Research in emergency medicine
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Research in emergency medicine

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ใช้ประกอบการบรรยาย แนะนำการวิจัยสำหรับแพทย์ประจำบ้านสาขาเวชศาสตร์ฉุกเฉิน 19 กันยายน 2008

ใช้ประกอบการบรรยาย แนะนำการวิจัยสำหรับแพทย์ประจำบ้านสาขาเวชศาสตร์ฉุกเฉิน 19 กันยายน 2008

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  • 1. Research in Emergency Medicine Medical School Aspect Boriboon Chenthanakij MD. Family Medicine Department Faculty of Medicine Chiangmai University 1
  • 2. Why Research? 2
  • 3. Why Research?• to improve QUALITY of our mission. 2
  • 4. Why Research?• to improve QUALITY of our mission. 2
  • 5. Why Research?• to improve QUALITY of our mission.• Our Mission 2
  • 6. Why Research?• to improve QUALITY of our mission.• Our Mission –Patient care 2
  • 7. Why Research?• to improve QUALITY of our mission.• Our Mission –Patient care –Teaching 2
  • 8. Why Research?• to improve QUALITY of our mission.• Our Mission –Patient care –Teaching • Undergraduate program 2
  • 9. Why Research?• to improve QUALITY of our mission.• Our Mission –Patient care –Teaching • Undergraduate program • Postgraduate program 2
  • 10. Why Research?• to improve QUALITY of our mission.• Our Mission –Patient care –Teaching • Undergraduate program • Postgraduate program –Research 2
  • 11. From Mission 3
  • 12. From Mission• We have many PLANs 3
  • 13. From Mission• We have many PLANs 3
  • 14. From Mission• We have many PLANs• How can we know that our plans are good ? 3
  • 15. From Mission• We have many PLANs• How can we know that our plans are good ? 3
  • 16. From Mission• We have many PLANs• How can we know that our plans are good ?• We run Deming Cycle 3
  • 17. From Mission• We have many PLANs• How can we know that our plans are good ?• We run Deming Cycle –Plan Do Check Act 3
  • 18. 4
  • 19. 4
  • 20. 4
  • 21. Check 5
  • 22. Check• To ensure that things are in the way we would like to see. 5
  • 23. Check• To ensure that things are in the way we would like to see. 5
  • 24. 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
  • 25. 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
  • 26. 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
  • 27. Research 6
  • 28. Research• can come from any plan check or any question to improve our quality. 6
  • 29. Patient Care 7
  • 30. Patient Care• We have STEMI fast tract, Stroke fast tract. 7
  • 31. Patient Care• We have STEMI fast tract, Stroke fast tract. 7
  • 32. Patient Care• We have STEMI fast tract, Stroke fast tract.• Many resources were use in fast tract policies. 7
  • 33. Patient Care• We have STEMI fast tract, Stroke fast tract.• Many resources were use in fast tract policies. 7
  • 34. 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? 7
  • 35. Patient care 8
  • 36. Patient care• We have 5 triage level for patient in Emergency Department. 8
  • 37. Patient care• We have 5 triage level for patient in Emergency Department. 8
  • 38. Patient care• We have 5 triage level for patient in Emergency Department.• But in the past we use only 3 level triage. 8
  • 39. Patient care• We have 5 triage level for patient in Emergency Department.• But in the past we use only 3 level triage. 8
  • 40. 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
  • 41. Teaching 9
  • 42. Teaching• Undergraduate 9
  • 43. Teaching• Undergraduate –In the past, before Tsunami attack in 2004, we seldom teach about disaster for medical student. 9
  • 44. 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
  • 45. 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
  • 46. 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
  • 47. Teaching 10
  • 48. Teaching• Postgraduate 10
  • 49. 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
  • 50. 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
  • 51. 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
  • 52. 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
  • 53. POLICY 11
  • 54. POLICY• Chiangmai University concern about Global warming and Energy crisis. 11
  • 55. 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
  • 56. 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
  • 57. Interest 12
  • 58. Interest• Some questions come from ourself. 12
  • 59. Interest• Some questions come from ourself.• May be we interest in some specific topic. 12
  • 60. Interest• Some questions come from ourself.• May be we interest in some specific topic. 12
  • 61. 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
  • 62. 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
  • 63. Question 13
  • 64. Question• Many questions occur in our daily life practice. 13
  • 65. Question• Many questions occur in our daily life practice. 13
  • 66. Question• Many questions occur in our daily life practice.• How can we answer these questions? 13
  • 67. Question• Many questions occur in our daily life practice.• How can we answer these questions? 13
  • 68. 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
  • 69. 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
  • 70. 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
  • 71. How strong is our evidence? 14
  • 72. How strong is our evidence?• We must have good methodology while looking for evidence. 14
  • 73. How strong is our evidence?• We must have good methodology while looking for evidence. 14
  • 74. How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our question? 14
  • 75. How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our question? – Descriptive study 14
  • 76. 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
  • 77. 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
  • 78. 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
  • 79. 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
  • 80. 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
  • 81. When we have subjects 15
  • 82. When we have subjects• We should learn about ICH/GCP 15
  • 83. When we have subjects• We should learn about ICH/GCP 15
  • 84. When we have subjects• We should learn about ICH/GCP• International Conference on Harmonization 15
  • 85. When we have subjects• We should learn about ICH/GCP• International Conference on Harmonization• Good Clinical Practices 15
  • 86. ICH GCP 16
  • 87. ICH GCP• An international ethical and scientific quality standard in –Designing –Conducting –Recording –Reporting 16
  • 88. ICH GCP• An international ethical and scientific quality standard in –Designing –Conducting –Recording –Reporting trials that involve human subjects. 16