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Webinar #1
July 15, 2015
Bringing Basic Orthopedic and
Concussion Care to the
Pediatric Medical Home:
A PPOC/CHICO Learning Community
& Advanced Primary Care Initiative
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
2© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
1. Welcome and Course Updates
2. How to Utilize Blackboard: Finding Content &
Uploading Assignments
3. Concussion Case Discussion and Review of
Algorithm
4. Qstream Update
5. Questions, Next Steps and Wrap-up
3
We have no financial relationships with
commercial entities producing, marketing, re-
selling, or distributing health care goods or
services consumed by, or used on, patients
relevant to the content we are planning,
developing, presenting, or evaluating.
Disclosure
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
4
Learning Community Schedule
Webinars
7:30am – 8:30am
Date Content
Thursday, June 11, 2015 Concussion
Thursday, September 10, 2015 Hand and Wrist
Wednesday, January 20, 2016 Foot and Ankle
Wednesday, March 23, 2016 Everything Knee
Date
Wednesday, July 15, 2015
Thursday, August 13, 2015
Thursday, December 10, 2015
Wednesday, February 24, 2016
Wednesday, April 27, 2016
Didactic Webinars
7:30am – 9:00am
© 2014 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
In-Person Sessions
7:00am – 9:00am, BCH Waltham
Date Content
Thursday, October 29, 2015 Practical Session
Wednesday, May 25, 2015 Practical Session
5© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Your Practice now has
a group on Blackboard!
6
Case study: concussion
7
CASE #1
• 6:00 PM parent call
• Injury 2 hour ago:
– Possible brief LOC (seconds), then dizzy/unsteady, no
recollection of collision
– Currently, patient is alert but tired, c/o 8/10 headache
Q: How should you triage this patient?
8
CASE #1, What if…
• 8:00 PM parent calls back
– Patient has vomited several times
– Patient is very tired; can be aroused but immediately falls
back to sleep
Q: How should you triage the patient now?
9
Concussion Algorithm: Suspected Concussion
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
10
CASE #1, continued
• Patient evaluated in your office day after injury
Q: What evaluations should you perform?
11
Concussion Algorithm: Suspected Concussion
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
12
Balance Error Scoring System (BESS)
NORMAL BESS SCORE ≥13 yrs
Double Leg Stance: normal score = 0 errors
Single Leg Stance: normal score < 5 errors
Tandem Stance: normal score < 3 errors
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
12 years and Younger
No Norms – For Internal Control Only
13
Post Concussion Symptom Scale (PCSS): ≥ 13
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Download this form from Blackboard by visiting:
Blackboard/Content/Concussion/Concussiontools
14
Post Concussion Symptom Scale (PCSS): ≤ 12
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Download this form from Blackboard by visiting:
Blackboard/Content/Concussion/Concussiontools
15
CASE #1, continued
Q: What are your treatment recommendations?
16
Concussion Algorithm: Suspected Concussion
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
17
Return to School
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
18
Return to Play
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
19© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Download this form from Blackboard by visiting:
Blackboard/Content/Concussion/Concussiontools/Patientforms
20© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
21© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
22
23
Concussion Algorithm: Suspected Concussion
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
24
Concussion Algorithm: Follow-Up
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
25
CASE #1, Follow-Up
Q: What are your treatment recommendations now?
26
Concussion Algorithm: Follow-Up
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
27© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Download this form from Blackboard by visiting:
Blackboard/Content/Concussion/Concussiontools/Patientforms
28© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
29
CASE #1, What if…
Q: What are your treatment recommendations now?
30
Concussion Algorithm: Follow-Up
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
31
Concussion Algorithm: Follow-Up
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
32
ONLINE COURSES (Physician Online Training)
• www.cdc.gov/concussion/HeadsUp/online_training.html
• www.nfhslearn.com/electiveDetail.aspx?courseID=38000
Resources for Training
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
33
• Algorithm
• Patient/Family Handout
• Teacher Letter
• Advice Line Flyer
Materials for Practice
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
34© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
35
Additional Questions & Discussion
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
36
Participate in August Webinars!
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
Due Date Coursework CME Performance
Improvement (PI)
Stages
PI ToolsCONCUSSION
Friday, August
7, 2015
Understand current practices trends for
caring for concussion by completing
Concussion Case Reviews.
Submit completed cases on your Blackboard
Group page.
Stage A & B: Baseline
Measurement,
Assessment and,
Intervention
• Case Review
• Root Cause
Analysis
• Test of Change
• Identification
Friday, Sept.
4, 2015
Build process for implementing concussion
algorithm and advice processes that fit your
practice
Submit PD of PDSA worksheet on to your
Blackboard Group page.
• Process Map:
• PDSA Cycle
- Plan
- Do
Ongoing Participate in and Complete Concussion
Qstream Course
• Spaced Learning
37
Concussion Coursework
Download your case review forms from
Blackboard:
1. Select 3 case reviews/participating
provider
2. Complete the case review form using
information from:
• Your EHR
• MyPatients (if applicable)
• Other visit documentation you may
have access to
3. Submit on Blackboard Group page by
Friday, August 7th
4. For instructions on how to fill out
assignments on blackboard visit:
Content/Blackboard How tos/How to
Assignment on Blackboard
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
38
Meeting Evaluation
We want to make this community as useful as possible
for you! You will be receiving a meeting evaluation via
email (sent to the email that you provided on the
demographic form) by 4:00 pm tomorrow.
Please take a moment to fill out the session evaluation
form and provide us with your feedback so that we can
continue to improve and meet your expectations!
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
39
Learning Community Schedule
Webinars
7:30am – 8:30am
Date Content
Thursday, June 11, 2015 Concussion
Thursday, September 10, 2015 Hand and Wrist
Wednesday, January 20, 2016 Foot and Ankle
Wednesday, March 23, 2016 Everything Knee
Date
Wednesday, July 15, 2015
Thursday, August 13, 2015
Thursday, December 10, 2015
Wednesday, February 24, 2016
Wednesday, April 27, 2016
Didactic Webinars
7:30am – 9:00am
© 2014 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
In-Person Sessions
7:00am – 9:00am, BCH Waltham
Date Content
Thursday, October 29, 2015 Practical Session
Wednesday, May 25, 2015 Practical Session
40
Thank You!
© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu

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PPOC CHICO.bringing basic orthopaedic and concussion care to the pediatric medical home. webinar 1.concussion

  • 1. Webinar #1 July 15, 2015 Bringing Basic Orthopedic and Concussion Care to the Pediatric Medical Home: A PPOC/CHICO Learning Community & Advanced Primary Care Initiative © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 2. 2© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu 1. Welcome and Course Updates 2. How to Utilize Blackboard: Finding Content & Uploading Assignments 3. Concussion Case Discussion and Review of Algorithm 4. Qstream Update 5. Questions, Next Steps and Wrap-up
  • 3. 3 We have no financial relationships with commercial entities producing, marketing, re- selling, or distributing health care goods or services consumed by, or used on, patients relevant to the content we are planning, developing, presenting, or evaluating. Disclosure © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 4. 4 Learning Community Schedule Webinars 7:30am – 8:30am Date Content Thursday, June 11, 2015 Concussion Thursday, September 10, 2015 Hand and Wrist Wednesday, January 20, 2016 Foot and Ankle Wednesday, March 23, 2016 Everything Knee Date Wednesday, July 15, 2015 Thursday, August 13, 2015 Thursday, December 10, 2015 Wednesday, February 24, 2016 Wednesday, April 27, 2016 Didactic Webinars 7:30am – 9:00am © 2014 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu In-Person Sessions 7:00am – 9:00am, BCH Waltham Date Content Thursday, October 29, 2015 Practical Session Wednesday, May 25, 2015 Practical Session
  • 5. 5© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Your Practice now has a group on Blackboard!
  • 7. 7 CASE #1 • 6:00 PM parent call • Injury 2 hour ago: – Possible brief LOC (seconds), then dizzy/unsteady, no recollection of collision – Currently, patient is alert but tired, c/o 8/10 headache Q: How should you triage this patient?
  • 8. 8 CASE #1, What if… • 8:00 PM parent calls back – Patient has vomited several times – Patient is very tired; can be aroused but immediately falls back to sleep Q: How should you triage the patient now?
  • 9. 9 Concussion Algorithm: Suspected Concussion © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 10. 10 CASE #1, continued • Patient evaluated in your office day after injury Q: What evaluations should you perform?
  • 11. 11 Concussion Algorithm: Suspected Concussion © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 12. 12 Balance Error Scoring System (BESS) NORMAL BESS SCORE ≥13 yrs Double Leg Stance: normal score = 0 errors Single Leg Stance: normal score < 5 errors Tandem Stance: normal score < 3 errors © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu 12 years and Younger No Norms – For Internal Control Only
  • 13. 13 Post Concussion Symptom Scale (PCSS): ≥ 13 © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Download this form from Blackboard by visiting: Blackboard/Content/Concussion/Concussiontools
  • 14. 14 Post Concussion Symptom Scale (PCSS): ≤ 12 © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Download this form from Blackboard by visiting: Blackboard/Content/Concussion/Concussiontools
  • 15. 15 CASE #1, continued Q: What are your treatment recommendations?
  • 16. 16 Concussion Algorithm: Suspected Concussion © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 17. 17 Return to School © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 18. 18 Return to Play © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 19. 19© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Download this form from Blackboard by visiting: Blackboard/Content/Concussion/Concussiontools/Patientforms
  • 20. 20© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 21. 21© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 22. 22
  • 23. 23 Concussion Algorithm: Suspected Concussion © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 24. 24 Concussion Algorithm: Follow-Up © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 25. 25 CASE #1, Follow-Up Q: What are your treatment recommendations now?
  • 26. 26 Concussion Algorithm: Follow-Up © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 27. 27© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Download this form from Blackboard by visiting: Blackboard/Content/Concussion/Concussiontools/Patientforms
  • 28. 28© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 29. 29 CASE #1, What if… Q: What are your treatment recommendations now?
  • 30. 30 Concussion Algorithm: Follow-Up © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 31. 31 Concussion Algorithm: Follow-Up © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 32. 32 ONLINE COURSES (Physician Online Training) • www.cdc.gov/concussion/HeadsUp/online_training.html • www.nfhslearn.com/electiveDetail.aspx?courseID=38000 Resources for Training © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 33. 33 • Algorithm • Patient/Family Handout • Teacher Letter • Advice Line Flyer Materials for Practice © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 34. 34© 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 35. 35 Additional Questions & Discussion © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 36. 36 Participate in August Webinars! © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu Due Date Coursework CME Performance Improvement (PI) Stages PI ToolsCONCUSSION Friday, August 7, 2015 Understand current practices trends for caring for concussion by completing Concussion Case Reviews. Submit completed cases on your Blackboard Group page. Stage A & B: Baseline Measurement, Assessment and, Intervention • Case Review • Root Cause Analysis • Test of Change • Identification Friday, Sept. 4, 2015 Build process for implementing concussion algorithm and advice processes that fit your practice Submit PD of PDSA worksheet on to your Blackboard Group page. • Process Map: • PDSA Cycle - Plan - Do Ongoing Participate in and Complete Concussion Qstream Course • Spaced Learning
  • 37. 37 Concussion Coursework Download your case review forms from Blackboard: 1. Select 3 case reviews/participating provider 2. Complete the case review form using information from: • Your EHR • MyPatients (if applicable) • Other visit documentation you may have access to 3. Submit on Blackboard Group page by Friday, August 7th 4. For instructions on how to fill out assignments on blackboard visit: Content/Blackboard How tos/How to Assignment on Blackboard © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 38. 38 Meeting Evaluation We want to make this community as useful as possible for you! You will be receiving a meeting evaluation via email (sent to the email that you provided on the demographic form) by 4:00 pm tomorrow. Please take a moment to fill out the session evaluation form and provide us with your feedback so that we can continue to improve and meet your expectations! © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu
  • 39. 39 Learning Community Schedule Webinars 7:30am – 8:30am Date Content Thursday, June 11, 2015 Concussion Thursday, September 10, 2015 Hand and Wrist Wednesday, January 20, 2016 Foot and Ankle Wednesday, March 23, 2016 Everything Knee Date Wednesday, July 15, 2015 Thursday, August 13, 2015 Thursday, December 10, 2015 Wednesday, February 24, 2016 Wednesday, April 27, 2016 Didactic Webinars 7:30am – 9:00am © 2014 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu In-Person Sessions 7:00am – 9:00am, BCH Waltham Date Content Thursday, October 29, 2015 Practical Session Wednesday, May 25, 2015 Practical Session
  • 40. 40 Thank You! © 2015 Pediatric Physicians’ Organization at Children’s (PPOC). For permission please contact ppoc@childrens.harvard.edu

Editor's Notes

  1. 2
  2. Jonathan
  3. Barry
  4. Madeleine
  5. Alex
  6. Why use the PCSS and BESS over the CDC’s ACE
  7. Meredith
  8. Meredith
  9. Jonathan
  10. Jonathan
  11. Talk about challenging questions such as question to ensure that participants understand the right answer
  12. Jonathan
  13. Jonathan
  14. Jonathan
  15. Barry
  16. Jonathan