1. New England Regional Spinal Cord Injury Center (NERSCIC) At Boston Medical Center & Gaylord Hospital …in affiliation with Northeast Rehabilitation Hospital Overview January 17, 2007

2. About NERSCIC At BMC, est. in 1955 as the first civilian SCI rehab unit in US At BMC, est. in 1955 as the first civilian SCI rehab unit in US Recently re-designated by NIDRR as 1 of 14 National Model Spinal Cord Injury Systems Recently re-designated by NIDRR as 1 of 14 National Model Spinal Cord Injury Systems BMC & Gaylord constitute NE network of care, in association w/ NortheastBMC & Gaylord constitute NE network of care, in association w/ Northeast Conduct socio-medical research and educational programs Conduct socio-medical research and educational programs More attention to rigor in research & multi-center collaborations More attention to rigor in research & multi-center collaborations

3. NERSCIC Components PI: Steve Williams Gaylord PI: Dave Rosenblum Clinical Svc Coordination Steve Williams Dave Rosenblum Directors Research Alan Jette Research Director Training & Dissemination Bethlyn Houlihan Director

4. NERSCIC Major Goals Research focus area: Technology and Science for Health and Function Research focus area: Technology and Science for Health and Function Use computer technology to measure function and to reduce secondary conditionsUse computer technology to measure function and to reduce secondary conditions Clinically, develop a New England Standard of Care Clinically, develop a New England Standard of Care Develop regional capacity for dissemination Develop regional capacity for dissemination Minority/underserved focus Minority/underserved focus Representation in researchRepresentation in research Reduce clinical disparitiesReduce clinical disparities Consumer products—ex. Low literacy wordingConsumer products—ex. Low literacy wording

5. Model System of Care Comprehensive Services Comprehensive Services Emergency careEmergency care Acute careAcute care Inpatient acute rehabInpatient acute rehab Outpatient / follow-up servicesOutpatient / follow-up services Interdisciplinary team: nursing, physiatrist, PT, OT, RT, psych., social work, case mngmt Interdisciplinary team: nursing, physiatrist, PT, OT, RT, psych., social work, case mngmt Other required services: Vocational rehabilitation education, peer mentors, psychosocial services Other required services: Vocational rehabilitation education, peer mentors, psychosocial services

6. National SCI Database: Purpose ~250 participants from BMC, Gaylord ~250 participants from BMC, Gaylord Northeast Rehab in Salem, NHNortheast Rehab in Salem, NH To ID & evaluate trends over time in: etiology, sociodemographics, injury severity, health services delivery, treatment To ID & evaluate trends over time in: etiology, sociodemographics, injury severity, health services delivery, treatment To establish standards of treatment To establish standards of treatment To facilitate other research (both internal & external) To facilitate other research (both internal & external) 30 new patients REQUIRED per year 30 new patients REQUIRED per year NMSCIS publications NMSCIS publications

7. National SCI Database: Methods Two data collection instruments: Post-discharge (“Form I”) Post-discharge (“Form I”) medical record, physiatristmedical record, physiatrist Demographics, acute care & rehab received, treatment outcomesDemographics, acute care & rehab received, treatment outcomes Phone interview @ 1 yr & every 5 th year thereafter (“Form II”) Phone interview @ 1 yr & every 5 th year thereafter (“Form II”) Change at Year 1, health status, psychosocial statusChange at Year 1, health status, psychosocial status FIM, CHART, CHIEF, Patient Health QuestionnaireFIM, CHART, CHIEF, Patient Health Questionnaire If refuse participation  Registry If refuse participation  Registry