Corita R. Grudzen, MD, MSHS

I first entered the research arena as an undergraduate at Stanford University, where I spent a quarter developing my own research project under the guidance of an esteemed biologist at the Hopkins Marine Station. Although I was captivated by the process of scientific inquiry, I quickly realized that my passion was human health. I envisioned that a career as a clinician-investigator would allow me the optimal balance of direct patient care and investigation into larger societal threats to health; I thus chose to pursue a career in medicine at the University of California, San Francisco (UCSF).

At UCSF, I met many role models who cared for patients on an individual level while using health services research methods to study and advance larger issues. Providing patient care informs what is important in my research. The study of these topics allows me to investigate new models of care while working towards structural changes in healthcare nationwide; this is especially relevant for the ED setting. Although advances in medical technology and clinical research have made it possible to restore physical functioning for some patients with acute illness and injury, a significant number of patients in the ED have chronic, life-limiting illness, such as cancer, and many are in crisis because of pain and other burdensome symptoms.

I completed my residency in emergency medicine at the New York University Grossman School of Medicine and Bellevue Hospital, where I served as Chief Resident during my final year. After witnessing the frequent discordance between patients’ wishes and the end-of-life medical attention that they received, I became determined to dedicate my career to improving care for this population. I was subsequently accepted into the Robert Wood Johnson Clinical Scholars Program, where I received a Master of Science in Health Services from the University of California, Los Angeles. Through the study of health services research methods, including econometrics, I received the tools and mentorship to conduct innovative research with communities, organizations, practitioners, and policymakers on issues important to health and wellbeing.

My focus as a junior investigator turned to developing interventions that integrate palliative care and emergency medicine; this remains my primary research focus today. Using the National Institutes of Health (NIH) Stage Model, I began at Stage 0, delineated the barriers and facilitators to palliative care delivery in the ED, and conducted a patient and family caregiver palliative care needs assessment. The work led to the first randomized controlled trial testing the efficacy of palliative care in the ED (NIH Stages 1 and 2). This culminated in one of my most notable contributions to the field, detailed in a JAMA Oncology article describing how early palliative care improves quality of life in patients with advanced cancer presenting to the ED.

During this time, I gained additional expertise in health services research, qualitative methods, patient-centered outcomes research, pragmatic trials, emergency care, and palliative medicine. I served on the National Advisory Board for the Center to Advance Palliative Care’s IPAL-EM initiative to integrate palliative care and emergency medicine. Additionally, my involvement as an Innovation Advisor to the Centers for Medicare and Medicaid Innovation led to a $12 million-plus Innovation Challenge grant to help define key interventions for geriatric patients in the ED to improve health and quality of care while decreasing costs for years to come. I also acted as the Chair of the 2016 Society for Academic Emergency Medicine Consensus Conference (with support from the Patient Centered Outcomes Research Institute [PCORI], the Agency for Healthcare Research and Quality [AHRQ], and the National Institute on Aging [NIA]) to bring together leaders within and outside of emergency medicine to set the research agenda on shared decision-making for years to come.

Currently, I am the principal investigator of two multi-site pragmatic trials funded through PCORI and the NIH that cumulatively total more than $20 million. The first grant, sponsored by PCORI, is a comparative effectiveness trial of nurse-delivered telephonic palliative care versus traditional outpatient palliative care for seriously ill, older adults discharged from the EDs across 18 hospitals. The second study, “Primary Palliative Care for Emergency Medicine (PRIM-ER),” is an NIH-funded pragmatic trial examining the effect of implementing palliative care education, clinical decision support, and audit and feedback mechanisms across 35 EDs throughout the United States. I continue to grow a robust network of national collaborators, serving as founding Co-Chair of the National Cancer Institute Comprehensive Oncologic Emergencies Research Network and expanding my PCORI-sponsored study to include 18 sites nationally, along with the 35 clinical sites participating in my NIH-funded trial.

At Memorial Sloan Kettering Cancer Center (MSK), I am Head of the Division of Supportive and Acute Care Services. I look forward to continuing to make individual contributions to patient care, education, and research while building capacity in the broader clinical, education, and research community. At MSK, I will partner with the leaders of the General Internal Medicine, Hospital Medicine, Supportive Care, and Urgent Care Services to represent these important groups in strategic planning and clinical operations.

In my free time, I enjoy spending time with my partner and children, running (slowly), and reading fiction and memoir.