IT Enhanced Peer Integrated Collaborative Care for US Trauma Care Systems (TSOS 7 Peer)

University of Washington

Status: Completed

Conditions: PTSD; Physical Injury

Treatments: Behavioral: Peer-Integrated Multidisciplinary Collaborative Care; Behavioral: Trauma surgery team notification

Study type: Interventional

Funder types: Other

Identifiers

NCT03569878

STUDY00005068

Details and patient eligibility

About

This study evaluates two readily implementable approaches to the delivery of transitional care for injured patients treated emergently in US trauma care systems. The two approaches to be compared are a multidisciplinary team collaborative care intervention that integrates front-line trauma center staff with peer interventionists to trauma surgical team notification of patient emotional distress with recommended mental health consultation. The collaborative care intervention will be supported by a novel Emergency Department (ED) health information exchange technology platform.

Full description

Collaborative care models are an established standard of care for treating combined mental health and chronic medical conditions in acute and primary care medical settings. However, very few interventions exist for the acute injury population transitioning between settings. While peer interventionist programs have been instituted for care delivery in many conditions, they have not yet been comprehensively integrated into acute post-injury interventions. Literature reviews support the need for comparative effectiveness trials of health care system interventions targeting high need injured patients with multiple complex mental health and medical comorbidities who are at risk for fragmented post-injury health service utilization. This study evaluates two readily implementable approaches to the delivery of transitional care for injured patients treated emergently in US trauma care systems. The two approaches to be compared are a multidisciplinary team collaborative care intervention that integrates front-line trauma center staff with peer interventionists to trauma surgical team notification of patient emotional distress with recommended mental health consultation. The collaborative care intervention will be supported by a novel Emergency Department (ED) health information exchange technology platform.

Enrollment: 450 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Inpatient/emergency admission for intentional and/or unintentional injury
• Score of ≥35 on the PTSD checklist
• Endorsement of ≥ 1 severe posttraumatic concern

Exclusion criteria

• Patients who required immediate psychiatric intervention
• Patients who are not Washington or Oregon State residents
• Patients who are currently incarcerated
• Patients not speaking Spanish or English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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450 participants in 2 patient groups

Peer-Integrated Multidisciplinary Collaborative Care

Experimental group

Description:

The peer-integrated collaborative care intervention includes front-line trauma center staff (e.g., nursing and masters in social work), joined by injured peer interventionists and supervised by an MD (psychiatrist). The collaborative care team will provide case management, behavioral intervention elements, psychopharmacologic medication recommendations as well as 24/7 cell phone coverage for approximately 6 months post-injury. The intervention will be supported by a novel emergency department health information technology platform.

Treatment:

Behavioral: Peer-Integrated Multidisciplinary Collaborative Care

Trauma surgery team notification

Active Comparator group

Description:

Trauma surgery team notification of patient emotional distress, with recommendation for mental health inpatient consultation will be the comparator condition.

Treatment:

Behavioral: Trauma surgery team notification