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Research in Emergency Medicine    Medical School Aspect              Boriboon Chenthanakij MD.             Family Medicine...
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                                  ...
Why Research?• to improve QUALITY of our mission.• Our Mission  –Patient care  –Teaching    • Undergraduate program       ...
Why Research?• to improve QUALITY of our mission.• Our Mission  –Patient care  –Teaching    • Undergraduate program    • P...
Why Research?• to improve QUALITY of our mission.• Our Mission  –Patient care  –Teaching    • Undergraduate program    • P...
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                          ...
From Mission• We have many PLANs• How can we know that our plans are good ?• We run Deming Cycle –Plan Do Check Act       ...
4
4
4
Check        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.                                                    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.   ...
Check• To ensure that things are in the way we would like to see.• To find some problems that can occur in our process.   ...
Check• To ensure that things are in the way we would like to see.• To find some problems that can occur in our process.• C...
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.                                                 7
Patient Care• We have STEMI fast tract, Stroke fast tract.                                                 7
Patient Care• We have STEMI fast tract, Stroke fast tract.• Many resources were use in fast tract policies.               ...
Patient Care• We have STEMI fast tract, Stroke fast tract.• Many resources were use in fast tract policies.               ...
Patient Care• We have STEMI fast tract, Stroke fast tract.• Many resources were use in fast tract policies.• Were these po...
Patient care               8
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.                                              8
Patient care• We have 5 triage level for patient in Emergency  Department.• But in the past we use only 3 level triage.   ...
Patient care• We have 5 triage level for patient in Emergency  Department.• But in the past we use only 3 level triage.   ...
Patient care• We have 5 triage level for patient in Emergency  Department.• But in the past we use only 3 level triage.• I...
Teaching           9
Teaching• Undergraduate                             9
Teaching• Undergraduate  –In the past, before Tsunami attack in 2004, we seldom   teach about disaster for medical student...
Teaching• Undergraduate  –In the past, before Tsunami attack in 2004, we seldom   teach about disaster for medical student...
Teaching• Undergraduate  –In the past, before Tsunami attack in 2004, we seldom   teach about disaster for medical student...
Teaching• Undergraduate  –In the past, before Tsunami attack in 2004, we seldom   teach about disaster for medical student...
Teaching           10
Teaching• Postgraduate                            10
Teaching• Postgraduate  –We look for an advance life support manikin for our   resident to practice in Central line placem...
Teaching• Postgraduate  –We look for an advance life support manikin for our   resident to practice in Central line placem...
Teaching• Postgraduate  –We look for an advance life support manikin for our   resident to practice in Central line placem...
Teaching• Postgraduate  –We look for an advance life support manikin for our   resident to practice in Central line placem...
POLICY         11
POLICY• Chiangmai University concern about Global warming  and Energy crisis.                                             ...
POLICY• Chiangmai University concern about Global warming  and Energy crisis.• We should know how much energy we use and h...
POLICY• Chiangmai University concern about Global warming  and Energy crisis.• We should know how much energy we use and h...
Interest           12
Interest• Some questions come from ourself.                                      12
Interest• Some questions come from ourself.• May be we interest in some specific topic.                                   ...
Interest• Some questions come from ourself.• May be we interest in some specific topic.                                   ...
Interest• Some questions come from ourself.• May be we interest in some specific topic.• We know that IV beta blockers is ...
Interest• Some questions come from ourself.• May be we interest in some specific topic.• We know that IV beta blockers is ...
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?                            ...
Question• Many questions occur in our daily life practice.• How can we answer these questions?                            ...
Question• Many questions occur in our daily life practice.• How can we answer these questions?• Some questions can be answ...
Question• Many questions occur in our daily life practice.• How can we answer these questions?• Some questions can be answ...
Question• Many questions occur in our daily life practice.• How can we answer these questions?• Some questions can be answ...
How strong is our evidence?                         14
How strong is our evidence?• We must have good methodology while looking for evidence.                                    ...
How strong is our evidence?• We must have good methodology while looking for evidence.                                    ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
How strong is our evidence?• We must have good methodology while looking for evidence.• Which methodology is best for our ...
When we have subjects                        15
When we have subjects• We should learn about ICH/GCP                                  15
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                           ...
When we have subjects• We should learn about ICH/GCP• International Conference on Harmonization• Good Clinical Practices  ...
ICH GCP          16
ICH GCP• An international ethical and scientific quality  standard in  –Designing  –Conducting  –Recording  –Reporting    ...
ICH GCP• An international ethical and scientific quality  standard in  –Designing  –Conducting  –Recording  –Reporting tri...
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Research in emergency medicine

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ใช้ประกอบการบรรยาย แนะนำการวิจัยสำหรับแพทย์ประจำบ้านสาขาเวชศาสตร์ฉุกเฉิน 19 กันยายน 2008

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Transcript of "Research in emergency medicine"

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