In the US, it is estimated that there are over 3.8 million traumatic brain injuries (TBI) annually, which account for approximately 2.5 million emergency department visits each year. For children 14 years of age and younger, there were approximately 640,000 TBI-related emergency department (ED) visits in 2013 [CDC 2018]. Over 80% of TBI is classified as mild (mTBI), with the term concussion used interchangeably [McCrory et al., 2017; Menon et al., 2010]. In addition to EDs, urgent care centers and primary care physicians are also charged with the initial evaluation and management of patients seeking care for mTBI. Despite the benign sounding term, mTBI often has significant short and long-term consequences that can be modified by early identification, intervention and management (Yang et al., 2017; Collins et al., 2016). However, the system of care is fragmented and clinician training on appropriate evaluation, coordination of care and management is limited. To overcome these limitations, the primary aim of this study is to demonstrate that evidence- based practice and education for the patient, caregivers, clinical providers and schools is feasible and will promote recovery following a mild TBI in children and adolescents. We have developed an evidence/best-practices based TBI Evaluation and Management (TEaM) Toolkit aimed at key providers in the system of mTBI healthcare. The TEaM Toolkit leverages the electronic medical record system (eMR) and a targeted training program to improve screening, management, and linkage throughout the continuum, or what we refer to as the neighborhood of care, with a goal of producing an effective and scalable toolkit to promote recovery. !
Emergency Departments (EDs), Urgent Care Facilities (UCFs), and Primary Care Physicians (PCPs) are charged with the initial evaluation and management of most patients seeking care for mTBI. However, the system of care is fragmented and clinician training on appropriate evaluation, coordination of care and management is limited. We propose that the TBI Evaluation and Management (TEaM) Toolkit with PCP training and tools, integrated within a Neighborhood of Care model will enhance detection, provide a more streamlined assessment, improve documentation, clinical management, injury prevention messaging and return to activity information, and provide a link between Emergency Care, Urgent Care, Primary Care, Parents and Schools that has the potential to improve the outcome of the child suffering from mTBI. !
