Acute Care Research

Tamp General Hospital & The University of South Florida
ED Based Acute Care Research Program

24/7 RESEARCH HOTLINE 813.394.3025

RESEARCH ROTATION AND RESEARCH STAFF SCHEDULE

Acute Care Research Vision Statement

Our acute care research program leverages the 24/7 operational model of emergency medicine in order to raise the quality and capacity of clinical research to that of our management of acute patient presentations such as STEMI, Stroke and trauma care while also creating a culture of research for our investigators and patients. We strive to make the same high quality research studies available to patients at 3am on Saturday that are available at 3pm on Monday.

If a patient would not settle for a lower standard of care for treatment for a medical condition, they should also not settle for decreased chance to benefit from clinical research. Our model increases enrollment volumes, expands capacity for new studies, supports investigator initiated projects, provides transparent pricing structures for services, and allows tracking of revenue and expenses for reporting purposes while also ensuring sustainability over time for investigators and research support staff by minimizing the impact of screening, enrollment and patient follow up on the research team through the synchronization of available research resources to the patient through the shift approach. Our clinical research vision is complemented by work in quality improvement and health care services. For both patient and investigator, we ensure that the intellectual resources and talent of the University of South Florida Morsani College of Medicine and the high quality patient environment of Tampa General Hospital work seamlessly together to provide the latest diagnostic and treatment strategies available.

USF/TGH Acute Care Research Mission

Our mission is to operate a 24/7 acute care research program with the capacity and capability to provide a drug, device or procedure at any time point. The success and expansion of acute care research studies relies on the demand for 24/7 quality via a shift work model that utilizes around the clock research assistants, research coordinators, and multiple investigators present in the ED. Furthermore, we leverage our EMR to provide robust patient capture support, minimizing the impact on clinically active staff to identify patients. We work to integrate our operational approach into the existing ED workflow in a way that does not burden busy staff or require research investigators and coordinators to be regularly queried on off days outside the hospital. We increase capacity to accept and initiate new studies by having each research team member cross cover multiple. The presence of research staff and investigators in the hospital 24/7 allows us to work across service lines to screen, enroll and provide treatment to patients under research protocol in and out of the ED during a hospital admission.

The Division of Emergency Medicine Research Section (USF EM Research) is integrated closely with the Tampa General Hospital Office of Clinical Research (TGHOCR). TGHOCR provides infrastructure for the Acute Care research group while the USF EM Research Team serve as the hub of Acute Care studies via the work of our research assistants, students, and residents.

USF/TGH/TEAMHealth Acute Care Research Staff

Research Director, Emergency Medicine: Jason Wilson, MD

Acute Care Research Team, Clinical Research RN Manager: Sandra Sanchez, RN, BSN, CCRP

Acute Care Research Team, Clinical Research RN: Ashley Bader, RN, BSN

Acute Care Research Team: Clinical Research RN: Elisabeth Ballans, RN, BSN

Director of Social Emergency Medicine Programs: Heather Henderson, MA

Research Chief 2020-2021: Johnathan Elkes, MD

Other Critical TGH OCR Staff can be found at the TGH OCR Page

Acute Care Research Team, Research Assistant: Onyeka Acholonu

Acute Care Research Team, Research Assistant: Brittany Mathaney

Acute Care Research Team, Research Assistant: Meera Navadia

Acute Care Research Team, Research Assistant: Amanda Mathies

Acute Care Research Team, Research Assistant: Marcelo Ramaikos

Acute Care Research Team, Research Assistant: Amar Mahbubani

USF EM Residency Research Section

The USF Emergency Medicine Research Section is responsible for organizing and creating a longitudinal research curriculum for the residency program and tracking the publications and presentations by residents and faculty for submission yearly to the RRC. The curriculum includes education in the IRB and study creation process, evidence based medicine and statistical concepts, as well as a journal club that meets eight times per year along with a PGY-3 clinically appraised topic presentation that often results in a publication for the resident.

The emergency medicine research section also acts as the hub for ED based acute care inpatient hospital
studies. Each year, we initiate 10 new sponsored clinical studies while maintaining 4-5 ongoing clinical studies in the ED. In addition, we also work with other service lines to identify and enroll patients into time sensitive studies. research department. Patients are identified for studies using research assistants that work in the emergency department 24 hours a day, as well as clinical decision support tools in the electronic medical record. Working closely with Tampa General Hospital Office for Clinical Research, patients are followed throughout their hospital course and during subsequent visits at our onsite outpatient clinic. We also have 1-2 investigator initiated studies at a time – often created by residents with input and assistance from our core and clinical faculty.

Residents become involved in research and the research curriculum beginning their intern year but formerly rotate with the research section during their PGY-3 year. During that month, residents act in an administrative role as a liaison between research staff, student volunteers, and research assistants while also providing clinical guidance and assessment of research patients when appropriate for clinical studies.

In addition, our team is able to leverage the research infrastructure to support investigator initiated projects as well as resident, medical student, graduate student as well as honors college education at the University.

The Emergency Medicine Research Section offers a one month third or fourth year medical student elective rotation (time period can be modified as needed) as well as a summer program for select undergraduate students, graduate students and rising second year medical students. At times, we are able to provide funding for summer students. (MDR 8710)

Resident Scholarly Activity Requirement


Scholarly activity is required by the ACGME as part of emergency medicine training. Minimum requirements exist to set a baseline. The USF EM curriculum is designed to ensure that all residents excel well above the minimum requirements in all aspects of training. In order to meet the resident scholarly activity requirement, a resident must contribute to body of knowledge in an original creative manner while meeting longitudinal scholarly milestones throughout the entire training period.

Scholarly activity at USF EM should not be thought of as a single project or a one-month rotation. Instead, scholarly activity is practice that produces a lifelong learner with the toolkit to contribute knowledge to the field of emergency medicine. Having said that, there are specific tangible requirements to mark progress that are found below.

Beginning in 2017, we implemented a longitudinal research experience into the curriculum that ensures that all residents have the opportunity to participate in original scholarly activity. During the PGY-1 year, residents are paired with staff research assistants and more experienced learners and faculty to develop projects. These sessions occur both during grand rounds time periods and outside of those scheduled time periods as needed.

To fulfill the USF EM and ACGME requirements for scholarly activity, each resident will design an original research hypothesis in collaboration with a faculty member. The project can utilize retrospective data obtained from the electronic medical record after appropriate permissions. Alternatively, residents with original clinical research questions or hypotheses that necessitate an intervention can conduct prospective studies if the process is initiated in sufficient time during training. Most prospective projects, especially those with a patient intervention, will need to be proposed by the end of the PGY-1 year.

In addition, the resident spends one month on the Research Rotation, usually during the PGY-3 year. This month provides an opportunity to both complete outstanding projects as well as to serve in an administrative capacity within the research division. During the research month, the resident should plan to attend scheduled research division meetings, site initiation/monitoring and closeout visits, as well as IRB and feasibility meetings. During the rotation, the rotating research resident should serve as an educational liaison to the research assistants that work every day in the emergency department to identify appropriate research patients, as well as to any students rotating with the research division. Residents will complete 4 clinical shifts and 16 hours of teaching shifts during this month as well.

Each year, every resident will also lead discussion of a journal article and, usually during the PGY-3 year, will also present a critically appraised topic (CAT) presentation that should not be a rehash of others work but, instead, an original review that should be publishable in EMPulse, EM Resident or another similar venue.

USF EM Minimum Expectations To Meet
Scholarly Activity Requirement Over 3 Year Period

  1. Lead discussion of 3 journal articles utilizing the Journal Club Worksheet
  2. Create and present an approved CAT
  3. Maintain Human Subjects Research Certification via CITI Training

  4. Attend a Medical IRB Meeting at USF
  5. Attend 2 Research Division Meetings during the PGY3 Research Month
  6. Attend 3 Research Project Grand Rounds Sessions
  7. Create, complete, and present/publish an approved scholarly project (must be a creative contribution to the science of emergency medicine, not an isolated case review or presentation of non-original work)
  8. Work 72 hours of  Clinical Shifts During Research Month
  9. Complete designated Teaching Hours during research month
  10. Meet yearly with Research Director. Scholarly Activity Project should be approved by mid- PGY-2 year
  11. Attend Friday morning undergraduate course with Dr. Wilson during PGY-3 Research Month

Employment Opportunities

TGH RN Research Coordinator
The research coordinator position is a full time position offered through Tampa General Hospital. To check for open positions and to apply, please visit the TGH Job Portal.

The Research Coordinator provides professional clinical nursing care under general supervision to study participants, as required under assigned research protocols; follows established policies, procedures and professional guidelines in planning, implementing, documenting and reporting study requirements; functions as a research coordinator in the Clinical Research Unit and the hospital; responsible for performing job duties in accordance with mission, vision and values of Tampa General Hospital.

Required Skills
Graduate of an accredited School of Nursing; Florida RN license; BSN required; A minimum of 2 years of bedside nursing required; Certification as a Certified Research Associate or completion within 3 years of assuming the role.

Research Assistant (RA)
Our research assistant positions are offered as independent contractor opportunities on an as needed basis. Research assistants are involved in support roles for both industry-sponsored and investigator initiated studies. RAs work within the ED and use the electronic medical record to identify patients as potential study enrollees. The RA reviews inclusion and exclusion criteria for all studies and acts as a liaison between clinical staff and research staff to facilitate patient screening and enrollment. The RA also works with residents, medical students and attending physicians to support investigator initiated studies through data collection, assistance with data analysis, as well as assistance with abstract, poster, and manuscript creation.

To apply for an RA position, please email tampaERdoc@gmail.com

The credentialing application should be uploaded to the RedCap application site when completed along with all required documents.

Research Assistant
The Research Assistant Position is an independent contractor position offered on an as available basis. The position is ideal for pre-medical students WITH experience in clinical settings (EMT, Paramedic, completion of Patient-Physician Interaction Course, prior RN, Scribe, etc) or foreign medical and US grads that are in a gap period between graduation and residency. If interested in this position, email tampaERdoc@gmail.com

ED Research Calendar

CITI/HSP Training Requirements

Journal Club Worksheet

Medical IRB Schedule

FUNDED CLINICAL RESEARCH STUDIES June 2020

  • NIDA CTN-0099 ED INNOVATION: Usual Care Oral Buprenorphine-Naloxone pathway compared to investigational IM Buprenorphine-Naloxone pathway. Status = Start Up Process 06/12/20
  • ANNEXA-I. Annexa vs. standard of care for ICH/Reversal of life threatening bleeds in patients on Factor Xa inhibitors. PI = Wilson, Coordinator = Ballans. Status = Enrolling 06/12/20

INVESTIGATOR/FACULTY/RESIDENT  CURRENT PROJECTS


FOCUS

  • HIV Acute Positive vs. False Positive Laboratory Testing
  • HIV Acute Positive and False Positive Clinical Presentation
  • HCV ECONOMIC MODEL
  • GONORRHEA AND CHLAMYDIA TREATMENT ADHERENCE
  • PrEP IN SUPERUTILIZERS
  • HIV FALSE POSITIVES
  • NNT/NNS HCV

RESIDENCY/GRAND ROUNDS

  • HYPOTENSION IN ED. Thomas
  • DIMER IN PREGNANCY. Derr
  • NALOXONE UTILIZATION. Peredy
  • PREHOSPITAL RESTRAINTS. Semmons

FACULTY IIS

  • Magnesium in Atrial Fibrillation – Okonkwo
  • PE/sPESI. Wilson/Hoida and Enrique – completed analysis. Writing
  • SEP-1. Wilson/Nassar.
  • IMPLUS. LOW BACK PAIN. IRB SUBMISSION. FUNDED. SUPPLIES ON SITE. Wilson
  • TEE IN RESUSCITATION. Mike Butterfield. PGY-3. 2/2/18. IRB Approved. Initiated
  • CYRACOM INTEPRETER. PHONE VS. VIDEO. Christian Jeanot PGY-3 and Seiichi Villalona, Anthropology.

MEDICAL STUDENTS

  • PARAMEDIC DISPOSITION.
  • THE RELATIONSHIP BETWEEN EARLY INITIATION OF ART AND DOWNSTREAM DRUG RESISTANCE
  • HIV FALSE POSITIVES

GRADUATE STUDENTS

    • STIGMA OF OPIOID ADDICTION. Heather Henderson. Anthropology, PhD Thesis.
      Tie in to Suboxone research
    • HALLWAY PATIENTS/PRESS GANEY. Seiichi VillalonaUNDERGRADUATES
    • LACTATE IN ADDITION TO MEWS. Louis Leon. Honors Thesis
    • SEXUAL ASSAULT. Abigail Parrigan. Tie in to Darbi Cox HUMAN TRAFFICKING
    • LEAFLET PROJECT. Alexis Mullner
    • ED COMMUNICATION. LucyOTHER
    • SCD. Carlos
    • POCT GLUCOSE IN PATIENTS RECEIVING VIT C. TGH Pharmacy

ED RESEARCH DASHBOARD

Total Active Sponsored Studies: 12

JAN 1, 2020 – JUN 6, 2020 SCREENS HOURS Raw Screens/Hour ADMIN/TRAINING EFFECTIVE HOURS Effective SCREENS/HOUR
X 328.00 670.00 0.49 60.00 268.00 1.22
Y 317.00 750.00 0.42 72.00 245.00 1.29
X 434.00 613.00 0.71 30.00 404.00 1.07
A 1276.00 747.00 1.71 30.00 1246.00 1.02
B 508.00 393.00 1.29 30.00 363.00 1.40
TOTALS 2863.00 3173.00 0.90 222.00 2951.00 0.97
*Research Assistants w/> 100h over training time
JAN 1, 2017 – JUN 16, 2017 *Research Assistants w/> 100h over training time
SCREENS HOURS Raw Screens/Hour ADMIN/TRAINING EFFECTIVE HOURS Effective SCREENS/HOUR % Total Admin Hours TOTAL COST Effective COSTS PER SCREEN
2863 3173 0.90 222 2951 0.97 7.75 $46,008.50 $14.93

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All researchers working with the TGH/USF Acute Care Team must complete the following:

1. CITI HUMAN SUBJECTS TRAINING
CITI_INSTRUCTIONS
CITI Training
2. TGH CREDENTIALING
(not required for residents, faculty and MS3/4)
3. . REQUEST FOR USF HEALTH EMAIL ADDRESS
4. REQUEST FOR REDCAP ACCESS:
Once steps 1-3 are completed and you have BOTH a TGH Badge & a USF HEALTH Email address, email Anthony Green at tgreen@usf.edu and copy Jason Wilson at tampaERdoc@gmail.com and request RedCap Access as a member of Dr. Wilson’s USF/TGH Acute Care Research Team

COURSES/SEMINARS
Research in Patient-Physician Interactions ANT4930
Designing Health Research IDH4950
2017 Summer Research Symposium

COVID RESEARCH – ACTIVE STUDY LIST

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