Center for Injury Research and Prevention

Minds Matter: Concussion Care at CHOP – A Chair’s Initiative

In 2011, in order to continue to provide a high level of care to CHOP patients, CIRP partnered with CHOP Sports Medicine and Performance Center to coordinate efforts to develop a new model of care for concussion in children and the CHOP Minds Matter Concussion Care Program, a comprehensive pediatric concussion management program, began. (Abstracted from Pediatric Annals, Sept. 2012).

Minds Matter: Concussion Care at CHOP

The objective of this effort was to ensure that all concussion patients seen within the CHOP network were receiving similar high quality care by developing a clinical practice model, standardizing assessment tools, training providers and providing education to families and other stakeholders regarding what to expect if their child sustains a concussion. An initial two-year project was accomplished in several phases:

Phase I (Formative) -

Comprehensively characterized the current state of pediatric concussion management within the CHOP Care Network, including primary care, emergency care, specialty care, and after-hours services. Read a study abstract on providers' self- reported knowledge, practice and attitudes on concussion; and a study abstract on primary care providers' experience with prescribing cognitive rest.

Phase II (Intervention development) -

in 2012, to develop a clinical practice model for diagnosis, treatment and follow-up management. On the local level, the model was accompanied by appropriate hands-on training for CHOP Care Network providers on its use. Critical components of the new practice model included electronic health record (her) diagnostic and management support tools (“smart set” prompts), modifications to the Emergency Department clinical pathways and After-hours triaging process.

Several post-implementation analyses of clinical practices have been conducted, including an evaluation that reported the positive impact of the EHR-based intervention on key primary care provider practices. (See study abstract.) One other review of the electronic medical records before- and after-implementation of the revised after-hours call center triage algorithm, which refers patients with a suspected concussion to a primary care provider within 24 hours, showed a significant increase in PCP referrals and increase in concussion diagnoses. ED visits and CT-use visits decreased, but differences were not statistically significant. (See study abstract.)

Phase III (Patient family education) -

Developed an internet-based resource explaining Minds Matter: Concussion Care at CHOP to parents, healthcare providers, athletic coaching and training staff, and school personnel. Visitors to the website can download educational resources such as video FAQs, infographics, posters, and fact sheets.

Phase IV - (Concussion registry development)

Develop the architecture of a prospective clinical database on pediatric concussion which will be instrumental in informing future clinical, research, and quality improvement initiatives. See Concussion Registry Development

Principal Investigators: Kristy Arbogast, PhD, Christina L. Master, MD, Matthew Grady, MD

Funding: Children's Hospital of Philadelphia Department of Pediatrics Chair’s Initiatives