Abstract
The objective of this study was to determine the feasibility of implementing an interdisciplinary approach to concussion assessment and management, including direct-access pediatric physical therapy in the pediatric emergency department (PED) with regards to parental satisfaction with early concussion management, documentation of clinical information for prognosis, and service organization metrics.
This was a single center retrospective analysis of prospectively collected data. Patients <18 years old presenting to the PED with a suspected concussion were included and either received care using the interdisciplinary model of care (pediatric physical therapy + usual care), or usual care alone depending on their time of presentation to the PED (12 hours/week of Pediatric physical therapy coverage). Clinical and administrative data were collected from the participants’ medical record. In addition, a random sample of participants received a quality improvement survey administered over the phone.
Three hundred and forty-seven patients were included in the study population (mean [SD] age = 7.56 [5.62] years), and 81 were seen by the pediatric physical therapist. Those seen by the pediatric physical therapist had a significantly higher average satisfaction score for the Family domain (94.69 [11.60]) of the Pediatric Quality of Life (PedsQL) Healthcare Satisfaction scale, than those who were not (89.02 [20.17]), as well as for Overall satisfaction (pediatric physical therapy = 95.45 [12.34] vs usual care = 89.21 [21.21]). Prognostic information was collected more systematically in patients seen by the pediatric physical therapist.
The presence of a pediatric physical therapist in the PED could improve early management of children presenting for suspected concussions. Further research will help determine factors related to sustainability and prepare broader implementation.
Physical Therapists, shown be a positive addition in adult emergency departments mostly for musculoskeletal conditions, were introduced in a PED in an interdisciplinary model of concussion care and was associated with improvements in satisfaction, clinical information documentation and service organization.
Lay Summary
The study aimed to see if having a team approach, including direct access to pediatric physical therapy, in the pediatric emergency department (PED) would improve parental satisfaction with care and early concussion management, enhance the documentation of clinical information for better prognosis, and improve service organization metrics.
The study was conducted at a single center and analyzed data collected from patients under 18 years old who came to the PED with suspected concussions. Depending on when they arrived, they either received care from a pediatric physical therapist plus usual care or just usual care. Data from medical records and a phone survey were used for analysis.
Out of 347 patients (average age 7.56 years), 81 were seen by the pediatric physical therapist. Parents of these children reported higher satisfaction scores compared to those who received usual care. Additionally, prognostic information was more systematically collected for patients seen by the pediatric physical therapist.
The study suggests that incorporating pediatric physical therapists into the ED could improve early concussion management, leading to higher parental satisfaction, better documentation, and improved service organization, making it a valuable addition to pediatric emergency care.
Accepted manuscripts
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