Providing specialized concussion care to the underserved

Franciscan Health Sports Medicine noticed a gap in concussion treatment when it came to providing earlier access to therapy services and specialized care in rural areas.

While research shows 80% of patients with concussions heal within two weeks, 20% experience prolonged symptoms. Franciscan Health Sports Medicine realized physicians were not prepared to treat the latter group and wanted to find a concussion training program that shared the latest advancements in treatment.

They also needed to find a way to improve concussion care for the schools they service in smaller rural areas. Student-athletes did not get baseline tested and often received treatment for head injuries from primary care physicians instead of concussion specialists.

Prioritizing early access to therapy

When the 2017 Berlin Concussion in Sport Group Consensus Statement was released, it emphasized for the first time the role therapy can play following a concussion. This made Franciscan Health Sports Medicine evaluate their concussion treatment program to make improvements. The main goals were to allow for earlier access to therapy services, develop a team of multidisciplinary concussion experts, and to avoid patients living with concussion symptoms as their new normal.

To accomplish this, they needed concussion assessment tools that could help physicians make informed treatment decisions while monitoring patient progress.

Finding the right concussion assessment tools

Franciscan Health Sports Medicine did their due diligence before making a decision. It was ImPACT Applications’ FDA-cleared tools and research that helped them stand out from competitors. They felt confident ImPACT would help inform their clinical practice on the types of concussions patients have to get them the right therapy.

“The fact that ImPACT is FDA-cleared played a big role in our decision. It showed ImPACT Applications’ willingness to go through a stringent process that not all of the competitors had done. I was also really impressed that it was the only tool that had tons of historical data to pull from to show how valid and reliable their tool was.”

Advancing concussion treatment with ImPACT

There was some skepticism when ImPACT and the early intervention with therapy were first introduced. Franciscan Health Sports Medicine relied on the research and data to move forward with their new treatment practices. Right away, physicians were able to determine clinical trajectories much faster, develop treatment strategies, and assess whether therapy improved reaction time and short-term memory issues.

Once they started seeing success stories, they began educating Athletic Trainers (ATs) about signs student-athletes were not recovering and how to use VOMS when assessing concussions. ATs were able to identify athletes dealing with symptoms four to six weeks out and get them into therapy. They saw how effective this form of treatment was and that fewer student-athletes were struggling in school or becoming depressed after head injuries.

“We’ve found that it's far more cost-effective to get patients in sooner and be able to get the problem treated in one or two visits versus letting it continue to fester and take twelve visits to get better.”

A multidisciplinary approach to care

Craig Voll, Manager of Sports Medicine, has been the point person responsible for building a network of Credentialed ImPACT Consultants (CICs), ImPACT Trained Athletic Trainers (ITATs), ImPACT Trained Occupational Therapists (ITOTs), and ImPACT Trained Physical Therapists (ITPTs). He identifies needs across the Franciscan Alliance to recruit physicians interested in learning the cutting edge and evidence-based best practices for concussion care.

This has also meant reaching out to nurse practitioners and primary care physicians in rural areas. These communities do not have access to concussion specialists so it is important to teach these healthcare providers the new treatment standards and signs a patient is not progressing.

As a result, Franciscan Health Sports Medicine has seen improved communication between physicians, CIC physicians, and nurse practitioners. Nurse practitioners in rural areas who suspect a patient is not progressing, refer them to Franciscan Health Sports Medicine for therapy or collaborate with the primary CIC and Franciscan Health Sports Medicine Medical Director, Dr. Rowdon. Allowing all disciplines to come together to discuss treatment strategies has been life-changing for their patients.

Empowering the community

In its mission to provide care to the underserved, Franciscan Health Sports Medicine has secured resources and volunteers to empower their community. Thanks to help from the Franciscan Foundation, they purchased 50,000 ImPACT baseline tests to provide free testing to any of the 29 schools they service.

ATs have also supported this mission by hosting concussion education workshops for parent-teacher associations, youth soccer and youth football leagues, as well as club lacrosse and club volleyball teams. During these sessions parents, coaches, and athletes learn the signs and symptoms of concussions, the importance of reporting concussions, and why the warrior culture should not be encouraged.

The value of concussion education

Franciscan Health Sports Medicine takes an active role in helping their patients recover from head injuries. Their goal is to get patients back to previous levels of functioning so they can live productive lives. It’s all about getting them the right care, at the right time, by the right provider. They have done this by investing in assessment tools and training programs that keep physicians up to date on the latest practices.

If healthcare systems do not start making this a priority, they risk having patients deal with concussion symptoms much longer than they need to.

“Telling a patient they will never be the person they used to be should not be the result. Studies show that if you diagnose a concussion correctly, physicians will know what they're dealing with to get patients the appropriate treatment and we can get them back to their previous activities or interests.”