Enabling Hospitals to be more Inclusive and Responsive to People with Intellectual Disabilities and Acquired Brain Injury

Bigby, Christine, Douglas, Jacinta; and Iacono, Teresa,

Living with Disability Research Centre, La Trobe University


Introduction: There is much evidence internationally about the poor quality of hospital care for people with intellectual disabilities but very little about that of people with acquired brain injury post rehabilitation. Evidence from Australia and Victoria has been limited. This study aim was to provide evidence about the processes and practices that enable hospitals to respond to the particular needs of these two groups.

Methods: Mixed methods were used in a study conducted across three Victorian health networks. Sixty primary participants with intellectual disabilities or acquired brain injury were recruited as they commenced a hospital encounter and followed through to discharge. Unstructured non-participant observation and semi-structured interviews were conducted with patients, those accompanying them and hospital staff about their respective experiences of accessing and being treated in hospital or treating these patients.

Results: Almost all encounters began in Emergency and close to half (46%) moved from Emergency to a short stay unit or a ward. Most patients spent longer in Emergency than the benchmark standards, had numerous diagnostic tests and were treated according to relevant guidelines. Qualitative analysis revealed promising strategies and processes within four themes (support, information, collaboration and knowledge) that could be applied across the hospital journey.

Implications: This study demonstrates more positive hospital care processes for people with intellectual disabilities than identified overseas. It has enabled identification of a clear set of strategies to guide the development of hospital practices to improve the care experiences and health outcomes of people with intellectual disabilities that can now be piloted.

Full report available from http://hdl.handle.net/1959.9/563685


Professor Christine Bigby is Director of the Living with Disability Research Centre at La Trobe University and Professor of Social Work. Her research is focused on the effectiveness of programs and policies that aim to support the social inclusion of people with intellectual disability in adulthood and later life. She has been particularly interested in system interfaces – informal and formal support, and mainstream and specialist services. She has published 6 book, 35 book chapters and over 135 peer reviewed journal articles. She has had continuous funding from the ARC for her research since 2004 as well as research funding from industry and state governments. She is the founding editor of the Journal of Policy and Practice in Intellectual and Developmental Disabilities and was Editor of Australian Social Work from 2008-2013.