8A concussion clinic or network of providers should clearly outline for patients whether they are able to provide the full spectrum of care from initial management to longer term management of persistent symptoms (if required).
Patients will have different needs throughout the continuum of care, and provision of the right care at the right time can lead to early identification of risks and persistent symptoms, while allowing for appropriate use of healthcare resources. Patients with persistent symptoms may need to be followed by an interdisciplinary clinic for an extended period of time and may also need considerable guidance in resuming regular activities.
Given the potential complexity of persistent symptoms and the profound effect that they can have on functioning, it is crucial that patients be accurately informed regarding the services that they might need, where they can access these services and how long they will be connected to services.
Currently in Ontario there are not many full service concussion clinics, yet there are many patients who will need interdisciplinary post-concussion care. This creates the opportunity for fragmented care that may not meet the longer term needs of patients.
Patients need to understand how care being offered will fit into current, mid and longer term needs so that they can make informed decisions about who is best suited to provide the right care at the right time.
What this standard means:
It is important to be upfront with patients about services provided and the length of time they can be provided, i.e. a specified period of time due to payor restrictions, or until the patient is mainly symptom free. As some of the healthcare costs are likely borne by the patient, it is important that patients be transparently informed regarding the availability of all pertinent services and the potential costs so that they are able to make an informed decision about their options. If the service(s) proposed are too expensive the provider(s) should be upfront and endeavour to highlight other options that would be cheaper and also appropriate; most professional standards that guide the practice of healthcare professionals mandate this.
Some clinic or network of provider environments are better at managing acute symptoms and have limited experience managing longer term persistent symptoms. The trajectory of care for patients with persistent symptoms is likely to involve support for symptom management and return to regular activity. It is important that patients understand what services from this trajectory can be provided by a specific clinic or network of providers. Patients need to be able to make informed decisions regarding the appropriateness of the proposed care and where they can access needed support.