Margaret L. (Gretchen) Schwarze, MD, MPP, FACS
Associate Professor of Surgery
Morgridge Endowed Professor of Vascular Surgery
Department of Surgery | University of Wisconsin School of Medicine and Public Health
Dr. Gretchen Schwarze is a recent recipient of an R01 award from the National Institutes of Health for her project, A Randomized Clinical Trial of Scenario Planning for Older Adults with Serious Injury. This work is vital to inform best practices for patient and family-centered care for critically injured patients, particularly with the growing rate of elderly trauma patients presenting to U.S. trauma centers.
Q: You were one of first people to come to CNTR with a research idea through our proposal submission form online. How did you hear about us, and how did the process work for you?
A: I’m not sure where I heard about the CNTR online proposal submission form– maybe from Karen Brasel. I know, as a researcher, that it is nearly impossible to get funded for a large multisite study without collaborators like this, so we always thought we would need CNTR or something like it. I was just grateful CNTR was ready for this proposal and this project.
Q: What was your initial request of CNTR?
A: We initially asked CNTR to help with the recruitment of study sites based on high volume trauma in older adults and interest in communication/palliative care. CNTR did this for us, tapping into their existing clinical trials network, and connecting me to the American College of Surgeons – Committee on Trauma’s (ACS-COT) Trauma Quality Improvement Program (TQIP). Working with TQIP, we were able to invite potentially high-enrolling sites to participate.
Q: Can you talk about the interaction with CNTR in identifying the sites and, later, in serving as the liaison to TQIP for the development of additional fields in the databank specific to your study?
A: Well, everyone was awesome. I talked to CNTR staff, like Michelle Price, and also with members of CNTR’s Scientific Advisory Board, like Eileen Bulger and Rosemary Kozar, so we were really able to understand the resources and think through some of the study design challenges. They also were so great about 1) supporting our study with their strong connections to ACS-COT, 2) helping us sort through the TQIP variables that the hospitals were already collecting to determine what we wanted and how they would work, and 3) connecting us with the right people at TQIP to make sure everyone was on the same page and to ensure that what we wanted to do would be feasible.
Q: Can you tell me a little bit about your project and how it might close some trauma research gaps? What might be the implementation challenges, if you confirm the benefits of this intervention?
A: As far as research gaps, I think there is always room for improvement in communication, teamwork and care for patients with serious illness. We are hoping our intervention will support patients and families in a way that allows them to clarify their preferences and will help us make sure patients receive treatments that align with their goals. We also hope that by getting the entire ICU team on the same page about what we are hoping for and what we are worried about in a consistent and systematic way, we can reduce clinician moral distress.
We will be doing some implementation work during this study, understanding the unique environment of each trauma center and how the barriers and facilitators to implementation may vary based on the setting. Given that these are all really large trauma centers, I feel confident we will learn enough about these challenges that we can scale this fairly well to other centers if we can show the intervention is effective.
Q: What will CNTR be doing for the project now that it’s funded?
A: CNTR will help keep all the sites and participants up to date about the study progress and help us trouble shoot any problems that might come up. CNTR will also help us identify replacement sites, if necessary during the study. Also, through CNTR’s infrastructure, we’ll be able to disseminate results at the end of the study and consider other implementation strategies.
Q: What would you say to investigators about your experience with CNTR? What CNTR service did you find most valuable?
A: Everything. It was just so pleasant to work with CNTR – everyone was really quick to respond to our needs, to help us make connections, and it really gave us confidence to see that CNTR was so enthusiastic about our project. I don’t think we could have gotten funded without the support of CNTR: this infrastructure is critical for reviewers to understand that the study is feasible and supported.