A team of emergency medicine researchers and clinical providers at Emory University School of Medicine will use new funding from the Centers for Disease Control and Prevention (CDC) to evaluate a clinical toolkit aimed at improving recovery in children with mild traumatic brain injury (mTBI).
The four-year research project, funded by a $550,000 grant from the CDC’s National Center for Injury Prevention and Control, will engage patients, caregivers, clinical providers and schools in studying and refining an Emory-developed TBI Evaluation and Management (TEaM) Toolkit aimed at better diagnosis, management and treatment of mTBI. When the project is complete, the Emory team plans to implement their toolkit in health systems across the country.
Approximately 640,000 children 14 years and younger have TBI-related emergency department visits annually, according to the CDC. Urgent care centers and primary care physicians also evaluate and manage patients with mTBI. More than 80 percent of TBI is classified as mTBI, or concussion.
“Although mTBI may sound benign, these injuries often have significant short and long-term consequences that can be modified by early identification, intervention and management,” says David Wright, MD, interim chair of the Department of Emergency Medicine at Emory and principal investigator of the grant. “Currently, the system of caring for these injuries is fragmented, and clinical training for evaluation, care coordination and management is limited.
To overcome these limitations, the primary aim of the CDC-funded study is to show that evidence-based clinical practice and education for patients, caregivers, clinical providers and schools is feasible and will promote recovery following mTBI in children and adolescents who present to emergency departments, urgent care facilities and primary care practices.
The TEaM Toolkit, aimed at key providers in the system of mTBI health care, relies on the electronic medical record system and a targeted training program to improve screening, management and linkage throughout the diagnosis and treatment continuum, referred to as “the neighborhood of care.”
Children’s Healthcare of Atlanta, with its network of emergency physicians, primary care physicians, urgent care physicians and advanced practice emergency providers will work with Emory School of Medicine’s Department of Emergency Medicine to study the implementation of the neighborhood model. Wright and his co-principal investigators Hal Simon, MD (Emory and Children’s Healthcare of Atlanta), Jonathan Ratcliff, MD MPH (Emory), and Gerard Gioia, PhD (Children’s National Healthcare) will oversee the study.
As part of their project, the Emory researchers aim to refine and implement the TEaM Toolkit and pilot test an eMR screening and notification system. This includes implementing clinical training modules, personalizing patient discharge instructions, and delivering post-mTBI management with input and coordination from school programs and disseminating educational materials across organizational settings.
“Overall, we expect our research to determine whether implementation of the TEaM Toolkit can decrease mTBI-related complications in school-aged children,” says Wright. “This will include education and adoption of best practices by patients, parents, clinical providers and schools in diagnosis, management and follow-up to improve recovery. We are optimistic that adoption of these best practices nationwide will improve the long-term quality of life for children with mTBI.”
Other study team members are Rachel Bull MPH, Shabnam Jain, MD, Andrew Reisner MD, Larry Hall MD, Usha Sathian MD, Brad Wesselman MD, April Zmitrovich, Alex Hall, Rie Calcaterra, Mona Hicks PhD, Ann Glang, PhD, Paula Tucker DNP, Dan Wu MD, and Tim Moran PhD.