research in emergency medicine
Post on 07-May-2015
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Research in Emergency Medicine
Medical School Aspect
Boriboon Chenthanakij MD.
Family Medicine Department
Faculty of Medicine Chiangmai University
1
Why Research?
2
Why Research?
• to improve QUALITY of our mission.
2
Why Research?
• to improve QUALITY of our mission.
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
•Postgraduate program
2
Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
•Postgraduate program
–Research 2
From Mission
3
From Mission
• We have many PLANs
3
From Mission
• We have many PLANs
3
From Mission
• We have many PLANs
• How can we know that our plans are good ?
3
From Mission
• We have many PLANs
• How can we know that our plans are good ?
3
From Mission
• We have many PLANs
• How can we know that our plans are good ?
• We run Deming Cycle
3
From Mission
• We have many PLANs
• How can we know that our plans are good ?
• We run Deming Cycle
–Plan Do Check Act
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4
Check
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Check
• To ensure that things are in the way we would like to see.
5
Check
• To ensure that things are in the way we would like to see.
5
Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
5
Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
5
Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
• Can help us find the way to improve our process.
5
Research
6
Research
• can come from any plan check or any
question to improve our quality.
6
Patient Care
7
Patient Care
• We have STEMI fast tract, Stroke fast tract.
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Patient Care
• We have STEMI fast tract, Stroke fast tract.
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Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
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Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
7
Patient Care
• We have STEMI fast tract, Stroke fast tract.
• Many resources were use in fast tract policies.
• Were these policies really improve quality of life for our
patient?
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Patient care
8
Patient care
• We have 5 triage level for patient in Emergency
Department.
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Patient care
• We have 5 triage level for patient in Emergency
Department.
8
Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
8
Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
8
Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
• Is 5 level triage improve quality of care compare to
3 level triage ?
8
Teaching
9
Teaching
• Undergraduate
9
Teaching
• Undergraduate
– In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
9
Teaching
• Undergraduate
– In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
9
Teaching
• Undergraduate
– In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
9
Teaching
• Undergraduate
– In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
–we now have 2 weeks selective program about
disaster medicine for medical student in 4th year.
– Is our selective program can actually improve our
medical student performance when disaster occur? 9
Teaching
10
Teaching
• Postgraduate
10
Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
10
Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
10
Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
10
Teaching
• Postgraduate
–We look for an advance life support manikin for our
resident to practice in Central line placement before
they perform in real patients.
–The price of manikin is around 1 or more million B.
– Is advance life support manikin can actually improve our
resident’s skill?10
POLICY
11
POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
11
POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
• We should know how much energy we use and how
much plastic garbage we produce.
11
POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
• We should know how much energy we use and how
much plastic garbage we produce.
• And how much we can reduce them.
11
Interest
12
Interest
• Some questions come from ourself.
12
Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
12
Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
12
Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
• We know that IV beta blockers is very helpful to control
heart rate in AF patients, but we don’t have this
medication form in ED.
12
Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
• We know that IV beta blockers is very helpful to control
heart rate in AF patients, but we don’t have this
medication form in ED.
• So, which medication can be used when we don’t have
this medication. 12
Question
13
Question
• Many questions occur in our daily life practice.
13
Question
• Many questions occur in our daily life practice.
13
Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
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Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
13
Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
13
Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
13
Question
• Many questions occur in our daily life practice.
• How can we answer these questions?
• Some questions can be answered easily, but many are not.
• We need evidences before we can do evidence
based ............13
How strong is our evidence?
14
How strong is our evidence?• We must have good methodology while looking for evidence.
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How strong is our evidence?• We must have good methodology while looking for evidence.
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
–Experimental study
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
–Experimental study
–Clinical trial
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
–Experimental study
–Clinical trial
• Which statistics is/are appropriate for our data?
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
–Experimental study
–Clinical trial
• Which statistics is/are appropriate for our data?
14
How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
–Experimental study
–Clinical trial
• Which statistics is/are appropriate for our data?
• Epidemiologist is our good friend in this situation.14
When we have subjects
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When we have subjects
• We should learn about ICH/GCP
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When we have subjects
• We should learn about ICH/GCP
15
When we have subjects
• We should learn about ICH/GCP
• International Conference on Harmonization
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When we have subjects
• We should learn about ICH/GCP
• International Conference on Harmonization
• Good Clinical Practices
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ICH GCP
16
ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
16
ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
trials that involve human subjects.
16
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