Feasibility of Direct-Access Physical Therapy for Concussion Management in the Pediatric Emergency Department: A Pilot Implementation Study
Notice bibliographique
Résumé
OBJECTIVES: 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 regard to parental satisfaction with early concussion management, documentation of clinical information for prognosis, and service organization metrics. METHODS: 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. RESULTS: 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 Health care 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. CONCLUSIONS: 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 for broader implementation. IMPACT: Physical therapists, shown to 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 were associated with improvements in satisfaction, clinical information documentation, and service organization. LAY SUMMARY: The study investigated whether direct access to pediatric physical therapy in the pediatric emergency department (PED) would enhance parental satisfaction, early concussion management, documentation, and service organization. Conducted at a single center, it analyzed data from patients under 18 years old with suspected concussions, comparing those who received care from a pediatric physical therapist plus usual care to those who received only usual care. Results showed that parents of children seen by the pediatric physical therapist reported higher satisfaction, and prognostic information was more systematically collected, suggesting that incorporating pediatric physical therapists into the PED could improve overall care and service organization.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».