Project Summary
The nation’s trauma care system, which includes trauma center hospitals and emergency departments, is where over 30 million Americans receive care after traumatic injuries each year. Injury victims are diverse patients who suffer from complications of the initial injury as well as from multiple complex medical and mental health conditions. Currently, high-quality patient-centered care is not the standard of care throughout US trauma care systems. Injured trauma survivors treated in trauma care systems frequently receive fragmented care that is not coordinated across hospital, emergency department, outpatient, and community settings. Post-injury care is frequently not individualized to integrate the patient’s most pressing post-traumatic concerns and preferences into medical decision making.
We, as a group of front-line trauma center providers, patients, researchers and policy makers, have been working together for over a decade to integrate patient-centered care into US trauma care systems. We began this work by asking large groups of injured patients the key patient-centered question: “Of everything that has happened to you since your injury, what concerns you the most?” We developed scientifically sound assessment tools that allowed us to follow patient concerns after injury hospitalization.
In May of 2011, our team convened an American College of Surgeons’ policy summit that addressed mental health and patient-centered care integration across US trauma care systems. As part of this policy summit, patient members of our team presented in their own words their experiences of traumatic injury and recovery. While giving injured patients a “voice” at the summit, these narratives did not move surgical policy makers to develop mandates or guidelines for patient-centered care. In contrast, presentations that included information from randomized comparative effectiveness trials and standardized outcome assessments convinced surgical policy makers to develop US trauma care system policy mandates and best practice guidelines for post-traumatic stress disorder and alcohol use problems.
Our team now realizes that in order to optimally integrate patient-centered care into US trauma care systems, we must use the best scientific methods that capture the highest-quality data. This PCORI proposal aims to demonstrate that a patient-centered care management treatment that addresses patient’s post-injury concerns and integrates patient concerns and preferences into medical decision making, while also coordinating care, can improve outcomes of great importance to patients and their caregivers, front-line providers and policy makers.
This proposal directly addresses two PCORI patient-centered research questions: “After a traumatic injury, what can I do to improve the outcomes that are most important to me?” and “How can front-line providers working in trauma care systems help me make the best decisions about my post-injury health and health care?”
Considering Patient Concerns during Trauma Care - A narrative highlighting the work and progress of this project's principal investigator and his patient co-investigator, who used his experience with patient-focused care after a traumatic accident at a young age to guide the study.
Project Details
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