Welcome!

News Feed Item

Survey of Emergency and Primary Care Pediatricians Highlights Need for Training, Tools to Manage Kids' Concussions

CHOP is using this study data to create a new model of care for pediatric concussion

PHILADELPHIA, Nov. 12, 2012 /PRNewswire-USNewswire/ -- While general pediatricians and pediatric emergency physicians value their role in concussion management, a study of their self-reported knowledge, practices and attitudes points to the need for improved concussion-specific training and infrastructure to support optimal patient care. The study, released today in the journal Pediatrics, served as a catalyst for The Children's Hospital of Philadelphia (CHOP) to create a new "medical home" model for managing pediatric and adolescent concussion.

The study surveyed 145 emergency medicine and primary care providers, among whom 91 percent had cared for at least one concussion patient and 92 percent had referred at least one patient to a concussion specialist in the prior three months. Authors noted variability in how respondents recognized signs, symptoms and physical exam findings for concussion.  They recommend specialized, continuing medical education training for primary care and emergency medicine clinicians, coupled with standardized clinical decision support tools and patient education tools. 

"We have seen concussion visits within our emergency department, primary care and specialty care network at CHOP quadruple since 2009 to a current total of more than 6,700 each year," says Mark Zonfrillo, M.D., M.S.C.E., the study's lead author, a researcher at CHOP's Center for Injury Research and Prevention and a pediatric emergency medicine specialist.  "The emergency department and primary care settings often serve as the entry point of care for children with a suspected concussion, and we know that early diagnosis and treatment of concussion can lead to faster, more complete recovery."

"With the increased occurrence and recognition of concussions, it can be challenging to schedule a follow-up appointment with a concussion specialist immediately following injury. However, families can usually see a CHOP primary care provider within the first few days after sustaining a concussion at one of more than 30 locations, so they can promptly begin treatment and monitor recovery," notes Zonfrillo.

Zonfrillo and his colleagues believe the primary care setting is the most appropriate place for management and follow-up for most pediatric concussion cases. The best practice for managing a diagnosed concussion in the initial weeks following the injury involves two essential components: using a systematic, clinical assessment to determine if concussion symptoms are resolving, and adhering to a step-by-step program of gradual return-to-learn and return-to-play. However, the study found inconsistent clinical assessment and inconsistent prescribing of the "return" protocols in discharge instructions. Pediatric primary care and emergency medicine providers agreed that standardized evaluation and decision-making tools, and training in their use, would increase their comfort with diagnosing and managing concussions.

With this valuable input from primary care and emergency medicine providers, concussion specialists at CHOP developed an infrastructure, including necessary diagnostic and patient education support tools, that is now delivered network-wide through CHOP's electronic medical record system.

"We adapted state-of-the-science protocols used by concussion specialists into an electronic interactive form that is part of the patient's medical record," says Zonfrillo. "This form, which is specific to concussion, provides a guide for the primary care provider for the systematic evaluation of concussion patients, including potential symptoms and physical exam findings."

The provider can print out fact sheets that walk the parents through the return-to-learn and return- to-play process, as well as a letter intended for the child's school explaining the diagnosis and treatment. The interactive form indicates when a patient should be referred to a specialist if, for example, they have certain pre-existing conditions or for persistent symptoms.

Earlier this year, CHOP's concussion experts provided special training to more than 100 providers, representing all 30 primary care locations in the CHOP Care Network. The CHOP Network is the largest pediatric health system in the country and its new Medical Home model for concussion management could eventually be applied in other health systems. Zonfrillo and his colleagues are closely monitoring and adjusting the new model in hopes that it can improve outcomes for children in the greater Philadelphia region, as well as the hundreds of thousands of children who suffer concussions each year across the U.S.  Visit www.chop.edu/concussion for information about youth concussions, as well as CHOP's unique approach to managing pediatric concussion.

Zonfrillo's co-authors are CHOP colleagues Christina Master, M.D., Matthew Grady, M.D., Flaura Winston, M.D., Ph.D., James Callahan, M.D., and Kristy Arbogast, Ph.D. The study was funded by the Chair's Initiatives at CHOP.

"General pediatric and emergency medicine providers' self-reported knowledge, practices, and attitudes about concussion," Pediatrics, published online Nov. 12, 2012. doi:10.1542/peds.2012.1431

About The Children's Hospital of Philadelphia:
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 516-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

Contact: Alison Fraser
The Children's Hospital of Philadelphia
(267) 426-6054
[email protected]

SOURCE The Children's Hospital of Philadelphia

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
DX World EXPO, LLC, a Lighthouse Point, Florida-based startup trade show producer and the creator of "DXWorldEXPO® - Digital Transformation Conference & Expo" has announced its executive management team. The team is headed by Levent Selamoglu, who has been named CEO. "Now is the time for a truly global DX event, to bring together the leading minds from the technology world in a conversation about Digital Transformation," he said in making the announcement.
"Space Monkey by Vivent Smart Home is a product that is a distributed cloud-based edge storage network. Vivent Smart Home, our parent company, is a smart home provider that places a lot of hard drives across homes in North America," explained JT Olds, Director of Engineering, and Brandon Crowfeather, Product Manager, at Vivint Smart Home, in this SYS-CON.tv interview at @ThingsExpo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
SYS-CON Events announced today that Conference Guru has been named “Media Sponsor” of the 22nd International Cloud Expo, which will take place on June 5-7, 2018, at the Javits Center in New York, NY. A valuable conference experience generates new contacts, sales leads, potential strategic partners and potential investors; helps gather competitive intelligence and even provides inspiration for new products and services. Conference Guru works with conference organizers to pass great deals to gre...
DevOps is under attack because developers don’t want to mess with infrastructure. They will happily own their code into production, but want to use platforms instead of raw automation. That’s changing the landscape that we understand as DevOps with both architecture concepts (CloudNative) and process redefinition (SRE). Rob Hirschfeld’s recent work in Kubernetes operations has led to the conclusion that containers and related platforms have changed the way we should be thinking about DevOps and...
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform. In his session at @ThingsExpo, Craig Sproule, CEO of Metavine, demonstrated how to move beyond today's coding paradigm and shared the must-have mindsets for removing complexity from the develop...
In his Opening Keynote at 21st Cloud Expo, John Considine, General Manager of IBM Cloud Infrastructure, led attendees through the exciting evolution of the cloud. He looked at this major disruption from the perspective of technology, business models, and what this means for enterprises of all sizes. John Considine is General Manager of Cloud Infrastructure Services at IBM. In that role he is responsible for leading IBM’s public cloud infrastructure including strategy, development, and offering m...
The next XaaS is CICDaaS. Why? Because CICD saves developers a huge amount of time. CD is an especially great option for projects that require multiple and frequent contributions to be integrated. But… securing CICD best practices is an emerging, essential, yet little understood practice for DevOps teams and their Cloud Service Providers. The only way to get CICD to work in a highly secure environment takes collaboration, patience and persistence. Building CICD in the cloud requires rigorous ar...
Companies are harnessing data in ways we once associated with science fiction. Analysts have access to a plethora of visualization and reporting tools, but considering the vast amount of data businesses collect and limitations of CPUs, end users are forced to design their structures and systems with limitations. Until now. As the cloud toolkit to analyze data has evolved, GPUs have stepped in to massively parallel SQL, visualization and machine learning.
"Evatronix provides design services to companies that need to integrate the IoT technology in their products but they don't necessarily have the expertise, knowledge and design team to do so," explained Adam Morawiec, VP of Business Development at Evatronix, in this SYS-CON.tv interview at @ThingsExpo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
To get the most out of their data, successful companies are not focusing on queries and data lakes, they are actively integrating analytics into their operations with a data-first application development approach. Real-time adjustments to improve revenues, reduce costs, or mitigate risk rely on applications that minimize latency on a variety of data sources. In his session at @BigDataExpo, Jack Norris, Senior Vice President, Data and Applications at MapR Technologies, reviewed best practices to ...
Widespread fragmentation is stalling the growth of the IIoT and making it difficult for partners to work together. The number of software platforms, apps, hardware and connectivity standards is creating paralysis among businesses that are afraid of being locked into a solution. EdgeX Foundry is unifying the community around a common IoT edge framework and an ecosystem of interoperable components.
"ZeroStack is a startup in Silicon Valley. We're solving a very interesting problem around bringing public cloud convenience with private cloud control for enterprises and mid-size companies," explained Kamesh Pemmaraju, VP of Product Management at ZeroStack, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Large industrial manufacturing organizations are adopting the agile principles of cloud software companies. The industrial manufacturing development process has not scaled over time. Now that design CAD teams are geographically distributed, centralizing their work is key. With large multi-gigabyte projects, outdated tools have stifled industrial team agility, time-to-market milestones, and impacted P&L stakeholders.
"Akvelon is a software development company and we also provide consultancy services to folks who are looking to scale or accelerate their engineering roadmaps," explained Jeremiah Mothersell, Marketing Manager at Akvelon, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Enterprises are adopting Kubernetes to accelerate the development and the delivery of cloud-native applications. However, sharing a Kubernetes cluster between members of the same team can be challenging. And, sharing clusters across multiple teams is even harder. Kubernetes offers several constructs to help implement segmentation and isolation. However, these primitives can be complex to understand and apply. As a result, it’s becoming common for enterprises to end up with several clusters. Thi...