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  • Comparing Two Ways to Coordinate Care...

Comparing Two Ways to Coordinate Care for Patients after Trauma

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Project Summary  

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Each year, more than 30 million Americans go to emergency rooms, or ERs, because of trauma injuries. These patients often have trouble adjusting to their lives afterward. They may have complications from their injuries. Their injuries may cause new medical and mental health problems, such as posttraumatic stress disorder, or PTSD. They may also have a hard time doing physical tasks that were easy before they were injured.

Patients with trauma injuries often need many different kinds of care when they leave the hospital. But hospitals, ERs, doctor’s offices, and community service agencies don’t always coordinate care to match what matters to patients.

This study compares two ways to care for patients with trauma injuries who have PTSD symptoms and who are getting ready to leave the hospital. The first is a team-based approach. The second approach refers patients to mental health services within the hospital. The research team is comparing the effect of each approach on ER visits, patients’ concerns after their injuries, their PTSD symptoms, and their ability to do physical tasks, such as sitting and walking.

Who can this research help?

Healthcare administrators and doctors can use findings from the study when considering ways to deliver care for patients after trauma injuries.

What is the research team doing?

The research team is enrolling 424 adults who go to the ER for a trauma injury and have symptoms of PTSD. The team is assigning patients by chance to one of two groups. Patients in one group get team-based care from nurses, social workers, and psychiatrists. A former trauma patient who has had training on how to support other patients, called an injured peer, is part of the team. Patients in this group get case management, mental health support, and recommendations for medicine to treat anxiety and other symptoms. They also have constant cell phone access to the study team for six months. Members of the care team are using a new technology platform to exchange information about patients’ care and track return visits to the ER.

In the other group, the trauma surgery team gets a notification that the patient is showing signs of emotional distress. These patients get referrals to mental health services within the hospital.

The research team is following patients for one year after injury. Across both groups, the team is comparing how many ER visits patients have, how concerned patients are about their injury over time, their PTSD symptoms, and their ability to do physical tasks.

Patients with trauma injuries, patient advocates, and trauma surgeons are helping the research team plan and conduct the study.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population Adults ages 18 and older in Oregon or Washington State with inpatient or emergency admissions for intentional or unintentional injury who have PTSD symptoms
Interventions/
Comparators
  • Peer-integrated multidisciplinary collaborative care
  • Trauma surgery team notification with referral for mental health consultation
Outcomes Number of visits to ER, patient rating of postinjury concerns, PTSD symptoms, functional status
Timeframe 1-year follow-up for study outcomes

Related Articles

BMJ Open

Rapid ethnographic assessment of the COVID-19 pandemic April 2020 'surge' and its impact on service delivery in an Acute Care Medical Emergency Department and Trauma Center

Psychiatry Interpersonal and Biological Processes

Experiences and Insights from the Early US COVID-19 Epicenter: A Rapid Assessment Procedure Informed Clinical Ethnography Case Series

Contemporary Clinical Trials

A comparative effectiveness trial of an information technology enhanced peer-integrated collaborative care intervention versus enhanced usual care for US trauma care systems: Clinical study protocol

More on this Project  

Videos

Improving Outcomes for Patients through Enhanced Trauma Care Transitions 
Douglas Zatzick, professor at the University of Washington School of Medicine, explains that a former trauma patient who has had training on how to support other patients, referred to as a peer, is part of the team being researched in his study. Using peers may improve outcomes for patients treated in trauma centers as they transition to primary care.

Project Details

Principal Investigator
Douglas Zatzick, MD
Other Principal Investigator
Peter Thomas, JD
Project Status
In progress; Recruiting
Project Title
A Comparative Effectiveness Trial of an Information Technology Enhanced Peer-Integrated Collaborative Care Intervention for US Trauma Care Systems
Board Approval Date
November 2017
Project End Date
March 2024
Organization
University of Washington
Year Awarded
2017
State
Washington
Project Type
Research Project
Health Conditions  
Cancer
Cardiovascular Diseases
Hypertension
Coronary or Ischemic Heart Disease
Infectious Diseases
HIV/AIDS
Kidney Diseases
Liver Diseases
Mental/Behavioral Health
Alcoholism
Addiction/Substance Abuse
Depression
Suicide
Post Traumatic Stress Disorder
Multiple/Comorbid Chronic Conditions
Neurological Disorders
Epilepsy
Nutritional and Metabolic Disorders
Diabetes
Obesity
Respiratory Diseases
Trauma/Injuries
Intervention Strategies
Behavioral Interventions
Drug Interventions
Screening Interventions
Other Clinical Interventions
Care Coordination
Patient Navigation
Other Health Services Interventions
Technology Interventions
Training and Education Interventions
Populations
Individuals with Multiple Chronic/co-morbid Conditions
Racial/Ethnic Minorities
Women
Funding Announcement
Improving Healthcare Systems
Project Budget
$4,942,552
Study Registration Information
HSRP20183350
NCT03569878
Page Last Updated: 
July 24, 2020

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February 2
PCORI 2021 and Beyond: Opportunities for Funding and Involvement in Patient-Centered Research
February 9
Board of Governors Meeting: February 9, 2021
February 11
Advisory Panel on Patient Engagement Winter 2021 Meeting

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