Neuropsychological referral pathways for adults with a traumatic brain injury at a tertiary hospital in Australia: gaps and recommendations for management

Objective The objective of this study was to evaluate the current neuropsychology referral pathways in a non-specialist hospital setting in Sydney, Australia, in adults hospitalised following a traumatic brain injury (TBI).Method This was a retrospective observational study at Royal North Shore Hospital (RNSH), a major trauma hospital in Sydney.Results The results revealed that ≤2% patients with a mild-severe TBI admitted to RNSH received neuropsychology referrals during admission or on discharge. While 30% of patients were discharged to an inpatient rehabilitation service, it remains unclear whether they accessed neuropsychology services during their later admission. Younger adults were more likely to receive recommendations for neuropsychology services on discharge. Discharge location differed by age, sex and injury severity.Conclusions Findings emphasise the need to re-evaluate current standards of neuropsychological care post-TBI in this setting. A standardised referral process for neuropsychology services, consistent with existing guidelines, should be implemented. Further research aimed at increasing age-inclusive neuropsychological referral processes is needed. Consistent reporting of injury severity classification across multidisciplinary teams and adoption of a neuropsychology referral process, with consideration of subgroups at risk, may be necessitated.