National Data and Statistical Center

Moss TBI Model System

The Moss Traumatic Brain Injury Model System (TBIMS) for 2007-2012, directed by Tessa Hart, PhD and John Whyte, MD, PhD, incorporates a sophisticated network of state-of-the-art, potentially lifelong treatments for persons with TBI and their families in the Philadelphia region and southern New Jersey. Seven Trauma Centers and the nationally recognized Drucker Brain Injury Center at MossRehab collaborate in the clinical component of the Moss TBIMS to offer a full continuum of high-quality treatment, from emergency and acute trauma/ neurosurgical care through community re-entry. Innovative post-acute components spanning two states include a full complement of vocational placement and supported employment services, two Clubhouses, a residential treatment facility, and an Affirmative Business providing transitional or permanent competitive employment for persons with disability due to TBI.

The research core of the Moss TBIMS is centered at the renowned Moss Rehabilitation Research Institute (MRRI). In addition to conducting longitudinal research in collaboration with the TBIMS centers nationally, with a high volume of participants and excellent follow-up rates, the 2007-2012 Moss TBIMS includes 2 site-specific research projects. Both have been designed to generate new knowledge that will lead to improved treatments for TBI. Project 1 is a placebo-controlled pilot study of the effects of dextroamphetamine (DEX) on attention, engagement in therapy, cognitive and motor speed, and other outcomes in subacute TBI. We will also examine the possibility that DEX accelerates the pace of functional recovery in the subacute phase. Project 2 is a cross-national collaboration with a specialty TBI service in a Copenhagen hospital, with which we share many similarities in terms of patient mix, treatment philosophy and cultural milieu. However, the Copenhagen facility provides significantly longer and in some respects, more intensive inpatient care and rehabilitation compared to Moss (and other US rehabilitation facilities), even for patients with comparable injury severity. This affords a natural experiment in which we will compare persons with TBI treated at the 2 facilities on a range of 6- and 12-month outcomes, including functional status, emotional well-being and quality of life, and caregiver burden. The Moss TBIMS will also collaborate fully in modular multi-center research and will continue to participate in separately funded TBI Collaborative projects.

The 2007-2012 Moss TBIMS includes strong components for dissemination and knowledge translation targeted to people with TBI and their families, clinical staff across the continuum of care, and other audiences. In collaboration with the Model Systems Knowledge Translation Center (MSKTC), we will compose “evidence base work groups” of clinicians and researchers who will work to improve assessment and treatment practices within the DBIC. With the Brain Injury Association of Pennsylvania, we will conduct regional caregiver seminars and provide TBI training to Trauma personnel across the state, and will collaborate on 2 conferences for consumers, clinicians and policy makers. We will also conduct a Moss TBIMS consumer conference in Philadelphia, in collaboration with all 5 of the other major TBI rehabilitation facilities in southeastern Pennsylvania and southern New Jersey. Extensive planning for consumer input and thorough evaluation processes will ensure timely, accurate feedback on the degree to which our products and activities have succeeded in their intended outcomes.