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 |
|
| Outcomes | Number of visits to ER, patient rating of postinjury concerns, PTSD symptoms, functional status |
 |
1-year follow-up for study outcomes |
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
Care Coordination
Drug Interventions
Other Clinical Interventions
Other Health Services Interventions
Patient Navigation
Screening Interventions
Technology Interventions
Training and Education Interventions
Women
Individuals with Multiple Chronic/co-morbid Conditions