Public Health in the Emergency Department: Surveillance, Screening, and Intervent

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DESCRIPTION (provided by applicant): Public Health In The Emergency Department: Surveillance, Screening And Intervention Consensus Conference 2009, sponsored by Academic Emergency Medicine New Orleans, LA-May 13, 2009. Illness and injury related to risky health behaviors account for a substantial proportion of ED visits. Illicit drugs, alcohol, tobacco use, injury, interpersonal violence, and unsafe sexual behavior collectively account for approximately 30% of all ED visits. Individuals who present to the ED as a consequence of risky health behavior may be receptive to a "teachable moment;" thus, the ED may provide an opportune time for intervention by a healthcare provider. These behaviors have become the focus of extensive clinical investigation in emergency medicine. Studying health behaviors at the population level (via surveillance), and individual level (via screening), and designing interventions, positions emergency medicine at the nexus between clinical medicine's traditional realm of disease- or injury-centered care, and the broader domains of population health and prevention. Policymakers and researchers have often used the ED as a site for surveillance for emerging trends in illness and injury, as noted in the 2006 report by the Institute of Medicine, Future of Emergency Care. While this work has focused on describing and defining the epidemiology of illness and injury attributed to risky behavior, much current investigation is focused on screening and intervention. Collectively, these latter activities are known as Screening, Brief Intervention, and Referral to Treatment (SBIRT). For example, a growing body of evidence suggests that brief ED-based interventions may reduce alcohol consumption and negative consequences of drinking in patients with hazardous and harmful drinking. For this reason, the Editors of Academic Emergency Medicine are convening a research consensus conference entitled, "Public Health in the Emergency Department: Surveillance, Screening, and Intervention." The conference will be held on May 13, 2009 in New Orleans, LA, the day prior to the Society for Academic Emergency Medicine (SAEM) annual scientific meeting. The day-long conference is intended to help define a national research agenda in the field of public health-relevant interventions in the ED, concentrating on the design and testing of screening and intervention measures for patients with risky health behaviors. The Public Health in the ED Consensus Conference's conceptual framework will be organized along five tracks, each designed to concentrate on a key area of public health-relevant emergency department research: Consensus Track 1, Alcohol and Substance Use; Consensus Track 2, Injury Prevention/Intimate Partner Violence; Consensus Track 3, Sexually Transmitted Infections/HIV; Consensus Track 4, Mental Health Disorders; and Consensus Track 5, Use of Surveillance Databases. A full journal issue of Academic Emergency Medicine will be devoted to the conference topics. The issue will be published in November 2009 and will include consensus recommendations and conference proceedings, as well as peer-reviewed research manuscripts. A group of national experts, both inside and outside of the specialty of Emergency Medicine, will lead the conference and compile the proceedings. The work of the group (about 160 expected participants) is intended to help lay the foundation for fundamental contributions to public health-relevant interventions in emergency medical care. PUBLIC HEALTH RELEVANCE: This conference on Public Health in the Emergency Department: Surveillance, Screening and Intervention, sponsored by the journal Academic Emergency Medicine, will define and advance a research agenda in public health and emergency medicine. This would be the first unified agenda of its kind in the field. This research agenda will allow emergency physicians and others to study the epidemiology and treatment of risky health behaviors, design evidence-based, cost- and time-sensitive interventions, and examine effects on clinically pertinent outcomes. We anticipate that research advances in this field will lead to substantial improvements in public health-relevant aspects of emergency care.