Evidence-based treatment of mild TBI: A service audit and checklist to improve concordance with guidelines

Purpose: Widespread acceptance of treatment options for mild traumatic brain injury (mTBI) has so far been limited in the UK. Guidelines have been created to standardise treatment, based on expert consensus (Ontario Neurotrauma Foundation; ONF). However, research indicates that clinician guidelines are not always used consistently. This paper audits the use of ONF guidelines in one mTBI clinic and explores recommendations to improve concordance. Methods: Criterion-based audit was used to assess guideline usage for patients seen within the clinic between January and August 2016. Results and conclusion: Results indicated that the clinic provided thorough assessment and reliable information, although intervention guidelines were not used consistently. Inter-rater reliability suggests patient notes were difficult to interpret. Outcome: A checklist was developed to guide clinics in recording assessment and intervention in line with ONF guidelines. A pilot is required to assess usability.