Promoting Recovery in Children Who Sustain a Mild Traumatic Brain Injury: The TBI Evaluation and Management (TEaM) Toolkit

项目总结 据估计，美国每年有超过380万例创伤性脑损伤(TBI)，其中 每年约250万急诊科就诊。年龄在14岁及以下的儿童 年轻人，2013年与脑外伤相关的急诊科(ED)就诊人数约为64万人次[CDC 2018年]。超过80%的脑损伤被归类为轻度(MTBI)，术语脑震荡可以互换使用 等人，2017年；Menon等人，2010年]。除了急诊室，紧急护理中心和初级保健医生也是 负责寻求mTBI治疗的患者的初步评估和管理。尽管这是良性的 听起来，mTBI通常具有重大的短期和长期后果，可以通过早期修改 识别、干预和管理(Yang等人，2017；Collins等人，2016)。然而，这一制度 护理支离破碎，临床医生在适当评估、协调护理和管理方面的培训 有限的。为了克服这些限制，这项研究的主要目的是证明证据- 以实践和教育为基础对患者、照顾者、临床提供者和学校进行培训是可行的 将促进儿童和青少年轻微脑外伤后的康复。我们已经开发出一种 基于证据/最佳实践的TBI评估和管理(团队)工具包，面向以下领域的关键提供商 MTBI医疗系统。团队工具包利用电子病历系统(EMR)和 有针对性的培训计划，以改进整个过程中的筛选、管理和联系，或者其他什么 我们称之为关怀社区，目标是生产一个有效且可扩展的工具包，以促进 恢复。 好了！

PROJECT SUMMARY In the US, it is estimated that there are over 3.8 million traumatic brain injuries (TBI) annually, which account for approximately 2.5 million emergency department visits each year. For children 14 years of age and younger, there were approximately 640,000 TBI-related emergency department (ED) visits in 2013 [CDC 2018]. Over 80% of TBI is classified as mild (mTBI), with the term concussion used interchangeably [McCrory et al., 2017; Menon et al., 2010]. In addition to EDs, urgent care centers and primary care physicians are also charged with the initial evaluation and management of patients seeking care for mTBI. Despite the benign sounding term, mTBI often has significant short and long-term consequences that can be modified by early identification, intervention and management (Yang et al., 2017; Collins et al., 2016). However, the system of care is fragmented and clinician training on appropriate evaluation, coordination of care and management is limited. To overcome these limitations, the primary aim of this study is to demonstrate that evidence- based practice and education for the patient, caregivers, clinical providers and schools is feasible and will promote recovery following a mild TBI in children and adolescents. We have developed an evidence/best-practices based TBI Evaluation and Management (TEaM) Toolkit aimed at key providers in the system of mTBI healthcare. The TEaM Toolkit leverages the electronic medical record system (eMR) and a targeted training program to improve screening, management, and linkage throughout the continuum, or what we refer to as the neighborhood of care, with a goal of producing an effective and scalable toolkit to promote recovery. !