New England Regional New England Regional Spinal Cord Injury Spinal Cord Injury Center (NERSCIC)Center (NERSCIC)At Boston Medical Center & At Boston Medical Center &

Gaylord HospitalGaylord Hospital……in affiliation with Northeast in affiliation with Northeast

Rehabilitation HospitalRehabilitation Hospital

OverviewOverview

January 17, 2007January 17, 2007

About NERSCICAbout NERSCIC

At BMC, est. in 1955 as the first civilian SCI At BMC, est. in 1955 as the first civilian SCI rehab unit in USrehab unit in US

Recently re-designated by NIDRR as 1 of Recently re-designated by NIDRR as 1 of 14 National Model Spinal Cord Injury 14 National Model Spinal Cord Injury SystemsSystems• BMC & Gaylord constitute NE network of care, BMC & Gaylord constitute NE network of care,

in association w/ Northeastin association w/ Northeast Conduct socio-medical research and Conduct socio-medical research and

educational programseducational programs More attention to rigor in research & multi-More attention to rigor in research & multi-

center collaborationscenter collaborations

NERSCIC ComponentsNERSCIC ComponentsPI: Steve WilliamsPI: Steve Williams

Gaylord PI: Dave RosenblumGaylord PI: Dave Rosenblum

Clinical SvcCoordinationSteve Williams

Dave RosenblumDirectors

ResearchAlan Jette

Research Director

Training & DisseminationBethlyn Houlihan

Director

NERSCIC Major GoalsNERSCIC Major Goals

ResearchResearch focus area: Technology and focus area: Technology and Science for Health and FunctionScience for Health and Function• Use computer technology to measure function Use computer technology to measure function

and to reduce secondary conditionsand to reduce secondary conditions ClinicallyClinically, develop a New England , develop a New England

Standard of CareStandard of Care Develop regional capacity forDevelop regional capacity for

disseminationdissemination Minority/underserved focusMinority/underserved focus

• Representation in researchRepresentation in research• Reduce clinical disparitiesReduce clinical disparities• Consumer products—ex. Low literacy wordingConsumer products—ex. Low literacy wording

Model System of CareModel System of Care

Comprehensive ServicesComprehensive Services• Emergency careEmergency care• Acute careAcute care• Inpatient acute rehabInpatient acute rehab• Outpatient / follow-up servicesOutpatient / follow-up services

Interdisciplinary team: nursing, physiatrist, Interdisciplinary team: nursing, physiatrist, PT, OT, RT, psych., social work, case PT, OT, RT, psych., social work, case mngmtmngmt

Other required services: Vocational Other required services: Vocational rehabilitation education, peer mentors, rehabilitation education, peer mentors, psychosocial servicespsychosocial services

National SCI Database:National SCI Database:PurposePurpose

~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: To ID & evaluate trends over time in: etiology, sociodemographics, injury etiology, sociodemographics, injury severity, health services delivery, severity, health services delivery, treatmenttreatment

To establish standards of treatmentTo establish standards of treatment To facilitate other research (both internal To facilitate other research (both internal

& external)& external) 30 new patients REQUIRED per year30 new patients REQUIRED per year NMSCIS publicationsNMSCIS publications

National SCI Database: National SCI Database: MethodsMethods

Two data collection instruments:Two data collection instruments: Post-discharge (“Form I”)Post-discharge (“Form I”)

• medical record, physiatristmedical record, physiatrist• Demographics, acute care & rehab received, Demographics, acute care & rehab received,

treatment outcomes treatment outcomes Phone interview @ 1 yr & every 5Phone interview @ 1 yr & every 5thth year year

thereafter (“Form II”)thereafter (“Form II”)• Change at Year 1, health status, psychosocial Change at Year 1, health status, psychosocial

statusstatus• FIM, CHART, CHIEF, Patient Health FIM, CHART, CHIEF, Patient Health

QuestionnaireQuestionnaire If refuse participation If refuse participation Registry Registry