Co-producing process maps to understand and support improvements in the hospital-to-school transition following moderate-to-severe acquired brain injury in primary school-aged children.

Abstract

Hospital-to-school transition following moderate-to-severe acquired brain injury (ABI) is a complex, cross-sectoral process, requiring timely and coordinated information sharing between health professionals, parents and educators. Despite its importance, families and educators often feel underprepared to support the child's return to school following ABI. This study aimed to develop and describe a participatory process mapping (PM) methodology to visualise and understand information sharing processes during hospital-to-school transition for primary school-aged children with ABI. This novel, cross-sector, two-staged PM approach involved co-developing seven child case maps through triangulation of semi-structured interviews with parents, health professionals and educators (n = 23) and medical records reviews (Stage 1). Stage 2 comprised participatory workshops with 16 stakeholders across health, community and educator sectors to synthesise case maps into an overall hospital-to-school transition process map. The final map depicted non-linear, iterative pathways of information transfer across inpatient, outpatient and school settings. Findings revealed variability in communication channels, a lack of standardised protocols and reliance on parents as primary mediators for transferring information between hospital and schools with limited resources available to support them to advocate effectively. Schools received tailored recommendations after the child had returned to school and limited provision of ABI-related resources. PM provided a pragmatic, collaborative research tool to visualise complex, cross-sector processes and identify gaps in information delivery. This method offers a foundation for driving improvements and developing targeted interventions to improve hospital-to-school transitions in paediatric rehabilitation for children with ABI.