Details:

Alternative Title:
Clin Pediatr (Phila)
Publisher's site:
http://dx.doi.org/10.1177/0009922817709555
Personal Author:
Arbogast, Kristy B.; Curry, Allison E.; Metzger, Kristina B.; Kessler, Ronni S.; Bell, Jeneita M.; ... More +
Arbogast, Kristy B.; Curry, Allison E.; Metzger, Kristina B.; Kessler, Ronni S.; Bell, Jeneita M.; Haarbauer-Krupa, Juliet; Zonfrillo, Mark R.; Breiding, Matthew J.; Master, Christina L.; Less -
Description:
Primary care providers are increasingly providing youth concussion care but report insufficient time and training, limiting adoption of best practices. We implemented a primary care-based intervention including an electronic health record-based clinical decision support tool ("SmartSet") and in-person training. We evaluated consequent improvement in 2 key concussion management practices: (1) performance of a vestibular oculomotor examination and (2) discussion of return-to-learn/return-to-play (RTL/RTP) guidelines. Data were included from 7284 primary care patients aged 0 to 17 years with initial concussion visits between July 2010 and June 2014. We compared proportions of visits pre- and post-intervention in which the examination was performed or RTL/RTP guidelines provided. Examinations and RTL/RTP were documented for 1.8% and 19.0% of visits pre-intervention, respectively, compared with 71.1% and 72.9% post-intervention. A total of 95% of post-intervention examinations were documented within the SmartSet. An electronic clinical decision support tool, plus in-person training, may be key to changing primary care provider behavior around concussion care.
Subject:
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Adolescent
Adult
Article
Brain Concussion
Child
Child, Preschool
Clinical Decision Support
Decision Support Systems, Clinical
Electronic Health Record
Electronic Health Records
Female
Humans
Infant
Male
Practice Guidelines As Topic
Practice Patterns, Physicians'
Primary Care
Primary Health Care
Traumatic Brain Injury
Young Adult

Source:
Clin Pediatr (Phila). 56(9):854-865.;
Pubmed ID:
28521519
Pubmed Central ID:
PMC6082149
Document Type:
Journal Article;
Funding:
CC999999/Intramural CDC HHS/United States;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:120e19ceec03b5b610c15c681e9ec69291505f48d41e07b0038a737077ed8515
File Type:

Supporting Files

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