research in emergency medicine
DESCRIPTION
ใช้ประกอบการบรรยาย แนะนำการวิจัยสำหรับแพทย์ประจำบ้านสาขาเวชศาสตร์ฉุกเฉิน 19 กันยายน 2008TRANSCRIPT
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Research in Emergency Medicine
Medical School Aspect
Boriboon Chenthanakij MD.
Family Medicine Department
Faculty of Medicine Chiangmai University
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Why Research?
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Why Research?
• to improve QUALITY of our mission.
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Why Research?
• to improve QUALITY of our mission.
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
•Postgraduate program
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Why Research?
• to improve QUALITY of our mission.
• Our Mission
–Patient care
–Teaching
•Undergraduate program
•Postgraduate program
–Research 2
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From Mission
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From Mission
• We have many PLANs
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From Mission
• We have many PLANs
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From Mission
• We have many PLANs
• How can we know that our plans are good ?
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From Mission
• We have many PLANs
• How can we know that our plans are good ?
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From Mission
• We have many PLANs
• How can we know that our plans are good ?
• We run Deming Cycle
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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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Check
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Check
• To ensure that things are in the way we would like to see.
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Check
• To ensure that things are in the way we would like to see.
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Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
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Check
• To ensure that things are in the way we would like to see.
• To find some problems that can occur in our process.
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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.
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Research
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Research
• can come from any plan check or any
question to improve our quality.
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Patient Care
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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.
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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.
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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
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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.
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Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
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Patient care
• We have 5 triage level for patient in Emergency
Department.
• But in the past we use only 3 level triage.
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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 ?
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Teaching
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Teaching
• Undergraduate
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Teaching
• Undergraduate
– In the past, before Tsunami attack in 2004, we seldom
teach about disaster for medical student.
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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.
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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.
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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
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Teaching
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Teaching
• Postgraduate
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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.
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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.
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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.
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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
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POLICY
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POLICY
• Chiangmai University concern about Global warming
and Energy crisis.
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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.
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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.
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Interest
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Interest
• Some questions come from ourself.
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Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
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Interest
• Some questions come from ourself.
• May be we interest in some specific topic.
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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.
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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
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Question
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Question
• Many questions occur in our daily life practice.
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Question
• Many questions occur in our daily life practice.
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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?
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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.
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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.
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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
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How strong is our evidence?
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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.
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How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
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How strong is our evidence?• We must have good methodology while looking for evidence.
• Which methodology is best for our question?
–Descriptive study
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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
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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
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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?
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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
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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
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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
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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
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ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
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ICH GCP
• An international ethical and scientific quality
standard in
–Designing
–Conducting
–Recording
–Reporting
trials that involve human subjects.
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