@article{ref1,
title="Improving primary care provider practices in youth concussion management",
journal="Clinical pediatrics",
year="2017",
author="Arbogast, Kristy B. and Curry, Allison E. and Metzger, Kristina B. and Kessler, Ronni S. and Bell, Jeneita M. and Haarbauer-Krupa, Juliet and Zonfrillo, Mark R. and Breiding, Matthew J. and Master, Christina L.",
volume="56",
number="9",
pages="854-865",
abstract="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 (&quot;SmartSet&quot;) 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.<p /> <p>Language: en</p>",
language="en",
issn="0009-9228",
doi="10.1177/0009922817709555",
url="http://dx.doi.org/10.1177/0009922817709555"
}