Introduction: In March 2014, the Ontario Ministry of Education was the first ministry in Canada to institute a formal concussion policy. The ministry stipulates that student long-term health and safety are essential preconditions for learning, and that concussions can negatively impact cognitive, physical, emotional, and social development. Policy/Program Memorandum (PPM) No. 158 requires all school boards and school authorities to establish a policy on concussions. Each school board in Ontario developed a concussion policy within their local context to address concussion awareness, prevention, identification, management, and training. Multiple stakeholders including administrators, teachers, staff, students, parents/guardians, volunteers, and community-based organizations were encouraged to participate in policy development as stated in PPM No. 158. Objectives: To understand how school boards in Ontario interpreted PPM No. 158 in the development and implementation of board concussion policies and administrative procedures. Methods: An interpretive policy analysis was conducted on English-language, publicly available concussion policy documents and related administrative procedures from 64 Ontario school boards and school authorities. Semi-structured interviews were conducted with four key informants from a large school board in Ontario to further contextualize this analysis. Informants included two elementary school Principals, one secondary school Vice Principal, and one secondary school Health and Physical Education Department Head. Informants were directly involved in the development of their school board’s concussion policy and administrative procedures, as well as the daily implementation of these policies in their respective schools as part of their leadership roles in the school community. Results: School boards in Ontario relied on partnerships across the domains of education, health, and safety in order to fulfill the requirements of PPM No. 158. Within each domain, collaboration between students, parents/guardians, teachers, administrators, coaches, and health care providers was essential for the development and implementation of school board concussion policies. Multiple stakeholder groups frequently share responsibility for student education, health, and safety. Conclusions: Effective collaborative partnerships require strong communication and a shared understanding of concussion prevention, identification, and management strategies. As a result of PPM No. 158, teachers and school administrators have increasingly taken on a leadership role in this regard. Findings highlight the need for policy makers and legislators to consider local context, community needs, professional practices of multiple stakeholder groups, and available resources when developing concussion policy and legislation.

Partners in Education, Health, and Safety: Development and Implementation of Concussion Policy in Ontario School Boards