The purpose of the TeAM study is to evaluate a multi-disciplinary, multi-setting intervention with the goal of improving outcomes for children who have experienced a mild Traumatic Brain Injury (mTBI) or concussion. The project aims to improve and support mTBI diagnosis and management and improve critical decision making by clinicians during their interaction with the injured child, their family, and their school.
The study has multiple phases.
- The first phase involves developing and refining an educational and electronic medical record intervention (eMR) for clinicians in Emergency Care, Urgent Care, and Primary Care settings. Clinicians will be consented to participate in the study and randomized into two groups, those with concussion diagnosis and management training (in addition to any prior education) and those without. This intervention includes adding a two-question screen in the electronic medical record to determine if a child is at risk of having an mTBI or concussion. Initially, the screening tool will be added without alerting the clinicians to determine a baseline number of how many children screen positive and how many are diagnosed with a concussion.
- Then we will have the screening tool facing forward in the eMR to alert clinicians when a child screens positive and provide a template for evaluation and treatment. These families will receive the CDC’s current concussion discharge instructions and letters with details on returning to school and play.
- We will also conduct follow-up phone calls with those families that screen positive for concussion and/or receive a diagnosis of concussion. These families will be contacted by phone, verbally consented if all inclusion criteria is met. For those families who consent, we will conduct follow-up surveys on the child’s symptoms and recovery at one week, two weeks, and one month post their return to school.
Both groups of study subjects, the clinicians and the children, will be compensated for their time and participation in the study. Clinicians will be recruited through the Children’s Healthcare of Atlanta system and affiliated Primary Care Providers. The school-aged children will be recruited following visits for potential concussions from a cohort of clinicians participating in the study.
The study aims to determine if an evidence-based, best practice mTBI Toolkit will decrease mTBI-related complications in school-aged children and improve the diagnosis and management of mTBIs by clinicians. The Toolkit is also designed to standardize mTBI diagnosis and management among clinicians in different practice settings, specifically Emergency Care, Urgent Care, and Primary Care. The study also aims to increase communication with children’s school by consistently and perhaps electronically providing schools with Return to School letters.