Quality Improvement in Concussion Care: Influence of Guideline-Based Education
| Autor: | Shabnam Jain, Laura S. Blackwell, Andrew T. Reisner, Thomas G. Burns, Joshua J. Chern, Kim E. Ono, Larry B. Hall, Brad C. Weselman, Ton J. de Grauw |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Quality management Referral Pediatrics 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Intervention (counseling) Concussion medicine Humans 030212 general & internal medicine Prospective Studies Child Brain Concussion Aged Response rate (survey) business.industry Emergency department Guideline Middle Aged medicine.disease Quality Improvement Pediatrics Perinatology and Child Health Practice Guidelines as Topic Physical therapy Community practice Self Report business |
| Zdroj: | The Journal of pediatrics. 184 |
| ISSN: | 1097-6833 |
| Popis: | To evaluate the potential impact of a concussion management education program on community-practicing pediatricians.We prospectively surveyed 210 pediatricians before and 18 months after participation in an evidence-based, concussion education program. Pediatricians were part of a network of 38 clinically integrated practices in metro-Atlanta. Participation was mandatory for at least 1 pediatrician in each practice. We assessed pediatricians' self-reported concussion knowledge, use of guidelines, and comfort level, as well as self-reported referral patterns for computed tomography (CT) and/or emergency department (ED) evaluation of children who sustained concussion.Based on responses from 120 pediatricians participating in the 2 surveys and intervention (response rate, 57.1%), the program had significant positive effects from pre- to postintervention on knowledge of concussions (-0.26 to 0.56 on -3 to +1 scale; P .001), guideline use (0.73-.06 on 0-6 scale; P .01), and comfort level in managing concussions (3.76-4.16 on 1-5 scale; P .01). Posteducation, pediatricians were significantly less likely to self-report referral for CT (1.64-1.07; P .001) and CT/ED (4.73-3.97; P .01), but not ED referral alone (3.07-3.09; P = ns).Adoption of a multifaceted, evidence-based, education program translated into a positive modification of self-reported practice behavior for youth concussion case management. Given the surging demand for community-based youth concussion care, this program can serve as a model for improving the quality of pediatric concussion management. |
| Databáze: | OpenAIRE |
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