The Trauma Collaborative Care Study (TCCS).
Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers. The TCC program was evaluated by comparing outcomes of patients treated at 6 intervention sites (n = 481) with 6 trauma centers where care was delivered as usual (control sites, n = 419). Compared with standard treatment alone, it is hypothesized that access to the TCC program plus standard treatment will result in lower rates of poor patient-reported function, depression, and posttraumatic stress disorder.
*Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; †R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; ‡Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; §Inova Fairfax Medical Campus, Department of Orthopaedic Surgery, Orthopaedic Trauma, Fairfax, VA; ‖Department of Orthopaedic Surgery and Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN; ¶The CORE Institute, University of Arizona Medical College - Phoenix, Banner University Medical Center, Phoenix, AZ; **Carolinas Medical Center, Department of Orthopaedic Surgery, Charlotte, NC; and ††Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Stephen T
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Wegener
Andrew N
AN
Pollak
Katherine P
KP
Frey
Robert A
RA
Hymes
Kristin R
KR
Archer
Clifford B
CB
Jones
Rachel B
RB
Seymour
Robert V
RV
OʼToole
Renan C
RC
Castillo
Yanjie
Y
Huang
Daniel O
DO
Scharfstein
Ellen J
EJ
MacKenzie
D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D014193:Trauma Centers / Q000458:organization & administration*; D016896:Treatment Outcome; D014481:United States; D014947:Wounds and Injuries / Q000523:psychology* / Q000628:therapy*