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
  • 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

Project Information

Douglas Zatzick, MD
Peter Thomas, JD
University of Washington
A Comparative Effectiveness Trial of an Information Technology Enhanced Peer-Integrated Collaborative Care Intervention for US Trauma Care Systems

Key Dates

November 2017
March 2024

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: September 26, 2023