A Supported Primary Health Pathway for Mild Traumatic Brain Injury: Quality Improvement Report

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aut.relation.endpage314
aut.relation.issue3
aut.relation.journalJournal of Primary Health Care
aut.relation.startpage308
aut.relation.volume16
dc.contributor.authorTheadom, A
dc.contributor.authorChua, J
dc.contributor.authorSintmaartensdyk, A
dc.contributor.authorKara, S
dc.contributor.authorBarnes, R
dc.contributor.authorMacharg, R
dc.contributor.authorLeckey, E
dc.contributor.authorMirza, A
dc.contributor.editorStokes, Tim
dc.date.accessioned2024-11-12T01:49:04Z
dc.date.available2024-11-12T01:49:04Z
dc.date.issued2024-03-04
dc.description.abstractIntroduction: Best-practice guidelines recommend that patients are followed-up to check if they have recovered following a mild traumatic brain injury (mTBI) and to refer to concussion services, if needed. However, in New Zealand, rates of follow-up are low and access to concussion services can be delayed. Aim: We aimed to improve rates of follow-up and access to concussion services for mTBI patients aged ≥8 years by the implementation of a supported health pathway and test its success. Methods: The pathway included a decision support tool, funded follow-up appointments, clinician training and a patient education resource. Sociodemographics, injury details and proportions of patients receiving a follow-up by type and time were extracted from the Accident Compensation Corporation (ACC) database between 18 May 22 and 30 June 23 and compared to national ACC data prior to implementation. Results: Data were extracted for 220 patients, with a mean age of 31.5 years, 51.4% female and 21.4% Māori and Pacific. There was an increase in the proportion of patients receiving a follow-up from 36% pre-implementation to 56.8% post-implementation. Sixty-three patients (28.6%) accessed a concussion service post-implementation compared to 10% pre-implementation. Time to concussion service reduced from an average of 55 (s.d. = 65.4) to 37 days (29.5). Discussion: Risk factor criteria within the decision support tool need to be weighted to improve specificity of referrals. Timing from injury to medical review in primary care needs to be considered. This quality improvement project provides preliminary evidence for implementation of a supported health care pathway for mTBI.
dc.identifier.citationJournal of Primary Health Care, ISSN: 1172-6156 (Print); 1172-6156 (Online), CSIRO Publishing, 16(3), 308-314. doi: 10.1071/hc23131
dc.identifier.doi10.1071/hc23131
dc.identifier.issn1172-6156
dc.identifier.issn1172-6156
dc.identifier.urihttp://hdl.handle.net/10292/18294
dc.languageen
dc.publisherCSIRO Publishing
dc.relation.urihttps://www.publish.csiro.au/HC/HC23131
dc.rights© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
dc.rights.accessrightsOpenAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject4203 Health Services and Systems
dc.subject42 Health Sciences
dc.subjectNeurosciences
dc.subjectHealth Services
dc.subjectTraumatic Head and Spine Injury
dc.subjectTraumatic Brain Injury (TBI)
dc.subjectBrain Disorders
dc.subjectPhysical Injury - Accidents and Adverse Effects
dc.subjectClinical Research
dc.subject8.1 Organisation and delivery of services
dc.subject3 Good Health and Well Being
dc.subject1110 Nursing
dc.subject1117 Public Health and Health Services
dc.subject4203 Health services and systems
dc.subject.meshHumans
dc.subject.meshFemale
dc.subject.meshNew Zealand
dc.subject.meshMale
dc.subject.meshQuality Improvement
dc.subject.meshBrain Concussion
dc.subject.meshAdult
dc.subject.meshPrimary Health Care
dc.subject.meshAdolescent
dc.subject.meshMiddle Aged
dc.subject.meshYoung Adult
dc.subject.meshCritical Pathways
dc.subject.meshChild
dc.subject.meshHealth Services Accessibility
dc.subject.meshReferral and Consultation
dc.subject.meshHumans
dc.subject.meshBrain Concussion
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshMiddle Aged
dc.subject.meshChild
dc.subject.meshReferral and Consultation
dc.subject.meshCritical Pathways
dc.subject.meshPrimary Health Care
dc.subject.meshHealth Services Accessibility
dc.subject.meshNew Zealand
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshYoung Adult
dc.subject.meshQuality Improvement
dc.subject.meshHumans
dc.subject.meshFemale
dc.subject.meshNew Zealand
dc.subject.meshMale
dc.subject.meshQuality Improvement
dc.subject.meshBrain Concussion
dc.subject.meshAdult
dc.subject.meshPrimary Health Care
dc.subject.meshAdolescent
dc.subject.meshMiddle Aged
dc.subject.meshYoung Adult
dc.subject.meshCritical Pathways
dc.subject.meshChild
dc.subject.meshHealth Services Accessibility
dc.subject.meshReferral and Consultation
dc.titleA Supported Primary Health Pathway for Mild Traumatic Brain Injury: Quality Improvement Report
dc.typeJournal Article
pubs.elements-id542036
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