Background: Health information technology and electronic medical records (EMRs) are potentially powerful systems-based interventions to facilitate diagnosis and treatment because they ensure the delivery of key new findings and other health related information to the practitioner. However, effective communication involves more than just information transfer; despite a state of the art EMR system, communication breakdowns can still occur. [1][2][3] In this project, we will adapt a model developed by the Systems Engineering Initiative for Patient Safety (SEIPS) to understand and improve the relationship between work systems and processes of care involved with electronic communication in EMRs. We plan to study three communication activities in the Veterans Health Administration's (VA) EMR: electronic communication of abnormal imaging and laboratory test results via automated notifications (i.e., alerts); electronic referral requests; and provider-topharmacy communication via computerized provider order entry (CPOE).

The current study supports prior work from our lab assessing the predictive value of the NAB-SM, as well as provides evidence for the ecological validity for select NAB-DL tests in patients with moderate to severe traumatic brain injury admitted to a residential PABIR program.

Halfway into the 10-yr American Occupational Therapy Association Centennial Vision initiative, occupational therapy has made notable progress in establishing itself as a science-driven profession. Through the diligent work of many talented occupational therapy scholars, 42 research studies exploring interventions used in rehabilitation research were published in the past 5 years. A variety of both novel and established intervention strategies were investigated using diverse research designs and measurement tools. A predominant number of studies were conducted with the poststroke population. Moving forward to 2017 and building on our success, we can recognize our full potential by fostering knowledge translation, expanding participant numbers, exploring less-studied populations, increasing the volume of systematic reviews published, and reporting occupation-centered outcomes, the unique and defining component of our profession.

score) between patients with IS and those without. Individuals with IS were more likely to have early radiographic evidence of intracranial mass effect (52%, IS patients vs. 40%, no IS; pZ0.003). At rehabilitation discharge, those with IS had lower FIMTM total scores (median 77, IS vs. 91, no IS; p<0.001), higher DRS scores (median 6.5, IS vs. 6.0, no IS; p<0.001), longer duration of PTA (median 49 days, IS vs. 30 days, no IS; p<0.001), and longer inpatient rehabilitation LOS (median 29 days, IS vs. 19 days, no IS; p<0.001). In multivariate analyses controlling for age, sex, initial clinical status and neuroanatomic injury characteristics, ischemic stroke predicted poorer outcome by all rehabilitation discharge measures assessed, accounting for a 13.6-point reduction in FIMTM total score (95% CI,-18.0,-9.2; p<0.001), a 1.7-point increase in DRS (95% CI, 0.975, 2.425; p<0.001), a 19.8-day increase in PTA duration (95% CI, 13.4,26.2; p<0.001), and a 12-day increase in LOS (95% CI, 7.2, 17.1; p<0.001). Conclusions: Ischemic stroke is observed in 2.5% of acute moderate to severe TBI patients, and predicts worse functional and cognitive outcome. These findings may help guide initial treatment decisions when IS is suspected after TBI, and help direct appropriate subsequent rehabilitation. Vigilance for stroke is warranted when associated signs or symptoms are observed acutely following TBI or polytrauma.