Model systems of care can be found in most industries. Such systems set standards against which other institutions can measure their own effectiveness. In the medical realm, a Model System is a center of excellence for both treatment and research related to a particular disability, such as traumatic brain injuries, burns, or spinal cord injuries.

The Model Systems are funded by the United States Department of Education and the National Institute on Disability and Rehabilitation Research (NIDRR). NIDRR gives Model Systems awards to centers that have a strong record of outstanding clinical care and treatment and the ability to carry out a program of research. The institutions are involved in developing and evaluating a continuum of comprehensive services from the emergency room through discharge from the rehabilitation setting.

A traumatic brain injury (TBI) is defined as damage to brain tissue caused by an external mechanical force as evidenced by a loss of consciousness due to brain trauma or post-traumatic amnesia (PTA), or skull fracture, or objective neurological findings that can be reasonable attributed to the TBI on the initial physical examination or mental status examination. (adapted from TBI Model System syllabus).

These types of brain injuries are usually the result of an accident or, sometimes, an assault. Often the injury results from a blow to the head that is suffered in an automobile accident, a fall, or as the result of a gunshot wound. Sometimes a brain injury can occur during sports activities such as football. These accidents can also occur in the home. A person may take a fall down the stairs or even in the bathtub and hit his or her head hard enough to sustain a brain injury.

A brain injury can be detected by a physician through a physical examination. The doctor may ask that the injured patients undergo other diagnostic tests such as CT scans of the brain or a MRI of the brain.

Traumatic brain injuries are a major cause of mortality and morbidity in the United States, particularly among persons below the age of 45. Each year in the United States, nearly 500,000 people are seen in hospital emergency rooms because of a traumatic brain injury. The Centers for Disease Control and Prevention (CDC) estimates that approximately 55,000 deaths each year result from TBI and that another 80,000 individuals each year are left with long term physical and psychological disabilities that limit their independence and ability to work.

Texas is the second most populous state in the United States, and accordingly, CDC statistics indicate that it is second in the nation in terms of occurrences of traumatic brain injury. The CDC reports that 144,000 Texans sustain a traumatic brain injury annually. Of these, 5,728 are permanently disabled yearly from TBI, and 4,214 Texans die each year from a catastrophic TBI. The 75-county North Texas area is the most populous region in the state, and it accounts for a substantial portion of TBI cases in the state (data from the Texas Trauma Registry, Texas Department of Health).

A person with a brain injury is generally taken to the nearest emergency room where the emergency room personnel will determine the severity of the injury. Depending on the severity the patient may be sent home with instructions to watch out for vomiting, dizziness, or other symptoms of concussion; sent to have further tests to determine the severity of the injury; sent to the hospital floor for observation; sent to the intensive care unit for one-on-one care by trained trauma staff; or rushed to emergency surgery to stop bleeding or to attempt to repair damage to the brain.

To be a patient involved in the research being conducted by the North Texas Traumatic Brain Injury Model System the patient must have suffered a TBI, be at least 16 years of age, have received initial treatment for the TBI at either Parkland Health & Hospital System, Baylor University Medical Center, or John Peter Smith Hospital, and then have received rehabilitative care at either Parkland, Zale Lipshy Pavilion - William P. Clements Jr. University Hospital, or Baylor Institute for Rehabilitation. The patient must also be able to understand and sign an informed consent to participate or, if unable, have a family member or a legal guardian who understands the form, sign the informed consent for the patient.

The information collected on the North Texas TBI Model System patients is added to the national database that contains data from thousands of people with TBI throughout the United States. This database is used to study the factors that predict recovery and outcomes of TBI. More information on the national database and the published articles based upon it may be found at the TBIMS national website. Your name and all other identifying information are kept confidential and are not submitted to the national database. Only the details about the injury suffered, the severity of the injury, the treatments given while hospitalized, subsequent recovery information, and responses to questionnaires are submitted.

The information sent to the national data center is combined with that of more than 2,000 other TBI survivors from 16 other Model System centers across the country. Combining data with these other Model Systems will help us learn about brain injuries much more quickly.

By allowing us to re-contact you every year, around the same month as you were first injured, we are able to get detailed information about the recovery process and about the problems and successes since discharge from the hospital. Again, this data is submitted to the national data center and combined with the other centers to help better understand recovery after a traumatic brain injury.

You may also be asked to participate in future research studies about patients who have suffered a traumatic brain injury. Through these many and varied projects we are continuing to learn more about how the brain responds, recovers, and heals after a traumatic brain injury.

The information that you provide in our ongoing education about the effects of traumatic brain injury will not directly affect the participant of the Model System or the patients currently under care for their injuries. However, the knowledge that we gain from following large numbers of patients throughout the United States will be invaluable for future development of research, acute and rehabilitative care, as well as treatment options for the traumatic brain injured patient.

The institutions and research centers designated as Traumatic Brain Injury (TBI) Model Systems conduct research in all aspects of TBI including applied technology, physical and rehabilitative medicine, therapeutic interventions, drug development, and quality of life issues. Activities are facilitated by the Traumatic Brain Injury National Data Center (TBINDC) at Craig Hospital in Colorado.

Whenever possible, the results of these efforts are published in scientific journals around the world. The Traumatic Brain Injury Research Projects & Publications Registry is a product of the Traumatic Brain Injury National Data Center (TBINDC) at Craig Hospital. The TBINDC coordinates, manages, and disseminates information for the collective TBI research activities of a number of research centers throughout the United States which have achieved the title “Traumatic Brain Injury Model Systems of Care” designation.

Our staff approaches everyone in the hospital who has had a traumatic brain injury in order to inform them about the research that is being conducted by the Texas Traumatic Brain Injury Research Center. If the patient qualifies for the Model System research, and they and their family agree, we ask that they sign a consent of participation to allow us to obtain information about their injury as well as follow them throughout their hospital course.