Motivation for the Action Collaborative

Action Collaborative participants are motivated by a goal of establishing a more accessible, sustainable, and evidence-based system of care for traumatic brain injury (TBI) during the follow-up period after acute injury. The collaborative is initially focusing on adults who experience community-acquired, milder traumatic brain injury, including concussion. These people are generally discharged home and often receive no follow-up care, although many continue to experience such symptoms as headaches, sleep disturbance, and concentration problems, among others. This work implements elements of the recommendations from the National Academies’ 2022 report Traumatic Brain Injury: A Roadmap for Accelerating Progress, particularly the following recommendations as they relate to milder TBI: (3) Reduce unwarranted variability and gaps in administrative and clinical care guidance to assure high quality care for TBI; (5) Establish and reinforce local and regional integrated care delivery systems for TBI; and (6) Integrate the TBI system of care with TBI research into a learning system.

Current Activities

Members of the Action Collaborative advance learning systems of care for people with TBI by developing a resource toolkit to inform development of a network of TBI follow-up care clinics and contribute to assessing the impacts of such programs on recovery outcomes. Current activities focus on marshaling and disseminating the evidence base on best practices and clinical care models during the follow-up period after acute care for adults with community-acquired TBI at the milder end of the severity spectrum. Collaborative participants have formed working groups taking these efforts forward:

• Action Collaborative lead: Geoffrey Manley, University of California San Francisco
• Working Group on Follow Up Care: Members are developing a framework that translates the 2022 report recommendations into multidimensional goals relevant to TBI follow-up care (led by Michael, McCrea, Medical College of Wisconsin and Flora Hammond, Indiana University School of Medicine).
• Working Group on Clinical Components: Members are identifying and describing core elements that form part of a multidisciplinary follow-up care clinic for TBI (led by Javier Cardenas, West Virginia University Health System and Christina Master, Childrens’ Hospital of Philadelphia).
• Working Group on Clinical Practice Guidelines: Members are analyzing available clinical practice guidelines to inform evidence-based management for optimizing recovery and wellness for people with TBI (led by Noah Silverberg, University of British Columbia and Kathy Lee, Department of Defense).
  • Now Available: Adapted Clinical Practice Guideline, jointly published in the Annals of Family Medicine and the Journal of Neurotrama
  • Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury
• Working Group on TBI Educational Materials and Discharge Instructions: Members provided input on adult TBI discharge instructions, symptom-based recovery tips, and return to work information (led by Kelly Sarmiento, Centers for Disease Control and Prevention and Odette Harris, Stanford University). Resources on mild TBI recovery are available from the CDC.
• Lived Experience Perspectives: Adults who have experienced traumatic brain injuries shared their insights through focus groups. A white paper is available summarizing perspectives and themes so far, authored by Scott W. Hamilton and Alan Hamilton.

The Action Collaborative is an ad hoc activity convened under the auspices of the Forum on Traumatic Brain Injury at the National Academies of Sciences, Engineering, and Medicine. The work the collaborative produces does not necessarily represent the views of any one organization, the TBI Forum, or the National Academies and is not subjected to the review procedures of, nor is it a report or product of, the National Academies.