Welcome to the Web site of the Office of Emergency Care Research (OECR) at NIH. This office coordinates and fosters clinical and translational research and research training for the emergency setting. While OECR does not directly fund research projects, it achieves this mission by working across the 27 institutes and centers at NIH. OECR has four objectives:
OECR catalyzes the development of new funding opportunities for research related to patients with time-sensitive medical conditions.
OECR creates opportunities for synergy, collaboration and new initiatives in the emergency care research community. The office also organizes scientific meetings to address high-impact, trans-NIH research questions in emergency care.
OECR helps train the next generation of emergency care researchers.
The Office of Emergency Care Research (OECR) was announced in July 2012. It is the culmination of more than 5 years of discussions between NIH and the emergency medicine community. It also responds to reports about the nation’s emergency medical system issued in 2006 by the Institute of Medicine:
- Hospital-Based Emergency Care: At the Breaking Point
- Emergency Care for Children: Growing Pains
- Emergency Medical Services At the Crossroads
These reports stated that, despite the lifesaving feats performed every day by emergency departments and ambulance services, the nation's emergency medical system as a whole was overburdened, underfunded and highly fragmented.
In response, NIH gathered representatives from its institutes and centers to form a task force (now called the NIH Emergency Care Research Working Group) in 2007. This group identified many separate NIH-funded research and research training activities in emergency medicine. It concluded that a coordinated, trans-NIH approach would improve efficiency, realize scientific opportunities and enable the rigorous training of new investigators. This would lead to significant, long-term benefits for patient outcomes and advances in the field of emergency care.
Using this feedback, members of the task force and academic leaders in the field participated in three roundtable discussions aimed at prioritizing emergency care research. They focused on three areas: 1) neurological and psychiatric emergencies, 2) medical/surgical emergencies and 3) trauma emergencies.
Roundtable participants were asked to:
- Identify current roadblocks and suggest solutions;
- Identify specific, achievable goals that had the potential to advance and transform the field of emergency care;
- Set priorities for research; and
- Determine how investigators in emergency care research could best access NIH resources through the competitive grant process.
The three roundtables resulted in a report to the NIH Director and the following four articles in the November 2010 issue of the Annals of Emergency Medicine:
- NIH and Research in the Emergency Setting: Progress, Promise, and Process
- NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies
- Summary of NIH Medical-Surgical Emergency Research Roundtable held on April 30 to May 1, 2009
- NIH Roundtable on Emergency Trauma Research
These reports identified several perceived barriers to emergency research and made recommendations for meeting research opportunities and overcoming challenges. In response, senior NIH leadership suggested the creation of a single office to coordinate NIH emergency care research and research training. The result is the NIH Office of Emergency Care Research (OECR).
Jeremy Brown, M.D., became the first permanent director of OECR in July 2013.
Answers to Questions About OECR
Q: What is OECR?
A: The Office of Emergency Care Research (OECR) is a focal point for clinical and translational emergency care research and training across NIH. Its mission is to help improve the health outcomes of patients who require emergency care.
Although OECR does not fund grants, it fosters innovation and improvement in emergency care and in the training of future researchers in this field by:
- Coordinating funding opportunities that involve multiple NIH institutes and centers.
- Working closely with the NIH Emergency Care Research Working Group, which includes representatives from many NIH institutes and centers.
- Organizing scientific meetings to identify new research and training opportunities in emergency settings.
- Catalyzing the development of new funding opportunities and informing investigators about funding opportunities in their areas of interest.
- Identifying and addressing areas in which more research is needed, such as health services provided to patients in the pre- hospital setting, emergency department or intensive care unit; and medical issues that, while not time-critical, are best studied in the emergency care setting.
- Fostering career development for trainees in emergency care research.
- Representing NIH in government-wide efforts to improve the nation's emergency care system.
Q: When and why was OECR created?
A: The creation of OECR was announced in July 2012. It was a culmination of more than 5 years of discussions between NIH and the emergency medicine community. The initial impetus for these conversations was three reports by the Institute of Medicine (IOM) in 2006.
The OECR History (see above) contains additional details, links to the IOM reports, and information about NIH's response—the creation of a task force, the request for information from the emergency care community, the launch of roundtable discussions and the publication of four articles in the Annals of Emergency Medicine.
Q: What is emergency care?
A: Emergency care includes a wide variety of conditions, only some of which are life-threatening. These life-threatening conditions include heart attacks, strokes, traumatic injuries, burns, allergic reactions, fractures, infections, drug overdoses, bleeding, asthma attacks, poisoning, and psychiatric crises. Because of the way that the practice of primary care medicine has changed, emergency physicians are now involved in admitting about half of all hopitalized patients in the US. But emergency medical services also deliver care for a larger number of conditions that do not require hospitalization and are not immediately life-threatening, but for which patients seek medical attention. These may be as simple as a prescription refill or the evaluation of a worsening chronic condition. As many as 80% of patients who visit an ED do so simply because they cannot access other medical providers.
Q: Why is emergency care research so important?
A: Emergency departments handle an enormous number of patients, many of which are the sickest and most vulnerable in the health care system. Consider these statistics:
- There are over 130 million visits to emergency departments in the U.S. each year. Other than pregnant women admitted for labor and delivery, more hospital patients are admitted through the emergency department than through any other department.
- Half of all patients in the intensive care unit are admitted from the emergency department.
- Emergency departments provide care to patients who are unable to receive treatment from their primary care providers or perceive they have no other source of medical care.
Q: What is different about research for patients with emergency conditions?
A: Many NIH institutes support research that is focused on specific organs, diseases or populations (for example children or the elderly). Patients in the emergency department present with a wide spectrum of diseases—or a collection of symptoms rather than a definitive diagnosis—and can come from any population. For these reasons, research in emergency care cuts across traditional research boundaries within the NIH organizational structure.
Q: How will OECR work with other government agencies?
A: The OECR director will work closely with other parts of the Federal Government and will represent NIH in regular meetings with these partners. For example, the OECR director will serve on the Council on Emergency Medical Care, which promotes synergy across the government to improve the nation's emergency care system. The Office also works closely with the Office of the Assistant Secretary for Preparedenss and Response (ASPR).
Q: Who is the OECR director?
A: Jeremy Brown, M.D., became the first permanent director of OECR in July 2013.
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