Pre-hospital and trauma care: Emergency trauma services for UPBI are provided through the Center for Emergency Medicine (CEM) The CEM is a multi-hospital consortium dedicated to the advancement of emergency medicine through research, education, air medical transport and quality care, and provides a catchment that includes western Pennsylvania, northern West Virginia, and eastern Ohio. Pitt's Emergency Medicine residents work with the City of Pittsburgh Bureau of Emergency Medical Services and fly on STAT MedEvac helicopters. STAT MedEvac, a service of the CEM, provides air medical transport to patients with critical illnesses and/or injuries. The program is one of the busiest air medical programs in the country. The mean transport time from the estimated time of injury to arrival to our trauma center is 35 minutes. Patients arrive at our trauma center via both ground (68%) and helicopter transport (32%). UPMC-Presbyterian, a Level I Trauma Center, has protocols currently in place that include the preferential transfer of all severe TBI patients to UPMC by our regional helicopter system.

Comprehensive rehabilitation: The University of Pittsburgh has a total of 180 inpatient rehabilitation beds located throughout the system. The UPMC Institute for Rehabilitation and Research (IRR) serves as the hub of this network and includes both inpatient and outpatient services. The IRR has dedicated rehabilitation units in two hospitals (i.e., UPMC South Side Hospital and UPMC Montefiore Hospital). At UPMC South Side, there is a 20-bed dedicated TBI unit; at UPMC Montefiore there is a 30-bed rehabilitation unit with up to 9 designated TBI beds. On both units, inpatient rehabilitation care is provided by multidisciplinary teams. Both units were renovated in 2005, providing patients with state-of-the-art facilities. The rehabilitation team consists of experienced professionals focused on treating this population. Standardized treatment and evaluation programs have been established in a multidisciplinary fashion. A unique informatics network allows for tracking and graphic representations of outcome parameters and acquisition of data from an electronic medical record. The clinical team consists of three physiatrists; a physiatric TBI Fellow; PM&R residents; rehabilitation nurses; occupational, physical, and speech therapists; neuropsychologists & rehabilitation psychologists; an orthotist; case managers; vocational rehabilitation counselor; a rehabilitation engineer, and a therapeutic recreation staff.

Post-Acute Services in Rehabilitation: Outpatient TBI services are under the direction of Drs. Lisa Lombard and Ross Zafonte. They are centered at UPMC IRR at South Side Hospital, but are also available at regional sites within our network. The program includes over 15 clinicians experienced in brain injury rehabilitation. The treatment plan addresses all aspects of cognitive, physical, social-behavioral function. Acute TBI patients are closely followed and seen within 1 month of rehabilitation discharge. It has been our policy to continue to follow such persons on an on going basis at 3, 6, 12, and 24 months post injury. The UPTBI Community Re-Entry Program aims to restore persons with TBI to the highest possible level of independent functioning at home, work, and in the community. A key component to successful community integration is transportation. The OT department at UPMC IRR provides a state-certified program for drivers with disabilities. The program provides driving pre-assessments and on-the-road evaluations. After discharge from the day treatment program, follow-up vocational and psychosocial services are provided, as needed. In conjunction with the State Office of Vocational Rehabilitation, our supported employment program places persons with TBI in programs facilitating return to work. Participants may also partake of the educational component of the program while continuing to live at home with decreasing family support.

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