Improving the Clinical Management of Pediatric Concussions in Rural Primary Care

Purpose: This project aims to determine if a targeted educational module about return-to-learn coupled with instruction about using a concussion symptom evaluation tool improves provider knowledge about guideline recommendations and the intent to translate knowledge into practice at North Country Health Care. Background: Concussions are a common cause of morbidity in youth, with the incidence rising. Since primary care providers (PCPs) are predominantly responsible for managing concussions, their knowledge about evidence-based care is crucial to patient outcomes. Significant gaps exist in provider knowledge of return-to-learn guideline recommendations, potentially resulting in suboptimal care. Numerous pediatric concussion clinical practice guidelines and validated concussion evaluation tools are available to guide practice. The literature suggests that provider education is a critical component of disseminating guideline recommendations. Methods: The quality improvement project consisted of a targeted educational presentation delivered to health care providers at North Country Health Care. The education highlighted key return-to-learn guideline recommendations and introduced a concussion symptom evaluation tool that the participants applied to a clinical case study. Pre and post-test surveys assessed knowledge and intent to apply knowledge to practice. Results: Using descriptive statistics, a comparative analysis of pre- and post-test surveys were completed to determine if the education intervention improved provider knowledge about return-to-learn recommendations. The findings showed a 47% improvement in overall knowledge about return-to-learn guideline recommendations following the education, and 60% of participants reported they intended to translate knowledge into practice. Conclusions: The project findings support the literature regarding existing knowledge gaps in primary care about return-to-learn guideline recommendations. Several guidelines exist, but effective dissemination is a barrier. The outcomes demonstrated substantial improvement in provider knowledge of key return-to-learn guideline recommendations using a targeted education designed for adult learners, reinforcing existing literature that education is a crucial component of evidence-based practice. Future quality improvement (QI) efforts should focus on disseminating return-to-learn guidelines to a larger number of providers. Research should focus on determining the most effective dissemination strategies for translating knowledge into practice