National Emergency Care Enterprise Advancing Care Through Collaboration: Workshop Summary (2009) / Chapter Skim
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4 Enhancing Emergency Care Research
4 Enhancing Emergency Care Research
Pages 37-48
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From page 37... ...
This includes appropriate standardized data collection tools, and perhaps access to shared medical records. The emergency department patient is usually cared for in multiple settings, including prehospital, in-hospital, and postacute rehabilitation.
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From page 38... ...
regulations are clearly a barrier to much of the health services and outcomes research we need to truly determine the effectiveness of emergency care interventions." Barriers to Emergency Care Research Jerry Jurkovich, chief of trauma and surgical critical care at Harborview Medical Center and president of the American Association for the Surgery of Trauma, said there is a crisis in U.S. emergency care, as was well documented in the 2006 Institute of Medicine (IOM)
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From page 39... ...
In fact, Koroshetz said, emergency medicine has an "amazing opportunity given that patients with all different sorts of illnesses are coming to one convergence point." If the field could develop a generic, efficient system to identify and enroll patients and conduct research, "You would be able to really leverage multiple different NIH Institutes with the same infrastructure to answer a myriad of scientific questions." In addition to discovery research, the NIH and AHRQ are investing in comparative effectiveness research. There is an expectation that the country is going to move more and more in that direction in order to inform medical decision making.
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From page 40... ...
In particular he pointed to an early collaboration among the National Highway Traffic Safety Administration, Health Resources and Services Administration, and the CDC regarding triage of the injured patient. Interagency collaboration is being advanced through the Federal Interagency Committee on Emergency Medical Services and the Emergency Care Coordination Center.
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From page 41... ...
"AHRQ is keenly aware that there are over 120 million emergency department encounters a year," Mutter noted, "and that the ED [emergency department] is a window into the health care system." AHRQ has supported research on the triage algorithm for EDs, ED crowding (causes and consequences)
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From page 42... ...
That is a way to address some of those questions. Tom Scalea, the session chair and physician-in-chief at the University of Maryland Medical Center Shock Trauma Center, asked whether it is possible to take all of those data and put them into a digestible form.
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From page 43... ...
Jon Mark Hirshon, of the University of Maryland, underscored that there are disease- and organ-specific silos among funders, and emergency care research appears to be almost an afterthought. As an emergency medicine researcher, he asked how he can convince junior physicians to become physician researchers.
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From page 44... ...
We are very hopeful that it will be a successful research effort. The key will be the ability to engage the emergency medicine community and successfully enroll subjects into the first two initial trials, one on traumatic brain injury, and the other on status epilepticus."
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From page 45... ...
But it never would have happened without that trial." Suggestions for Advancing Emergency Care Research Workshop chair Arthur Kellermann asked the panelists and federal funders in the room, "What recommendations would you have to most directly and immediately advance science and emergency care research in the United States? " Lewis said the first thing he would emphasize would be research training, and the development of funding streams for research training that target
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From page 46... ...
Jurkovich said he would explore creative solutions for addressing the difficulty in maintaining higher compensated clinicians for conducting research. These might include debt forgiveness, raising the NIH salary cap, or dropping the time commitment requirement for K08 and R01 awards.
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From page 47... ...
If you confine data collection to a shortterm, emergency medicine environment, then the research will not impact patients or medicine in general. Long-term follow-up of patient outcomes is what is critical to achieve.
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