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Quality Improvement in Concussion Care: Influence of Guideline-Based Education.
Reisner, Andrew; Burns, Thomas G; Hall, Larry B; Jain, Shabnam; Weselman, Brad C; De Grauw, Ton J; Ono, Kim E; Blackwell, Laura S; Chern, Joshua J.
Afiliação
  • Reisner A; Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA. Electronic address: Andrew.Reisner@choa.org.
  • Burns TG; Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA.
  • Hall LB; Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA.
  • Jain S; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA.
  • Weselman BC; Kids Health First Network, Atlanta, GA.
  • De Grauw TJ; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA.
  • Ono KE; Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA.
  • Blackwell LS; Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA.
  • Chern JJ; Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA.
J Pediatr ; 184: 26-31, 2017 05.
Article em En | MEDLINE | ID: mdl-28233546
OBJECTIVE: To evaluate the potential impact of a concussion management education program on community-practicing pediatricians. STUDY DESIGN: We prospectively surveyed 210 pediatricians before and 18 months after participation in an evidence-based, concussion education program. Pediatricians were part of a network of 38 clinically integrated practices in metro-Atlanta. Participation was mandatory for at least 1 pediatrician in each practice. We assessed pediatricians' self-reported concussion knowledge, use of guidelines, and comfort level, as well as self-reported referral patterns for computed tomography (CT) and/or emergency department (ED) evaluation of children who sustained concussion. RESULTS: Based on responses from 120 pediatricians participating in the 2 surveys and intervention (response rate, 57.1%), the program had significant positive effects from pre- to postintervention on knowledge of concussions (-0.26 to 0.56 on -3 to +1 scale; P < .001), guideline use (0.73-.06 on 0-6 scale; P < .01), and comfort level in managing concussions (3.76-4.16 on 1-5 scale; P < .01). Posteducation, pediatricians were significantly less likely to self-report referral for CT (1.64-1.07; P < .001) and CT/ED (4.73-3.97; P < .01), but not ED referral alone (3.07-3.09; P = ns). CONCLUSIONS: Adoption of a multifaceted, evidence-based, education program translated into a positive modification of self-reported practice behavior for youth concussion case management. Given the surging demand for community-based youth concussion care, this program can serve as a model for improving the quality of pediatric concussion management.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pediatria / Concussão Encefálica / Melhoria de Qualidade Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Qualitative_research Limite: Adult / Aged / Child / Humans / Middle aged Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pediatria / Concussão Encefálica / Melhoria de Qualidade Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Qualitative_research Limite: Adult / Aged / Child / Humans / Middle aged Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos