{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:29:19Z","timestamp":1766489359659,"version":"3.48.0"},"reference-count":32,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Safe discharge after neurosurgical traumatic brain injury (TBI) depends on documented counseling and appropriate referrals, yet real-world fidelity is uncertain in resource-constrained settings. We quantified discharge process quality and identified digitally actionable gaps. Methods: The sample for this study was a retrospective cohort of 559 consecutive neurosurgical TBI patients discharged from a Brazilian public tertiary center (2012\u20132022). Data were abstracted from electronic health records. The primary outcome was documentation of warning sign counseling at discharge. Proportions are reported with exact Clopper\u2013Pearson 95% confidence intervals. Results: The median age was 66 years (IQR 47\u201379.5); 78.5% were male and most received care under the public health system. Subdural hematoma predominated; hematoma drainage was the most frequent procedure. Warning sign counseling was documented in 16.1% of cases (89\/559; 95% CI 13.2\u201319.5), and no palliative care referrals were recorded. Conclusions: A low baseline for a safety-critical discharge element exposes an immediately actionable target. Embedding discharge order sets with mandatory counseling fields in the EHR, clinical decision support prompts for palliative care screening and follow-up, and QR-coded patient handouts represent a pragmatic path to improve discharge quality and end-of-life readiness in the digital era.<\/jats:p>","DOI":"10.3390\/healthcare14010032","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:57:18Z","timestamp":1766487438000},"page":"32","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Digitally Enabled Discharge Quality After Neurosurgical Traumatic Brain Injury: A 10-Year Cohort from a Brazilian Public Tertiary Center"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0451-2447","authenticated-orcid":false,"given":"Roberto Salvador Souza","family":"Guimar\u00e3es","sequence":"first","affiliation":[{"name":"School of Medicine, Universidade Jos\u00e9 do Ros\u00e1rio Vellano (UNIFENAS), Alfenas 37132-440, Minas Gerais, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2223-6927","authenticated-orcid":false,"given":"Victoria Ragognete","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Jos\u00e9 do Ros\u00e1rio Vellano (UNIFENAS), Alfenas 37132-440, Minas Gerais, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1207-2867","authenticated-orcid":false,"given":"Carlos Marcelo","family":"Barros","sequence":"additional","affiliation":[{"name":"Department of Medicine, Federal University of Alfenas (UNIFAL-MG), Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas 37133-840, Minas Gerais, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-082X","authenticated-orcid":false,"given":"Ma\u00edsa Ribeiro Pereira Lima","family":"Brigag\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Medicine, Federal University of Alfenas (UNIFAL-MG), Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas 37133-840, Minas Gerais, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-7895","authenticated-orcid":false,"given":"Francisca","family":"Rego","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990\u20132016","volume":"18","author":"James","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/S1474-4422(22)00309-X","article-title":"Traumatic brain injury: Progress and challenges in prevention, clinical care, and research","volume":"21","author":"Maas","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury","volume":"130","author":"Dewan","year":"2018","journal-title":"J. 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