Johns Hopkins University

Johns Hopkins is one of the oldest medical research universities in the world and as such continues to rank in the top 3 medical research institutions by impact and funding. The Department of Anesthesiology and Critical Care Medicine has continued to follow this tradition by leading the field in high impact research and remaining in the top 3 funded Departments in the country. Our portfolio of research is diverse and covers areas of research from the molecular mechanisms of neuroprotection to integrative medicine and operations research. Our traditional areas of research (Clinical and Basic/Translational) has expanded to include the important areas shown in the schematic below. We pride ourselves on being at the cutting edge in all of these areas. Moreover, we are proud to have trained and continue to train leaders in research in our field through rigorous didactic and mentored programs that are proven pathways to success. Our T32 NIH training program grant as well as other Departmental and Institutional resources are significant contributors to this success. The recent robust financial investment in internal grant support through our Stimulating and Advancing ACCM Research speaks to the seriousness with shih we take the research mission and is already leading to profound growth in our discovery portfolio. Our collaborations with the Whiting School of Engineering, Carey Business School and Bloomberg School of Public Health not to mention other Departments at Hopkins and beyond speaks to the depth and breadth of what we are engaged in at Johns Hopkins ACCM research.

Basic and Translational Research:

The Dept. of ACCM’s basic and translational science research programs are amongst the most robust and well funded in the country. Our Clinician and PhD scientists focus on a diverse range of medical problems that are not only of relevance to anesthesia and critical care, but medicine in general. Our ~19000sq/ft of laboratory space forms the hub of our research activity with a vast array of sophisticated shared and core equipment including 3 confocal microscopes, a flow cytometer, multiple qPCR machines, and all manner of sophisticated physiologic equipment relevant to each investigators work. Our laboratories are also in close proximity to the institutional genomic, proteomic, metabolomics and transgenic mouse cores that provide essential services necessary for the “big Science” of today. Our research efforts are focused on a number of specific high impact areas. The primary focus of our long standing neuroscience program is stroke, anoxic, head injury, and prevention and protection of neural injury associated with these events. This has led to the identification of numerous targets and interventions that might preserve neurologic function. Moreover our researchers are investigating the long term effects of anesthetics on neural development and cognition. Our pain research program in collaboration with the Blaustein Pain center in the Dept. of Neurosurgery is one of the most productive and innovative in the country, identifying novel pathways for neuropathic pain and identifying novel pain mediators and spinal cord orphan receptors that represent therapeutic targets. Our pulmonary hypertension group is well down the path in developing a new biologic targeted to a novel mitogenic factor critical in the development of PH, and our integrated vascular biology group has uncovered new mechanisms that contribute to age-associated vascular stiffness and systolic hypertension as well as atherosclerosis. Our endothelial biologists are in the process of engineering new pulmonary microvessels. Finally, our immunology group is focused on understanding the role of sex hormones in regulating macrophage function on the context of reactive airways disease and asthma. Our investigators have a vast network of collaborators that span both the basic (physiology, biochemistry and neuroscience) and clinical departments, amplifying the impact and importance of the research. Moreover, a significant portfolio of IP and commercialization of our discoveries is now emerging.

Clinical Research and Clinical Research Core:

The mission of the ACCM Clinical Research Core (CRC) is to facilitate the design, execution, and analysis of clinical research and QI projects that transform the quality and efficiency of care for patients who are critically ill, experience pain, and/or undergo invasive procedures. The CRC has 2 units: an analytics unit and clinical trials unit. The core functions of the analytics unit are database construction, quality control, study design, statistical analysis, and reporting. The core functions of the clinical trials unit are to assist with IRB applications, compliance issues, patient screening, recruitment and consent, and sample collection and processing. By providing the necessary personnel, infrastructure and mentorship, the CRC facilitates the design, execution, and analysis of clinical research projects, and accelerates the career development and scholarly productivity of ACCM faculty, staff and trainees.

Operations Research:

Johns Hopkins Department of Anesthesiology and Critical Care Medicine has developed an innovative operations research program, in collaboration with the John Hopkins Carey Business School and the Johns Hopkins Bloomberg School of Public Health (Department of Health Policy and Management). Through this unique program, faculty earn joint appointments in the School of Medicine and either the Carey Business School or the Bloomberg School of Public Health—teaching courses in each school. The main goal of the program is to provide the opportunity to work with faculty in the School of Medicine/Department of Anesthesiology and Critical Care Medicine to students from the Carey Business School and Bloomberg Health Administration program. One component of the program is a practicum in which students lead an array of projects aimed at improving process efficiency in various areas of the hospital (outpatient, inpatient, ICU and Operating Rooms), with resultant publications co-authored with the supervising faculty. The program has expanded to include a formal Operations Management training for Anesthesiology Residents. The training will employ a team-based approach to the process improvement project, with teams formed between the residents and business school/hospital administration students (medical/administrative team). The goal of the Resident Operations Management teaching and research program is to develop residents who, by the time of graduation, will be leaders and have experience in managing Operating Room and Clinic operations, as well as publications conveying the results of their project work.

Data Analytics, Informatics and Integration:

ACCM is highly engaged in applying systems engineering methods and to the development of predictive models to improve safety and quality of health care. This work has been led by many members of the Department and supported by the close relationship with the Armstrong Institute for Patient Safety and Quality. ACCM research teams have formed collaborations with The Johns Hopkins School of Engineering, Care Business School, and the Applied Physics Lab to address a wide range of issues in health care that include early detection of sepsis, the sensitivity and specificity of clinical alarms, improving clinical efficiency and patient experience, establishing new work flows based on systems integration and the development of new medical devices. The research in this area spans the realms of quality improvement, clinical research, and healthcare administration and relies on the resources of the ACCM CRC, Hospital information technology and biomedical engineering.

Education Research and Core:

The ACCM Education Research Core is designed to support faculty, staff and trainees in the mission of creation, completion and publication of educational scholarship. This is a department level initiative that aligns with strategic goals and vision to create a culture of educational inquiry and scholarly successes. The research structure for this endeavor includes administrative assistance, IRB submission support, database management, statistical analysis, consultation with professional educators and a community of thought partners. A monthly education lab meeting is an opportunity for education researchers to present works in progress, conceive of new projects, be educated about techniques or relevant educational literature.

Safety and Quality:

The ACCM Safety and Quality leaders have been involved in training, research, and dissemination in the focus areas of Healthcare Quality Initiatives and Patient Safety strategies. Many of our department were educated in the science of healthcare quality by completing courses at the renowned Intermountain Healthcare under the tutelage of Dr. Brent James, an innovator and leader of the course for over 25 years. We are currently creating dashboards to demonstrate each divisional quality and patient safety initiatives in order to engage and encourage residents and fellows to participate in and learn how to conduct quality initiatives. Our research is being conducted with collaboration between the CRC, data analytics, and most significantly with the Armstrong Institute, The Johns Hopkins Patient Safety Institute, led by Dr. Peter Pronovost.