Spaulding-Harvard Traumatic Brain Injury Model System

The Spaulding-Harvard TBI System of Care has unparalleled access to world-class personnel, facilities and resources, which will be fully-exploited to serve NIDILRR in its mission to support research that contributes to evidence-based rehabilitation procedures, interventions and practice guidelines for TBI. In response to the 2017-2022 TBIMS Competitive Priorities, we have proposed an ambitious, consumer-driven agenda that interleaves state-of-the-art clinical practices with core principles of research, engages in empirically-sound research to solve pressing, “real-world” problems and effectively disseminates emerging knowledge to TBI stakeholders. Our research objectives target the needs of two closely-linked underserved populations- persons with chronic disorders of consciousness (DoC), and their caregivers. Both have been marginalized by the healthcare system in a so-called, “societal neglect syndrome.” Our aims center on developing new approaches that will more effectively integrate the continuum of care from the acute through post-acute phases of recovery, and better understand the challenges faced by caregivers of persons with chronic DoC. Achieving these aims will inform person-centered decision-making during the critically-important acute period and expand knowledge of post-acute outcome in this areana. Our highly-experienced research team has the requisite knowledge and skills to:
a) Provide a Multidisciplinary System of Care that Addresses the Needs of Persons with TBI. Our inpatient clinical care programs provide evidence-based brain injury rehabilitation services across the spectrum of severity, from the time of emergence from coma through readiness for return to the community. The Spaulding-Harvard TBIMS will assist the multidisciplinary clinical care teams by applying principles of research to clinical activities aimed at achieving accurate diagnostic assessments, patient-centered care plans and cost-effective outcomes.
b) Contribute to the TBIMS national database and monitor long-term functional outcomes.
Our center has the capacity to enroll and follow a large cohort of persons per year in the TBIMS NDB. During the 2012-2017 TBIMS cycle, our annual average enrollment was two times the minimum required for a TBIMS center, and we conducted over 100 Form II follow-ups per year. We expect to maintain or exceed this level of performance in 2017-2022.
c) Conduct One Site-Specific Research Project. Diagnostic studies indicate that 4 of 10 persons judged to be unconscious after severe brain injury actually retain conscious awareness. Because diagnostic error can lead to inappropriate medical decisions, we have designed a new standardized assessment scale to monitor recovery of consciousness and will validate its performance in the ICU. We expect this new measure (ie, “CRSR-FAST”) to reduce diagnostic error and improve coordination of care between acute and post-acute care providers.
d) Contribute to improved long term TBI outcomes by participating in at least one module research project. To better understand the trajectory of recovery in persons with chronic DoC, we will develop and pilot a structured telephone-based interview to acquire post-acute outcome data directly from caregivers while concurrently providing important information about factors that influence caregiver effectiveness and burden of care.
g) Partner with the TBIMS Knowledge Translation Center (MSKTC) to disseminate findings. We will work closely with the MSKTC to disseminate our research findings and promote public awareness of TBI issues that are misrepresented and misunderstood. We have partnered with a short film company to produce, “A Day in the Life”, a unique film that will offer a “birds-eye” view of the tightly-intertwined daily existence of a person in VS and their caregiver. We will also conduct a series of “TBI Education Symposia” for consumer and professional audiences.
Quality Control. Our framework for operational management emphasizes full inclusion of diverse stakeholders and underrepresented groups, and robust quality assurance and human subjects protections to ensure the security, integrity and validity of all of our TBIMS activities.

Spaulding Rehabilitation Hospital

300 First Ave.
Boston MA 02129

Project Officer: Kris Painter, Ph.D
Project Number:
Joseph T. Giacino, Ph.D.
Project Director/Principal Investigator, Site Specific 952-5232
Ross Zafonte, D.O.
Medical Director/ 573-2754
Therese O'Neil-Pirozzi Sc.D., CCC-SLP
Associate Project Director/Co-Investigor/Database 573-2456
Hong Pan, Ph.D.
Site Specific Project 732-9122
Mel Glenn, M.D.
Project 573-2625
Martha Shenton, Ph.D.
Site Specific Project Neuroimaging 525-6117
Sylvain Bouix, Ph.D.
Site Specific Project Neuroimaging 525-6233
Brian L. Edlow, M.D.
Site Specific Project Neuroimaging 238-5600
Emilia Bagiella, Ph.D. 525-6117
Yelena Guller, Ph.D.
Neuropsychology 573-2698
Srivatsan Uchani
Research 952-6354
Laura Burns
Research Assistant 952-6192
Amber Thomas
Research 952-6391
Ally Sterling
Research 952-6354
Katherine Golden
Student 424-8845
Kelsey Goostrey
Research 952-6391
Jenna Szostak
Student 685-0130
Abigail Waters
Research 952-6392
MaryLourdes Andreu
Student InternMLANDREU@PARTNERS.ORG(786) 973-1182
Nicole Riepl
Student 932-0927
Meredith Adams
Student 351-7801