7A concussion clinic or network of providers should offer/utilize an interdisciplinary team with varying scopes of practice, with three (3) or more different regulated health care provider disciplines.
No one provider or discipline is sufficient to manage and treat all persistent symptoms of concussion. Interdisciplinary care requires that patients have access to a variety of different practitioners according to their symptom cluster. There is a need for the clinic/network of providers to have a shared approach/philosophy and an integrated, inter-professional plan of patient-centred care (not several individual plans of care).
A concussion clinic or network of providers cannot be considered interdisciplinary unless a patient is seen by, and can access three (3) or more different health care provider disciplines. Thus, a concussion clinic or network of providers does not meet the standard if fewer than three (3) different providers are providing care through the clinic.
Evidence regarding the provision of post-concussion care demonstrates that symptom presentation is broad and encompasses three major areas (physical, emotional, and cognitive) calling for a symptom-based approach. Thus, post-concussion care requires the access to, or capacity to, integrate interdisciplinary care based on the constellation of symptom presentation10.
What this standard means:
Persistent symptoms can be classified as physical, emotional and cognitive and no one provider has the training and scope of practice to manage all of these elements in isolation. Collaboration with other providers is necessary to ensure that support be provided in each of these areas.
The core functions required to manage post-concussion symptoms include: diagnosis and access to medical services; physical treatment options; cognitive evaluation and treatment; evaluation and treatment of emotional conditions; functional integration; provision of education; and coordination of care. These functions will involve a wide range of regulated healthcare professionals who can provide specialized and general care.
Individual providers offering post-concussion care where concussion clinics do not exist, provide valuable care, but cannot call their practice a concussion clinic. In order to meet this standard, a concussion clinic must be interdisciplinary. Where providers are not in one setting, care can occur through a network of providers, with a physician affiliated through a formal arrangement or in active ongoing collaboration with existing medical providers (e.g., family physician, nurse practitioner) operating in an interdisciplinary manner.