A knock to the system: A new sociotechnical systems approach to sport-related concussion

ABSTRACT Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.

[1]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[2]  Rachael Sharman,et al.  Return-to-Play Confusion: Considerations for Sport-Related Concussion , 2013, Journal of Bioethical Inquiry.

[3]  Paul M. Salmon,et al.  All about the Teacher, the Rain and the Backpack: The Lack of a Systems Approach to Risk Assessment in School Outdoor Education Programs , 2015 .

[4]  Hamish A Kerr,et al.  Concussion risk factors and strategies for prevention. , 2014, Pediatric annals.

[5]  Philip Schatz,et al.  Current Issues in the Identification, Assessment, and Management of Concussions in Sports-Related Injuries , 2003, Applied neuropsychology.

[6]  Michael Makdissi,et al.  Revisiting the modifiers: how should the evaluation and management of acute concussions differ in specific groups? , 2013, British Journal of Sports Medicine.

[7]  C. Finch,et al.  Rasmussen's legacy in the great outdoors: A new incident reporting and learning system for led outdoor activities. , 2017, Applied ergonomics.

[8]  Caroline F Finch,et al.  Compliance with return-to-play regulations following concussion in Australian schoolboy and community rugby union players , 2011, British Journal of Sports Medicine.

[9]  Michael Makdissi,et al.  Translating Guidelines for the Diagnosis and Management of Sports-Related Concussion Into Practice , 2016, American journal of lifestyle medicine.

[10]  Paul M. Salmon,et al.  Looking Beyond People, Equipment and Environment: Is a Systems Theory Model of Accident Causation Required to Understand Injuries and Near Misses During Outdoor Activities? , 2015 .

[11]  Michael Makdissi,et al.  Consensus statement on Concussion in Sport - The 4th International Conference on Concussion in Sport held in Zurich, November 2012. , 2013, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[12]  Sidney Dekker,et al.  Drift into Failure: From Hunting Broken Components to Understanding Complex Systems , 2011 .

[13]  Paul M. Salmon,et al.  Responsibilities in the Prevention of Concussion in Community Rugby Union , 2015 .

[14]  C L Collins,et al.  When the rules of the game are broken: what proportion of high school sports-related injuries are related to illegal activity? , 2008, Injury Prevention.

[15]  Naznin Virji-Babul,et al.  Concussion: Current Concepts in Diagnosis and Management , 2013, Journal of neurologic physical therapy : JNPT.

[16]  J. Reason Human error: models and management , 2000, BMJ : British Medical Journal.

[17]  G. Gioia,et al.  Sports-related concussions in pediatrics , 2009, Current opinion in pediatrics.

[18]  Patria A Hume,et al.  Sport-related concussions in New Zealand: a review of 10 years of Accident Compensation Corporation moderate to severe claims and costs. , 2014, Journal of science and medicine in sport.

[19]  Icek Ajzen,et al.  From Intentions to Actions: A Theory of Planned Behavior , 1985 .

[20]  C. Finch,et al.  The Extent to Which Behavioural and Social Sciences Theories and Models are Used in Sport Injury Prevention Research , 2010, Sports medicine.

[21]  D. Gould,et al.  Sport-Related Concussion Knowledge Among Youth Football Players , 2014 .

[22]  Jens Rasmussen,et al.  Risk management in a dynamic society: a modelling problem , 1997 .

[23]  Natassia Goode,et al.  Injury causation in the great outdoors: A systems analysis of led outdoor activity injury incidents. , 2014, Accident; analysis and prevention.

[24]  G. Kok,et al.  The Theory of Planned Behavior: A Review of its Applications to Health-Related Behaviors , 1996, American journal of health promotion : AJHP.

[25]  Jonathan Stewart Drift into failure: From hunting broken components to understanding complex systems , 2012 .

[26]  Paul McCrory,et al.  Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies , 2012, British Journal of Sports Medicine.