The New York Traumatic Brain Injury Model System (NY-TBI-MS) proposes to: (1) demonstrate and evaluate a multidisciplinary system of care for persons with TBI in the New York City (NYC) metropolitan area, including a number of innovative clinical programs; (2) contribute longitudinal data to the National Database of the TBI Model Systems program; and (3) conduct one module and two local studies to: (a) systematically study sleep architecture, insomnia and other types of sleep disorders after TBI, to better understand post-TBI fatigue; and (b) evaluate the effectiveness of exercise as a treatment of post-TBI fatigue, mood and cognition.
The NY-TBI-MS of the Department of Rehabilitation Medicine of Mount Sinai Medical Center, addresses the needs of persons with TBI through (1) clinical care; (2) research; and (3) dissemination, education and training.
The comprehensive clinical program consists of:
• The NYC Emergency Medical Service, which ensures the early and safe extrication of individuals with TBI from the site of injury, their immediate care and transport to the Level I trauma center at Elmhurst Hospital Center (EHC) or the Level II trauma center at The Mount Sinai Hospital (MSH).
• Acute medical/surgical care at EHC or at MSH, both of which provide state-of-the-art emergency and medical/surgical services.
• Comprehensive inpatient and outpatient medical rehabilitation services. These include services provided on the 40-bed, CARF-accredited brain injury inpatient rehabilitation unit of MSH and on the 28-bed inpatient medical rehabilitation unit at EHC. The program stresses interdisciplinary care and employs a primary team model to enhance coordination among caregivers. Outpatient rehabilitation services include neuropsychological and social services, vocational rehabilitation services and consumer-directed day programs (Bridge, Phase II) to promote community reintegration. Long-term medical and rehabilitation services are provided/prescribed by physiatrists with expertise in TBI.
• A comprehensive specialized TBI sub-acute program at Park Terrace Care Center.
All key positions within the NY-TBI-MS are staffed by professionals who have extensive experience working with individuals with TBI and are committed to delivering high quality care. Many of the members of the interdisciplinary team have earned national recognition for their clinical, educational and research efforts related to TBI.
The research program of NY-TBI-MS aims to advance the understanding of TBI and develop better methods of treating secondary conditions of TBI, especially fatigue, mood, cognition and sleep disorders. NY-TBI-MS will continue to contribute data to the National Database, enrolling an expected 200 new cases during the next cycle and continuing follow-up evaluations of Form II data for patients enrolled in the current cycle. The proposed research program is focused on fatigue, one of the most disabling and least understood secondary conditions of TBI. These projects build on the extensive clinical and research expertise on post-TBI fatigue gained during the current cycle of the NY-TBI-MS, as well as on our research on sleep, mood and exercise.
Dissemination, education and training activities constitute the third component of the NY-TBI-MS, including a policy newsletter, expanded web-based information, journal publications, presentations at national and local meetings, a newsletter for consumers, and several formal educational and training programs, including training of physiatric residents as well as interns and post-doctoral researchers in psychology.