Archive for the ‘National Trauma Institute News’ Category

NTI Shares Lessons Learned Over a Decade of Study Management

Thursday, September 8th, 2016

Just published in the Journal of Trauma and Acute Care Surgery (Vol 81, No 3), “The National Trauma Institute: Lessons learned in the funding and conduct of sixteen trauma research studies” analyzes and discusses how funded researchers approached obtaining regulatory approval, enrolling patients, navigating the Exception from Informed Consent process, coordinating multiple study sites and more.

The article offers some solutions for reducing challenges and lag times inherent in the study completion timeline. Among the insights, 40 percent of the funded investigators reported delays in obtaining regulatory approval at one or more institutional levels, which had serious impacts on study management. “The time required to obtain approvals delayed the funding awards considerably and resulted in the loss of study sites, turnover in research trainees, and the need to use alternate sources of funds for research staff salaries, protocol review, and community consultation costs,” NTI found.

NTI’s insights about navigating the regulatory environment square with the findings of the National Academies of Sciences, Engineering and Medicine (NASEM) in its June 2016 report: A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury. “To accelerate progress toward the aim of zero preventable deaths after injury and minimizing disability, regulatory agencies should revise research regulations and reduce misinterpretation of the regulations through policy statements” is one of the recommendations of the NASEM Committee on Military Trauma Care’s Learning Health System and Its Translation to the Civilian Sector. [Read a summary of the NASEM report HERE].

In all, NTI reports lessons that are instructive for trauma researchers in four key areas: regulatory processes, multisite coordination, adequate funding, and research infrastructure.

NTI Chair Jurkovich Joins UC Davis Health System

Tuesday, June 14th, 2016

In February 2016, Gregory “Jerry” Jurkovich, MD, FACS, joined the UC Davis Health System in Sacramento, California as Professor and Vice-Chairman of the Department of Surgery. In this role, he is responsible for the clinical affairs and quality of the department, as well as being an acute care surgeon.

Prior to relocating to California, Dr. Jurkovich served as Director of Surgery and Trauma Services at Denver Health, and the Rockwell Professor of Surgery at the University of Colorado. This appointment followed nearly 24 years at the University of Washington and Harborview Medical Center in Seattle as Professor and Chief of Trauma. He began his surgical career as Chief of Trauma at the University of South Alabama.

Dr. Jurkovich has held numerous leadership positions in addition to serving as Chair of the National Trauma Institute for the past three years. He has been the President of the American Association for the Surgery of Trauma (AAST), the Western Trauma Association (WTA), and the Western Surgical Association (WSA). He also has served as Vice Chairman and Chief of Regions of the American College of Surgeons Committee on Trauma (ACS/COT), and is currently a Director of the American Board of Surgery. He serves on the editorial board of the Journal of Trauma and Acute Care Surgery, Annals of Surgery, and the Journal of the American College of Surgeons. He is also the editor of the textbook “ACS Surgery: Principles and Practices.”

Dr. Jurkovich is well known for his leadership of the AAST Committee on the Acute Care Surgeon, working to define the future training and practice paradigm for trauma surgery that combines surgical critical care, emergency general surgery, and trauma surgery. Throughout the course of his career, Dr. Jurkovich has explored some of the most critical problems in trauma, including methods of measuring outcome in trauma patients, the role of hypothermia in trauma, alcohol and injury, the immune-inflammatory response to injury, and nutritional support in the critically injured.

He received an undergraduate degree in biomedical engineering (cum laude) from Northwestern University and his MD degree from the University of Minnesota. His surgery residency was at the University of Colorado, with a trauma research fellowship at Duke University.


Dr. Donald Jenkins, NTI Board Member and Past Chair, Takes New Post at UTHSCSA

Friday, June 10th, 2016

A founding board member and immediate past chair of the National Trauma Institute, Donald H. Jenkins, MD, FACS, began service on June 1, 2016 as Vice Chair for Quality, Department of Surgery, at the University of Texas Health Science Center at San Antonio (UTHSCSA). He is also a professor in the Division of Trauma and Emergency Surgery, the Betty and Bob Kelso Distinguished Chair in Burn and Trauma Surgery and Associate Deputy Director of the university’s Military Health Institute.

Bringing decades of experience in care of the injured patient, trauma system development and advanced resuscitation of patients with hemorrhage, Dr. Jenkins will collaborate locally, regionally, nationally and internationally to further the science of health care delivery as it relates to these fields of expertise. Dr. Jenkins also brings a wealth of experience related to surgical quality measures, performance improvement and patient safety which will be adapted, where necessary, in his new role.

Dr. Jenkins retains his role as Assistant Professor of Surgery at the Uniformed Services University in Bethesda, MD. He retired in 2008 from the U.S. Air Force, having served as the Trauma Medical Director at Lackland AFB, TX. He was responsible for all trauma medical care and administration of the USAF’s only American College of Surgeons Verified Level 1 Trauma Center at Wilford Hall USAF Medical Center in San Antonio in the decade prior to his retirement. He was also the Flight Commander and Chairman of General Surgery for 59MDW.

Dr. Jenkins was formerly Professor of Surgery and Director of Trauma in the Division of Trauma, Critical Care and General Surgery at the Mayo Clinic in Rochester, Minnesota, where he worked from 2008 (upon his retirement from the USAF) until last month. In this role, he helped establish the first regional trauma organization in the State of Minnesota, oversaw a nearly 50 percent decline in trauma mortality at Saint Mary’s Hospital in Rochester and led a team in the use of plasma in the pre-hospital setting as well as initiated the use of cold stored platelets and whole blood.

Dr. Jenkins received his BS in biochemistry from the University of Scranton, Pennsylvania; earned his MD from the Uniformed Services University in Bethesda, Maryland; and performed residencies at Wilford Hall and Lackland AFB. He was a trauma/critical care fellow at the University of Pennsylvania and received the Diploma Medical Care of Catastrophes from the Society of Apothecaries of London. Dr. Jenkins is Past President of the Eastern Association for the Surgery of Trauma (EAST).

Surgeons Hit Capitol Hill to Talk about Trauma

Friday, March 4th, 2016

Dr. Tom Scalea and Rep. Dutch Ruppersberger.

Last week 27 trauma surgeons from across the country visited members of their state Congressional delegations to persuade them to support additional funding of the Trauma Clinical Research Program in the Department of Defense Health Program. All told, the surgeons made more than 150 visits to both Senate and House offices.

The effort was made possible by the Coalition for National Trauma Research, of which NTI is a member.

In addition to their individual meetings, the trauma surgeons heard from Representative Dutch Ruppersberger (MD-02), one of CNTR’s champions who is sponsoring a letter to the Defense Appropriations Subcommittee asking for consideration of the Trauma Clinical Research Program. Ruppersberger, whose life was saved by trauma surgeons at Maryland’s Shock Trauma Center years ago following an automobile crash, spoke to the group as a long-time supporter of their work and unwavering champion in the House of Representatives.

Drs. Ronald Stewart, William Cioffi and Donald Jenkins gave presentations during a trauma briefing organized by COL Bob Mabry, serving this year as a Robert Woods Johnson Fellow in the Health Subcommittee of the House Committee on Education & The Workforce.

It will be many months before the trauma advocates learn whether their efforts to secure a $20 million appropriation for the clinical research program are successful. The program was initially launched with internal DoD funding and received a $10 million appropriation in FY16. CNTR, working closely with a DoD work group, has begun to identify priorities and has already coalesced a group of 140 trauma centers across the country willing to be part of a trials network that can respond to DoD research requests.

May is National Trauma Awareness Month

Monday, May 4th, 2015

May is National Trauma Awareness Month. Established by President Ronald Reagan in 1988, National Trauma Awareness Month is a time to recognize the tremendous toll trauma takes on our society.

More than 190,000 Americans die from traumatic injury each year, and trauma costs us more $585 billion in health care and lost productivity. Traumatic injury is the #3 cause of death in the U.S., yet there is no consistent funding mechanism or health institute for its study. NTI advocates for consistent federal funding, a focused research agenda, a trauma clinical trials network and a trauma research repository so the trauma care community can begin to close the gaps in knowledge and save more lives.

Learn more about trauma in America and NTI’s work HERE.


NTI Meets and Greets at EAST 28th Annual Scientific Assembly

Friday, January 16th, 2015

The National Trauma Institute met with members of the Eastern Association for the Surgery of Trauma (EAST) during its annual meeting in Orlando Florida this week. The young surgeons and investigators attending the meeting benefited from scientific presentations, career-building and leadership sessions, and networking opportunities with colleagues and mentors from across the United States.

NTI provided information about its mission, recently published research and upcoming advocacy activities in Washington, DC.

NTI Appoints New Officers and Board Members

Thursday, August 21st, 2014

The National Trauma Institute (NTI) appointed new leaders and welcomed four new members to its Board of Directors this month.

Jerry J. Jurkovich, MD, FACS, assumes the Board Chair position, relieving Donald H. Jenkins, MD, FACS, who served in the position for two years and moves to the Vice-Chair position to provide continuity for NTI’s advocacy efforts. Basil A. Pruitt, Jr., MD, FACS, replacing long-serving M. Margaret Knudson, MD, FACS, begins a three-year term as Science Committee Chair, while Gregory J. Beilman, MD, FACS, succeeds David B. Hoyt, MD, FACS in the Science Committee Vice-Chair role.

Newly appointed at-large members serving two-year terms, Drs. Martin Croce, Eric Elster, Nicole Gibran and Wayne Meredith join the 24-member board during an exciting period in the organization’s evolution. With its first funded studies closing and beginning to return and publish meaningful results, NTI now turns to advocate for development of two major trauma research infrastructure projects: a National Trauma Research Repository and a Trauma Clinical Trials Network.

“We’re very optimistic about acquiring the funding for both a repository and a clinical trials network,” said Board of Directors Chair Jerry Jurkovich. “Our new board members and leaders are sure to add influence and enthusiasm to our efforts.”

NTI works in coalition with like-minded organizations to achieve rapid advances in traumatic injury treatment that can save lives. The organization’s leaders believe that a robust research infrastructure is long over-due, pointing to a 40-year history of federally acknowledged research funding inadequacies.

To read board member bios, visit the NTI Board of Directors page.

NTI-Funded Research Provides Guidance on Iron Supplementation for Critically Injured Patients

Tuesday, July 15th, 2014

Research funded by the National Trauma Institute finds that routine IV iron supplementation of anemic, critically ill trauma patients is not recommended.

Nearly all trauma patients admitted to the ICU are anemic, and the anemia is associated with poor outcomes, yet current therapies for ICU anemia are unsatisfactory. Intensivists inconsistently prescribe iron supplementation for critically ill patients, and it has been unclear whether the practice can overcome the iron debt enough to impact the patient positively. Also unclear is the relationship between iron supplementation and risk of infection.

The research conducted by Fredric M. Pieracci, MD, MPH, at the UC Denver medical campus and three participating academic sites set out to determine whether iron supplementation of anemic trauma patients positively affects outcomes.

They found that while supplementation increased the serum ferritin concentration significantly, it had no discernable effect on transferrin saturation, iron-deficient erythropoiesis, hemoglobin concentration or packed red blood cell transfusion requirements.

The research is published in Critical Care Medicine.

Ronald Stewart Assumes ACS Committee on Trauma Chairmanship

Monday, February 10th, 2014

NTI founding board member and immediate past chair, Ronald M. Stewart, M.D., FACS, begins his appointment as chair of the American College of Surgeons (ACS) Committee on Trauma in March 2014. A professor and chair of the Department of Surgery at the UT Health Science Center San Antonio, Stewart is also a physician with UT Medicine San Antonio and a trauma surgeon at University Hospital.

He succeeds Michael F.  Rotondo, M.D., FACS, of Rochester, N.Y. He serves as the Committee on Trauma’s 19th chairman. Click here for full press release.

NTI Study Refutes Dogma of Ventilator Bundle Use to Prevent Ventilator Associated Pneumonia

Friday, March 1st, 2013

Ventilator associated pneumonia (VAP) is the most common serious infection that occurs in severely injured patients. For those who develop VAP, approximately 20% will not survive. While the mainstay of treatment of VAP remains antibiotic therapy, the emphasis from healthcare organizations has been on VAP prevention, and the Institute for Healthcare Improvement has advocated a “bundle” of care maneuvers to help prevent VAP, including stress ulcer prophylaxis, deep venous thrombosis prophylaxis, head-of-bed elevation, and daily sedation vacation with weaning assessment. Although the use of the ventilator bundle has been widely accepted, there is little evidence of its effectiveness. Furthermore, the Centers for Medicare and Medicaid Services have determined that VAP may be preventable with ventilator bundle use, and has threatened to reduce or eliminate payment to hospitals when a patient develops VAP.

The National Trauma Institute’s first completed research study analyzed the efficacy of the ventilator bundle in prevention of ventilator associated pneumonia in trauma patients who were in the Intensive care Unit (ICU) on a ventilator for at least two days. The research study, highlighted in the February issue of the Journal of Trauma and Acute Care Surgery, and first presented at the AAST Annual Meeting in Kauai, was led by Dr. Martin Croce at the University of Tennessee in Memphis, and enrolled over 600 patients at six Level 1 trauma centers nationally.

This study shows that VAP is more likely to occur in male patients, and those with severe chest injury, regardless of the ventilator bundle. Moreover, the study found that use of the ventilator bundle does not prevent or reduce the occurrence of VAP. Ultimately, critical analysis of dogma is important for patient care, and new, innovative means of ventilator associated pneumonia prevention are needed.