooling followed by Emergency Decompression (ICED) project applied the Spinal Emergency Evaluation of Deficits (SPEED) assessment to a prospective cohort of patients with suspected cervical spinal cord injury (SCI) to examine whether brief and simple assessments of neurological function can rapidly determine the level and severity of cervical SCI. The SPEED assessment has been rapidly integrated into current paramedic practices. Rapid identification of patients with SCI facilitated direct patient admission to surgical centres and pre-hospital notification, minimising times to decompression.	December 2019
T008 - Spinal community integration programs: identifying best practice	The aim of the project was to identify best-practice service delivery and care models for spinal community integration programs (national and international). A number of elements were identified that should be considered for inclusion in a best practice program, and a number of gaps in service provision were identified, in addition to areas that warrant future research.	June 2019
T016 - Development of a framework integrating peer support activities at the Australian Quadriplegic Association (AQA) Spinal Injury Resource and Support Network (SPIRE)	SPIRE (Spinal Injury Resource & Support Network) is a peer-led, peer-facilitated and peer-resourced support network provided by AQA (Australian Quadriplegic Association) which is specifically designed to encourage, inform and assist people living with a Spinal Cord Injury. This project developed a framework to summarise activities in the current SCI peer-mentoring program in Victoria at AQA SPIRE, while also providing recommendations to facilitate future peer-mentoring program service improvements. Nine primary principles were identified, which will inform the ongoing development and improvement of peer-mentoring programs. The project also demonstrated the unique contribution of peer support, and the inherent value it provides to this specific population.	September 2019

Trauma and Acute Care

Project title	Key findings	Completion
T026 - Health economic analysis of Major Trauma Recovery Coordinator (MTReC) project with Alfred Health	This analysis was the final component of the Major Trauma Recovery Coordinator (MTReC) study which compared resource utilisation and costs, in the first 6-months of major trauma patients who received coordination services and those who did not. The MTReC role was not shown to be a cost-effective intervention for major trauma patients. Limitations with the study design and bias are likely to have contributed.	August 2022
T017 - Optimising Patient Outcomes Following trauma (BeFIT)	This project developed and piloted a new allied health model of care. The new model aimed to deliver an early, expanded, intensive, innovative, multidisciplinary model of allied health care designed to support improved recovery outcomes for trauma patients and provide a greater intensity of therapy to patients, delivered Monday through Sunday.	March 2022
T023 - Allied Health Trauma Workforce Model of Care	The TAC and Alfred Health partnered to modernise the Alfred Allied Health Trauma workforce and associated environment to enable early and intense therapy to commence in the acute environment in order to support improved recovery outcomes for Victorian trauma patients.	March 2022
T046 – Independent review of TAC-funded Data Registries	The review found that the Registries are high-functioning, high-quality and meet most characteristics of mature, high-functioning clinical quality registries. Impacts of the registries were examined with reference to patients, clinicians, researchers and government/policy. Opportunities to improve governance and reporting arrangements, measuring translation and impact, contract management and data sharing were identified.	October 2021
M202 - Trauma System – State-wide Capability Program	Trauma team training sessions using a mixture of prescribed pre-learning, didactic lectures, skill stations and simulated team based scenarios resulted in significant improvement in participant-reported outcomes in clinical confidence and real life team leadership.	July 2021
H032 - Major Trauma Recovery Coordinator (MTReC) Project	The absence of a consistent point of contact for coordination of care and information has been identified as a major deficit in care by trauma patients. Therefore, the TAC provided funding to The Alfred for two Major Trauma Recovery Coordinators (MTReC) for a 2-year period. The aim of this study was to explore the impact of the MTReC roles on patient experiences and outcomes. Results found no compelling and consistent evidence to continue funding the MTReC roles using the current model, and the discharge planning component of the role has subsequently been incorporated into the new allied health model of care for major trauma patients. Other recommendations included the provision of written information for patients in a consistent and appropriate format, improvements to the outpatient booking system and the development of a service map with respect to pain management and mental health services.	March 2020
M201 - Ambulance Victoria Heads up Display (HUD) decision-support technology usability and effectiveness evaluation	Evaluated the usability and effectiveness of HUD technology for paramedics. The project encountered difficulties that prevented a successful in-field clinical trial. The three main difficulties were: technical challenges related to software and hardware development, operational constraints such as willingness to wear the HUD, and limitations with existing digital infrastructure such as poor internet connectivity at remote locations.	June 2020
T020 - Supporting young people following major trauma	This study utilised a systematic review and environmental scan approach to provide a comprehensive evidence base of current approaches to health and disability assessment, planning, and management for young people aged 0-18 years who have sustained major traumatic injuries. Factors related to outcome were education, social relationships, and mental health. Longer school retention, completing secondary school, and undertaking further education were all positively associated with achieving key adult goals, such as living independently and gaining employment. Positive relationships were protective and related to improved outcomes. A diagnosis of mental illness placed young people at increased risk of poorer outcomes, including unemployment and lower levels of community integration.	July 2019
T011 - Acute allied health models of care	The aim of this Evidence Review was to determine whether allied health interventions provided to adults with a traumatic injury in an acute inpatient hospital setting improves health outcomes, and to examine the elements of interventions shown to be effective. For all of the small number of studies that reported significant gains in the intervention arm, a greater intensity of allied health treatment and therapy was utilised for the intervention group. However, the specifics of each intervention varied between studies, ranging from increasing the amount of therapy provided by a single allied health professional, to establishing large multidisciplinary teams and implementing structured care pathways. Most of the studies identified were NHMRC level III studies, giving a high risk of selection bias. Therefore, results should be interpreted with caution as the impact of the proposed interventions may have been overestimated.	February 2019
T025 - Leveraging Victorian State Trauma Registry (VSTR) and Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) outcomes Data	The TAC views client outcomes as a primary strategic objective, through the lens of clients getting their lives “back on track”. The TAC is exploring opportunities to better leverage outcomes data that have already been collected for TAC clients. One important potential source of existing outcomes data for TAC clients is the Victorian State Trauma Registry (VSTR) and Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) (“the registries”). Of the 157,215 claims provided by the TAC, 14,309 (9.1%) were captured in the registries. The coverage rates differed substantially based on claims management division; 4% of Rapid Recovery clients, 27% of Supported Recovery clients, and 86% of Independence clients. There were notable gaps in registry coverage of TAC clients, particularly children, non-hospitalised TAC claims, and injuries not routinely requiring admission to hospital. Despite these gaps, the key finding of this study was that a propensity score approach could be feasibly applied to the wider TAC claims data, with some caveats for claimants with extremely low registry coverage.	December 2019

Virtual Healthcare (Telehealth)

Project title	Key findings	Completion
T047 - Effectiveness of telehealth for hospitalised clients	A mixed methods study aiming to understand the experience and cost effectiveness of telehealth services for hospitalised TAC clients. Phase 1 found telehealth services created both challenges and opportunities for clients, providers and the TAC. Individual, technology, environment and support-related factors influenced the experience of telehealth. Opportunities to enhance the use and experience of telehealth were identified, some of which were in the TAC's sphere of influence. Phase 2 analysed TAC claims data matched to Victorian State Trauma Registry (VSTR) data for 1,390 clients. Seven percent of services were delivered by telehealth between March 2020 and August 2021. Psychology, network pain management and hospital rehabilitation were the most frequently delivered services via telehealth. Clients who used telehealth were more severely injured, more likely to have worked or studied prior to injury, and at 12 months post injury had a greater odds of higher disability, pain and anxiety/depression, compared to non-users.	August 2022