Acute Care & Emergency Medicine
Our investigators develop innovative, patient-centered care practices to improve the quality, safety and efficiency of trauma, emergency, acute and critical care. Investigators are also focused on improving patients’ experience of emergency and critical care, quality of life during and after critical illness, and tackling policy and systems barriers that limit clinicians’ ability to deliver acute care efficiently and equitably.
Active Projects
Identifying Older Adults with Delirium in the Emergency Department: Risk Factors and Phenotypes
This project aims to externally validate the Kennedy delirium risk prediction score to identify delirium in older adults across 5 different EDs in the Northeast, South, and Midwest regions of the United States, and to identify ED delirium phenotype classifications and identify frequency of delirium phenotypes.
Geriatric Emergency care Applied Research network 2.0 – Advancing Dementia Care
A core tenant of the Geriatric Emergency care Applied Research Network 2.0—Advancing Dementia Care (GEAR 2.0-ADC) is the inclusion of community members during all stages of clinical research. As such, we deliberately integrated and supported patient and public involvement in the evaluation and selection of GEAR 2.0-ADC Pilot Research Grants by developing and adapting traditional grant application review structures, with input from community members, to create the GEAR 2.0-ADC Community Review Committee approach.
A Cluster-Randomized Trial of the Northwestern Embedded Emergency Department Physical Therapy (NEED-PT) Protocol for Acute Low Back Pain
Emergency department-based physical therapy is a rapidly growing resource and represents a promising treatment approach to low back pain. We propose to develop and test an innovative model of an emergency department “embedded” physical therapist to evaluate and treat patients with acute low back pain. We hypothesize that the embedded physical therapy intervention will improve patient functioning, reduce opioid use, and decrease unnecessary testing.
Hemostasis, Hematoma Expansion, and Outcomes After Intracerebral Hemorrhage
Intracerebral hemorrhage (ICH) is the most morbid form of stroke and has no treatment approved by the US Food and Drug Administration. Hematoma expansion (HE), interval growth of the hematoma, is a proximate cause of worse patient outcomes and death as larger hematomas displace brain tissue; hematomas > 60 mL reliably lead to disability or death at follow-up. Preventing HE is a promising strategy to improve outcomes for patients with ICH. Our relative inability to predict HE, however, has impeded the development of effective treatment strategies for ICH, and several clinical trials have been unsuccessful. Even when HE has been reduced, our ability to detect a benefit is hampered by relatively insensitive patient outcomes. This proposal will resolve two roadblocks that prevent the development of effective treatments for ICH, the most morbid form of stroke.
Precise Prediction and Treatment of Seizures After Intracranial Hemorrhage
Seizures are a common and morbid complication of intracranial hemorrhage, leading to brain herniation, worse patient outcome, and death. While a few risk factors for seizures have been described, the ability to predict seizures is still crude. At the conclusion of this proposal, we will deliver a model to predict patients most likely to have seizures, and determine which patients are likely to have higher HRQoL as a results of prophylactic seizure medications, leading to targeted treatment and non-treatment to maximize patient HRQoL.
Improving Interhospital Transfer of Patients with Neurologic Emergencies
More than 2.3 million patients are transferred from one hospital to another, an interhospital transfer (IHT). Most IHT originate from the Emergency Department, and neurologic emergencies (NE) are one of the most common reasons for transfer. Communication during the IHT process is often poor, which may be a major contributor to the poor outcomes that are often associated with undergoing IHT. The overall goal of this project is for the applicant, an emergency physician, to become a leader in cutting edge intervention design techniques to improve the quality and safety of care for emergency department patients while improving patient-centeredness.
Timeliness of Management of Trauma Related Hemorrhage and Trauma Related Coagulopathy
This proposal focuses the processes and systems of care contributing to the timeliness of managing trauma induced hemorrhage and trauma related coagulopathy at non-trauma and low-level trauma centers and subsequent re-triage to high-level trauma centers. This application involves methods from engineering, quality improvement, learning collaboratives, data science and the learning health system.
Shock Patients: Interprofessional Communication to Enhance Diagnosis (SPICED)
Does Improving Care Team Communication Reduce Delay in Response among Critically Ill Surgical Patients with Abdominal Sepsis?