In June 2006, the Institute of Medicine IOM released a report on the “Future of Emergency Care”, outlining recommendations to advance the delivery of emergency care in the United States and highlighted the dearth of NIH-funded research directed at the delivery of emergency care. The report called for academic medical centers to strengthen their research resources and capacity and to support faculty committed to this area of research. One of the primary goals woven throughout the IOM’s report is for research on improving the delivery Emergency Care to generate evidence-based standards to better inform future clinical practice and health policy.
In response, our group has three general interests:
1. Improving the quality of emergency department administration and communication. Members of the new Center for Evidence-based Medicine and several young emergency physicians, mentored by senior epidemiology and health services research faculty, are interested in designing and testing interventions that will reduce ED crowding and eliminate the medical errors that occur during transitions of care. Potential for funding for these initiatives is available through AHRQ and NIA and other disease-oriented NIH institutes, as well as several foundations and federal and state-level organizations concerned about surge capacity in emergency care.
2. Use of the ED visit as an opportunity to screen and intervene in important and common community health problems, such as tobacco use intimate partner violence, STDs, and major depression ((ED patients have at least twice the rate of these conditions as community samples.) Two directions currently are proposed within this category:
- A collaboration between CHOP and HUP EDs and senior members of the Trans-disciplinary Tobacco Use Research Center to seek funding for the development and testing of interventions tailored to smokers who are parents of young children. The funding for tobacco-cessation projects – particularly targeted at vulnerable populations– is wide, and ranges from foundation and other heart, lung, and cancer organizations (RWJ, AHA, ACS, etc) to Federal PA s from the Tobacco Control Research Branch of the National Cancer Institute (PA-06-321 and PA-06-322) for “Cross-Disciplinary Translational Research” and for Tobacco and Health Research and Capacity Building Program (RFA-TW-06-006).
- The second project, in an earlier stage of conceptualization and development, will involve collaboration between the departments of Emergency and Family Medicine, Schools of Social Policy and Nursing, and the new department of Criminology (Arts and Sciences) to develop, implement and assess interventions for intimate partner violence that target health behaviors and mental health. Potential funding in this field is available from NIMH, NIDA, NIAAA, and/or NIJ. Tentative plans by the team members are an initial proposal to NIJ and two K-awards to NIMH from the departments of Nursing and Family Medicine.
3. Developing new therapies to improve successful emergency resuscitation (cardiac and trauma). Penn’s new Center for Resuscitation Science is working across a number of disciplines, departments, schools, and centers on a truly translational research agenda, integrating cellular, animal, human and community level perspectives and knowledge to reduce mortality from sudden death. The Center is working with a broad-based interdisciplinary group to develop the infrastructure needed for a T-32 training grant in Resuscitation Science from NHLBI. In addition, NIH has announced its intention to reissue (~ August 14, 2006) a RFA soliciting applications for Institutional Clinical and Translational Science Awards (CTSAs) with a receipt date of January 17, 2007. The goal of the CTSA program is to enable institutions to engage in innovative and transformative efforts that will develop and advance clinical and translational science as a distinct discipline within a definable academic home and for institutions to work together at a national level to advance clinical and translation science.
Listing of Participant Faculty Academic Affiliations:
Schools and represented Departments, Centers and Programs
School of Medicine (Departments, Centers & Programs)
Emergency Medicine at HUP
Emergency Medicine CHOP
Epidemiology & Biostatistics
Center for Clinical Epidemiology and Biostatistics
Hospital University of Pennsylvania
Center for Evidence-Based Medicine (HUP
General Internal Medicine
Center for Health Outcomes
Center for Injury Research and Prevention
Center for Mental Health Policy and Services Research
Trans-disciplinary Tobacco Use Research Center
Depression Research Unit
Division of Trauma & Surgical Critical Care (HUP)
Division of Health Services Research
School of Engineering
School of Law
School of Nursing
Center for Outcomes Research & Health Policy
Center for Health Disparities Research
Injury and Firearm Center at Penn (FICAP).
School of Social Policy & Practice
Center for Cartographic Modeling
Center for Mental Health & Criminal Justice Research
Center for the Study of Youth Policy
Ortner Program on Family Violence
Health Care Systems
Leonard Davis Institute
Robert Wood Johnson Clinical Scholars Program
Arts and Sciences
Jerry Lee Center of Criminology, Department of Criminology