Introduction

Hennepin County Medical Center (HCMC), is a Level I adult and pediatric trauma center and safety net hospital in Minneapolis, Minnesota. The Emergency Department of HCMC is the home of the Research & Quality Improvement Program which has enabled emergency medicine physicians and research interns to perform clinical inquiries into many levels of patient care - ranging from public health surveys to studies on the efficacy of medications and procedural interventions. The mission of the Research Program at HCMC is to "partner with our community, our patients and their families to ensure access to outstanding care for everyone, while improving health and wellness through teaching, patient and community education, and research" (Information for Prospective Volunteers).

In order to achieve its mission the Research Program at HCMC recruits research interns each term to help in their pursuit of improving healthcare and ensuring access to all. The Research Program hosts medical students, undergraduates, graduate students, and post-graduate students interested in medical careers to participate in data collection for academic research projects. As research interns, students are afforded the opportunity to learn basic methodologies in clinical research, interact with patients from diverse backgrounds, and observe the practice of emergency medicine.

Background

This program was particularly interesting to me because it provided me with the opportunities to learn more about the community I lived in while exploring areas that are of interest to me and making a difference. One of the main reasons why I found the program particularly intriguing was because I think clinical research is one of the ways to make the biggest impact on patients, especially those from underserved communities. A doctor can only help a certain number of patients per day, but a clinical trial that ultimately brings a new drug or treatment to the market could potentially impact thousands of lives. More specifically, HCMC provides favorable conditions for this to happen as it serves patients from diverse races and ethnicities: 37% White, 31% Black/African American, 20% Hispanic/Latino, 3% American Indian/Native American, 3% Asian, and others (Hennepin County Medical Center).

Having a diverse patient population in a clinical trial is of particular importance not only because of differences in susceptibility to diseases, but because due to genetics, diverse populations have variable responses to specific medications. For instance, people who come from an African American background are more susceptible to hypertension and in general cardiovascular disease. Previous clinical research has shown that patients with this background do not respond well to angiotensin-converting enzyme (ACE) inhibitors, which is the second most common hypertension medication. This important detail was discovered only due to clinical trials conducted on diverse patient populations.

Takeaways

All the medicines, vaccines, and devices that are currently being used in clinical practices have undergone thorough testing in multiple clinical trials before they were approved for use. Without clinical trials, many of the discoveries and advances in medicine and health care that we are so used to, would not be available. So as part of the research program, I learned about what it takes to make a medicine or device available to the patients. I have worked in multiple research labs where I have conducted pre-clinical research. I have also been in the shoes of the patient, where I was taking medicines and receiving treatment with novel devices. But I was curious to know what happened in between and the experience at HCMC thaught me all about the steps of getting a novel drug/treatment to the patients. I learned the details associated with the translational process and all the steps that must be taken to bring a product from the lab bench to the hospital. I learned about government institutions and the regulations for the conduct of clinical trials. Lastly, I learned about good clinical practice, the protection of human subjects, informed consent, investigational new drug regulations, etc.

Most importantly the program allowed me and the other interns to interact with patients from underserved communities and incredibly diverse backgrounds and make an impact on their healthcare and hospital experiences. The ability to adapt and communicate directly with patients from all backgrounds was thus an incredibly valuable skill that I learned. Coming into my first term of the program, I knew I was going to interact with a diverse patient population, so I took some time to think about my own cultural beliefs. Thus, I was able to identify my own prejudices and attitudes that could be a potential barrier when it came to good communication with people of diverse backgrounds. The same experiences were echoed by my fellow research interns. This is what Cait Olson, who has been part of the Research Program for a long time, had to say about her experiences as a research intern: “As a RQI I feel that I am getting hands on knowledge of what it means to be a medical professional while also learning more about clinical research. The diverse population of patients at HCMC gives insight into the medical needs of the community that I hope to one day serve. Working as a part of a team has given me necessary skills to one day be a physician including professionalism, efficiency, and communication skills” (Information for Prospective Volunteers).

Conclusion

The practice of Emergency Medicine is constantly changing as new research reveals the most effective ways to provide patient care. The Research & Quality Improvement Program offers undergraduates and post-baccalaureate students the ability to engage with clinical research and quality improvement in an Emergency Department at a Level 1 Trauma Center, while at the same time benefiting the community and serving patients from underserved backgrounds.

Sources:

Hennepin Healthcare. (2020). Retrieved April 20, 2020, from https://www.hennepinhealthcare.org

Information for Prospective Volunteers. (n.d.). Retrieved April 18, 2020, from https://www.hennepinemresearch.org/prospective-volunteers

Hennepin County Medical Center. (n.d.). Retrieved April 18, 2020, from https://www.mnhospitals.org/Portals/0/Documents/data-reporting/CHNA/hcmc_p_050360.pdf

Header photo credit: Photo of HCMC ED, hennepinhealthcare.org