Department of Emergency Medicine, Faculty of Medicine; Ottawa Hospital Research Institute
Refining the treatment guidelines for patients admitted to hospital emergency rooms, as well as groundbreaking work on the most successful approaches to resuscitating patients prior to hospital admission.
The resulting rules for emergency room procedures are intended to make the activities of doctors, nurses, and technicians as efficient and effective as possible, reducing costs while ensuring the best possible outcome for patients.
Tackling medical costs while answering emergency calls
The rising cost of health care is driven by “small ticket” items, relatively minor expenditures that have a major impact because they are carried out in such high volume. One of the most significant of these items is radiography, x-ray images that are taken almost automatically whenever a patient is suspected of seriously injuring a key area like the ankle, knee or spine.
As the head of a pioneering clinical research team, Stiell has revealed that the vast majority of these images are redundant. In no more than a fraction of cases have patients actually broken a bone or suffered an injury important enough to merit radiographic analysis. Nevertheless, emergency room practitioners err on the side of caution, ensuring that no patient’s condition will be underestimated or overlooked, but likewise ensuring that hospital operating costs will go up.
Over the course of more than 15 years, Stiell and his colleagues have conducted unique and outstanding studies to evaluate and refine the rules that determine emergency room procedures. This work has led to major changes in the way these critical health care facilities go about their work, changes that have become known in the field as “Ottawa rules” for such matters as x-raying injured ankles, knees, and cervical spines, or conducting computerized tomographic scans to examine head injuries.
Stiell has also been the principal investigator in a 10-year, multi-centre trial that studied the impact of paramedic care on some 34,000 patients suffering from cardiac arrest, chest pain, respiratory distress, and major trauma. The “Ontario Prehospital Advanced Life Support Study,” which ran from 1994-2004, discovered key links in the chain of patient survival, including the vital role of such measures as early defibrillation and CPR conducted by bystanders at the scene.
Stiell was among the leaders responsible for creating the University of Ottawa’s Department of Emergency Medicine in 2003, which he currently chairs. He regards this move as an important step forward in this relatively new discipline, which is finally bringing an academic perspective to one of the most established and familiar facets of modern medicine.
Awards and Accomplishments
- Senior Investigator Award, Society for Academic Emergency Medicine
- Dr. J. David Grimes Research Career Achievement Award, Ottawa Health Research Institute
- Order of the International Federation of Emergency Medicine
- Distinguished Investigator, Canadian Institutes for Health Research
- Member, Institute of Medicine, National Academy of Sciences
- Faculty Mentoring Award, Faculty of Medicine, University of Ottawa