9A concussion clinic or network of providers should have the following core functions/services in place to manage patients comprehensively and provide the best post-concussion care:
- Diagnosis and medical treatment decisions;
- Physical treatment;
- Cognitive, functional, emotional support;
- Coordination of care function
Core functions/services should be available in all concussion clinics or networks of post-concussion care providers. 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.
With persistent symptoms, return to activity and management of symptoms is complex, and may require a number of providers, therefore a coordination function is required to properly support patients.
By viewing the care provided by an interdisciplinary clinic from the perspective of core functions rather than healthcare disciplines allows for needed clinical and fiscal flexibility. There may be several professions within a given core function who can provide appropriate care consistent with their scopes of practice.
What this standard means:
This standard does not aim to direct what disciplines should be present in a concussion clinic, but rather provide information on which functions should be provided. This enables a clinic to build its interdisciplinary profile of services based on comprehensively addressing patients’ symptoms.
Concussion clinics will be able to map the providers available in the clinic or network to these core functions. This mapping can be useful to present to patients so that they know who the key providers are in their care, and useful to providers to ensure focus and efficiency of service delivery.
To date, the term “concussion clinic” has been used broadly to describe many types of service provision entities. There are many “clinics” that only provide half of the core functions and are also not well connected to other providers to enable patients to obtain the full range of services. Patients can be left with the burden of identifying and finding their own ad hoc network of services and providers to help them manage their persistent symptoms.
Adoption of this standard will mean that patients will be able to receive the interdisciplinary post-concussion care that is required for persistent symptoms in one locale or organized network, reducing the pressure to identify and create their own interdisciplinary network of providers. Many of the “clinics” that currently exist will have to expand the services and functions that they are able to provide in order to call themselves concussion clinics.