title: Multidisciplinary acute care research organization (MACRO): if you build it, they will come.
abstract: BACKGROUND
  Clinical research will increasingly play a core role in the evolution and growth of acute care surgery program development across the country. What constitutes an efficient and effective clinical research infrastructure in the current fiscal and academic environment remains obscure. We sought to characterize the effects of implementation of a multidisciplinary acute care research organization (MACRO) at a busy tertiary referral university setting.
  
  
  METHODS
  In 2008, to minimize redundancy and cost as well as to maximize existing resources promoting acute care research, MACRO was created, unifying clinical research infrastructure among the Departments of Critical Care Medicine, Emergency Medicine, and Surgery. During the periods 2008 to 2012, we performed a retrospective analysis and determined volume of clinical studies, patient enrollment for both observational and interventional trials, and staff growth since MACRO's origination and characterized changes over time.
  
  
  RESULTS
  From 2008 to 2011, the volume of patients enrolled in clinical studies, which MACRO facilitates has significantly increased more than 300%. The percentage of interventional/observational trials has remained stable during the same period (50-60%). Staff has increased from 6 coordinators to 10, with an additional 15 research associates allowing 24/7 service. With this significant growth, MACRO has become financially self-sufficient, and additional outside departments now seek MACRO's services.
  
  
  CONCLUSIONS
  Appropriate organization of acute care clinical research infrastructure minimizes redundancy and can promote sustainable, efficient growth in the current academic environment. Further studies are required to determine if similar models can be successful at other acute care surgery programs.
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Early
authors.forename: David T
authors.initials: DT
authors.lastname: Huang
authors.forename: Clifton W
authors.initials: CW
authors.lastname: Callaway
authors.forename: Mazen
authors.initials: M
authors.lastname: Zenati
authors.forename: Derek C
authors.initials: DC
authors.lastname: Angus
authors.forename: Scott R
authors.initials: SR
authors.lastname: Gunn
authors.forename: Donald M
authors.initials: DM
authors.lastname: Yealy
authors.forename: Daniel
authors.initials: D
authors.lastname: Unikel
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Billiar
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Peitzman
authors.forename: Jason L
authors.initials: JL
authors.lastname: Sperry
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D035843:Biomedical Research / Q000458:organization & administration*; D003422:Critical Care / Q000458:organization & administration*; D004635:Emergency Medicine / Q000458:organization & administration*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D009936:Organizational Innovation; D016730:Program Development; D015397:Program Evaluation; D058996:Quality Improvement; D014481:United States