TY  - JOUR
PY  - 2017//
TI  - Improving primary care provider practices in youth concussion management
JO  - Clinical pediatrics
A1  - Arbogast, Kristy B.
A1  - Curry, Allison E.
A1  - Metzger, Kristina B.
A1  - Kessler, Ronni S.
A1  - Bell, Jeneita M.
A1  - Haarbauer-Krupa, Juliet
A1  - Zonfrillo, Mark R.
A1  - Breiding, Matthew J.
A1  - Master, Christina L.
SP  - 854
EP  - 865
VL  - 56
IS  - 9
N2  - 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.<p />  <p>Language: en</p>
LA  - en
SN  - 0009-9228
UR  - http://dx.doi.org/10.1177/0009922817709555
ID  - ref1
ER  -