The HIA Review Process is an education, training and compliance support process developed to underpin player welfare and safety in elite adult rugby with respect to head injuries. This process will monitor adherence to the latest HIA Protocols.
This HIA Review Process, outlined in the accompanying flow chart, is required to be implemented by all Tournaments and Competitions seeking approval to access temporary substitution for head injury.
The key features of this process that must be implemented by all Unions and their Chief Medical Officers accessing temporary substitution by September 1, 2017 are:
- Identification and appointment of a Union HIA Reviewer(s) – this appointment is to be made by each Union Chief Medical Officer for Competitions, Tournaments and Test Matches played by teams within their jurisdiction. This HIA Reviewer may be the Union CMO or their appointee and must have experience in head injury video review and concussion recognition and management. As a minimum, this Union HIA Reviewer must have completed World Rugby’s on-line ‘Video Interpretation’ and ‘Concussion’ education modules. The HIA Reviewer will monitor adherence of practitioners to the current HIA Protocols and be the central contact person for Team Doctors and Match Day Doctors with respect to education and training.
- Confirmation regarding video-incident support. Each Union CMO must confirm whether all HIA and suspicious video incidents within their jurisdiction will be identified and ‘clipped’ by the Union’s video support technicians or where this service is not available within a Union by World Rugby’s Game Analysis department. Unions requiring support from World Rugby MUST contact Marc Douglas (firstname.lastname@example.org) to coordinate this service.
- Each Tournament and Competition must appoint an HIA Review Panel as a condition to access temporary substitution for head injury. This HIA Review Panel will become involved if the identified ‘thresholds’ (see flowchart) are breeched. The membership qualifications of this HIA Review Panel are also identified in the flow chart document. The possible actions arising from this HIA Review Panel for breech, of the Protocols are:
- recommendation for further education and training for the team doctor
- recommendation for the World Rugby HIA Working Group to consider an alteration in the process
- referral to that Tournament or Competition’s Disciplinary Committee.
- This HIA Review Process will be supported by the appointment of a World Rugby independent video interpretation expert group. World Rugby will appoint three video interpretation experts from each hemisphere. A Union requiring the support of an independent video interpretation expert (as per the flow chart) will contact an expert from the opposite hemisphere to provide an opinion where an interpretation dispute exists. Disputes unable to be resolved by the independent video interpretation expert group will be referred to World Rugby’s Chief Medical Officer.
The attached flowchart outlines the HIA Review Process.