Theadom, AChua, JSintmaartensdyk, AKara, SBarnes, RMacharg, RLeckey, EMirza, AStokes, Tim2024-11-122024-11-122024-03-04Journal of Primary Health Care, ISSN: 1172-6156 (Print); 1172-6156 (Online), CSIRO Publishing, 16(3), 308-314. doi: 10.1071/hc231311172-61561172-6156http://hdl.handle.net/10292/18294Introduction: 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.© 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)https://creativecommons.org/licenses/by-nc-nd/4.0/4203 Health Services and Systems42 Health SciencesNeurosciencesHealth ServicesTraumatic Head and Spine InjuryTraumatic Brain Injury (TBI)Brain DisordersPhysical Injury - Accidents and Adverse EffectsClinical Research8.1 Organisation and delivery of services3 Good Health and Well Being1110 Nursing1117 Public Health and Health Services4203 Health services and systemsHumansFemaleNew ZealandMaleQuality ImprovementBrain ConcussionAdultPrimary Health CareAdolescentMiddle AgedYoung AdultCritical PathwaysChildHealth Services AccessibilityReferral and ConsultationHumansBrain ConcussionAdolescentAdultMiddle AgedChildReferral and ConsultationCritical PathwaysPrimary Health CareHealth Services AccessibilityNew ZealandFemaleMaleYoung AdultQuality ImprovementHumansFemaleNew ZealandMaleQuality ImprovementBrain ConcussionAdultPrimary Health CareAdolescentMiddle AgedYoung AdultCritical PathwaysChildHealth Services AccessibilityReferral and ConsultationJournal ArticleOpenAccess10.1071/hc23131