Documentation of Return to Play Strategy or Protocol
Measure purpose: Return to activity with no symptoms of concussion
The numerator: Patients who had documentation of a return to play strategy or protocol*
*RTP strategy or protocol should include a gradual increase in physical activities. Each step should take at least 24 hours or longer. Patients should return to previous step if symptoms return or worsen. While other progressions may be used and tailored to the specific sport or activity, below is the most common protocol:
Step 1: Symptom-limited activity (daily activities)
Step 2: Light aerobic exercise (walking, stationary bike)
Step 3: Sport-specific exercise (running, sprinting, agility)
Step 4: Non-contact practice (including resistance training)
Step 5: Full contact practice (following medical clearance)
Step 6: Competition (normal game play)
is divided by
The denominator: Patients > 5 years of age diagnosed with concussion who were cleared for full participation in sports
Exclusions are removed from the denominator for:
- Patient and/or caregiver who refuse return to play strategy
- Patients who are currently participating in sports without symptoms
Key Phrases
Examples of key phrases you could use to meet the measure include:
- Return to play strategy documented
- Return to play protocol documented
Measure Calculation Example
Dr. Webster has 50 patients between January 1 and December 31 with a diagnosis of concussion who were cleared for full participation in sports. This is the denominator.
Three patients refused a return to play strategy and one patient was already participating in sports without symptoms. These four patients are excluded from the denominator (50-4).
20 patients had documentation of a return to play strategy. This is the numerator.
Quality of patient care = 20/(50-4). Dr. Webster has a score of 43% for this measure.