Development and implementation of an integrated orthoptic-speech therapy assessment protocol in neurorehabilitation setting: A community case study.

Introduction and context: Patients with Severe Acquired Brain Injuries (SABI) are a complex challenge in neurorehabilitation. They often cause visual and cognitive-communicative disorders that require a multidisciplinary approach, yet few clear strategies exist for effectively integrating rehabilitation professionals and optimizing care pathways. To improve care for complex patients, this study aimed to examine how clinicians perceive the impact of deficits in vision and communication. The research specifically focused on the state of team collaboration among clinicians (including physicians and nurses), healthcare professionals, and between speech and language therapists and orthoptists, while identifying effective strategies to address these challenges. Methods: This qualitative study used a mixed-method approach, combining documentary research, participant observation, a focus group, and an open-ended questionnaire, which were administered to two distinct groups of professionals. Data were collected and triangulated to ensure ecological rigor and provide a deep understanding of the clinical process and its challenges. All data were analyzed thematically to identify recurring themes and common perceptions. Findings and discussion: The results confirmed clinicians' perception of the important role that visual, cognitive, and communicative disorders play. They highlight a perceived lack of information regarding visual aspects in medical records. The analysis revealed a clear difference in the perception of professional integration; the Speech and Language Pathologist was perceived as a well-integrated figure, while the orthoptist was found to be less effective in the team. The participants' recommendations emphasized the need for shared written evaluation communication tools regarding speech and language therapy and orthoptic aspects. These tools should use a common language, such as a written protocol. Conclusions: The study underscores the importance of overcoming informational and coordination barriers between disciplines to optimize the care pathway for patients with SABI. The results suggest that the adoption of a shared protocol can significantly improve multidisciplinary integration and the quality of care.