Creating Standards for Concussion Care in Ontario

2016 Concussion Care Summit: Getting the right care, from the right provider, at the right time. 

Toronto, April 21, 2016:  Concussion providers and neurotrauma experts from around Ontario met in Toronto last week for the 2016 Summit on Concussion Care hosted by the Ontario Neurotrauma Foundation.

Close to 150,000 Ontarians are diagnosed with concussions each year - by a family or emergency department physician or pediatrician – of whom 40,000 are children and youth under 18 years of age.(1)  Though concussion patients often recover within a few weeks, 15 to 20 per cent of patients experience persistent symptoms of dizziness, headaches, fatigue, cognitive impairment and trouble sleeping that greatly affect their daily lives. Thirty percent of children and youth are still symptomatic at one month.(2)

At the summit, more than 60 leading concussion experts met to develop standards of care for the more than 50 concussion clinics that treat patients in Ontario.  The new standards will address the following questions:

  • What is a concussion clinic and what features should a clinic have?
  • What are the core services that should be provided in any concussion clinic in Ontario?
  • What qualifications should a ”concussion expert” have?
  • What do patients and their families need to know, and what questions should they ask, if they visit a concussion clinic?

The information that informed the summit deliberations came from a study on the incidence of concussion and referral patterns in Ontario; a research survey of clinics currently providing concussion care; surveys and focus groups of people who had sustained concussion and had persistent symptoms; and a pre-survey of the Summit participants themselves.

“Today there are large variations in concussion care offered across Ontario, and few standards to ensure everyone gets the right care, at the right time, and in the right place,” said Dr. Mark Bayley, from the University Health Network in Toronto. Dr. Bayley served as summit chair and is the lead author of a recent study of concussion incidence in Ontario.

The information for that study, provided through the Institute for Clinical Evaluative Sciences, revealed that in the five-year period from 2008 to 2013, almost 900,000 Ontarians were diagnosed with a concussion.(1)  

The summit discussions confirmed there is a large number of people in Ontario who suffer from the effects of concussion, and not all of them are getting the right care, from the right provider, at the right time.  ONF will be preparing the proceedings of the Summit and discussing these with stakeholders over the next few months, including how these can developed formally and measured, how, and by whom. In addition, a position paper will be prepared.  

1.  This study made use of de-identified data from the ICES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners:  Canada’s Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario.  The opinions, results and conclusions reported are those of the authors.  No endorsement by ICES or any of its funders or partners is intended or should be inferred.

2.    Zemek R, et al. Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED. JAMA. 2016;315(10):1014-1025. doi:10.1001/jama.2016.1203.