1. The Traumatic Injury Spectrum: A Novel Primary Care Perspective for Training, Education, and Practice Steven A. Hankins, MD, MPH, MTS Department of Family Medicine and Community Health (DFMCH), John A. Burns School of Medicine (JABSOM), University of Hawaii (UH), Mililani, HI 96789 hankinss@hawaii.edu SUMMARY Traumatic injury causes significant morbidity & mortality Traumatic injury represents a huge spectrum of disease Much of care for injuries happens in primary care Novel curriculum trains Family Physicians to intervene through: Public Health Advocacy Patient and Community Education Acute and Chronic Management Multidisciplinary Long-term Follow Up New perspective of traumatic injury allows us to better train and educate primary care physicians to practice more effective interventions in their local communities Enables family medicine physicians to have a far greater impact on reducing the burden of disease related to traumatic injury. Sponsored through an agreement with Hawaii Department of Health as authorized by HRS§321-22.5 establishing the Trauma System Special Fund and Conditions for its use funded by the Hawaii Legislature in Act 164, Session of Laws of Hawaii, 2011, Section 3, Item E-4, p.439, appropriating funds from the Trauma System Special Fund for Fiscal Year 2012. FUTURE REASEARCH & DIRECTIONS Assess Curriculum efficacy and outcomes – Knowledge assessments – Self-efficacy ratings by residents – Community Outreach Site Impact Community Primary Care CME Development and Implementation Duplication of model in other Family Medicine training sites. REFERENCES 1.Trauma statistics. National Trauma Institute Website. http://www.nationaltraumainstitute.org/home/trauma_statistics.html Updated April 16, 2015. Accessed April 21, 2015. 2.Schappert, S., & Burt, C. (2006). Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. Vital and Health Statistics. Series 13, Data from the National Health Survey, (159), 1-66. 3.Levi, J., Segal, L., & Kohn D. The facts hurt: a state-by-state injury prevention policy report. Trust for America’s Health. 2012. Available from http://healthyamericans.org/reports/injury12/ Accessed April 21, 2015. PROBLEM Family medicine training programs currently lack a comprehensive traumatic injury curriculum that addresses the spectrum of disease and the spectrum of interventions available related to injuries. Poster Number: SP063 Residency Needs Assessment Survey CURRICULAR INTERVENTION Develop novel traumatic injury curriculum that : views trauma as a spectrum of disease incorporates structured experiences in public health advocacy community outreach and education multi-disciplinary management develops the skills necessary to intervene across the entire continuum of disease prevention and care Produces a cadre of family medicine physicians who are literate, articulate, and active in the areas of traumatic injury prevention, management, and rehabilitation METHODS Complete Needs Assessment Establish Advisory Committee Define Goals, Objectives, & Key Competencies Identify Focus Areas Determine Key Curriculum Components Identify Methods of Instruction & Evaluation Draft Outline of Specific Content Assess Community Interest & Needs Develop Implementation Timeline Evaluation Unique Curricular Elements Public Health Advocacy Didactic and Experiential Community Outreach & Education Tai Chi for Falls Prevention Structured Experiences in Rehabilitation Didactic and Experiential BACKGROUND Traumatic injuries in the U.S. 3 rd leading cause of death overall The #1 cause for ages 1-46 192,000 deaths 2 million hospitalizations 41 million ER visits 110 million outpatient visits 1 1/3 of injury visits are to Primary Care Physicians 2 Injury spectrum ranges from minor injuries through debilitating injuries with long-term sequelae Family Physicians can reduce the burden of injuries through: Public Health Advocacy Community Education and Outreach Screening for Risk Factors Patient Education Acute and Sub-acute Management Multidisciplinary Care of Long-term Sequelae Currently Family Medicine training for traumatic injuries is often: Disjointed Largely focused on acute management Lacking formal curriculum on: Prevention Advocacy Non-surgical definitive management Long-term follow up and rehabilitation 2 3 Scan for Details