The Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN) was created to enable conduct of high-quality, multicenter clinical trials to improve the outcomes for patients with neurologic, cardiac, respiratory, hematologic, and trauma emergency events. In this application, we propose the Northern California Acute Care Research Consortium (NORCARES) as a new SIREN Hub, with a Co-Hub and M-PI structure that includes UC Davis (Daniel Nishijima, MD, MAS), Stanford (Karen Hirsch, MD), and UC San Francisco (Robert Rodriguez, MD). These three institutions and PIs are well suited to lead a Hub, having demonstrated broad and sustained growth in their research programs and productivity over the past 20 years with robust research infrastructure to facilitate patient enrollment into trials. NORCARES includes 30 Spokes and 7 EMS systems across Northern California and adjacent areas with whom our investigators have previously collaborated. We have selected Spokes and EMS agencies with extensive research experience and infrastructure, drawing on large patient volumes with diverse racial and ethnic backgrounds, urban and rural geography, and academic and community hospitals. Annually across the NORCARES Hub, there are over 1.8 million ED visits, 520,000 prehospital 911 scene transports, and 21,000 trauma admissions. Compared to the US population, our Hub serves larger proportions of Black, Asian, Native Hawaiian and Pacific Islander, and Hispanic ED patients. We will ensure that NORCARES provides solid research infrastructure, training and oversight to our Spokes and EMS agencies. Our Hub will enroll substantial numbers of research subjects, maintain Good Clinical Practices, adhere to research regulations, and comply with quality control activities. We will collaborate with the other SIREN Hubs, the Data Coordinating Center, the Clinical Coordinating Center, and federal partners in all research activities. We will implement an innovative Junior Faculty Training Program to transform junior scholars into trial investigators, capable of designing and leading emergency care trials. We will seek to promote the careers of women and under-represented minorities in medicine faculty, who constitute 44% of our key personnel. With outstanding infrastructure and an innovative collaborative plan, our proposed Hub is uniquely positioned to boost enrollment and promote equity and diversity of patient populations and faculty in SIREN trials.

The primary objective of the Northern California Acute Care Research Consortium (NORCARES) Hub is to facilitate the enrollment of a diverse population of patients into SIREN clinical trials. The highly adaptable design of NORCARES includes an innovative Co-Hub and multi-PI model, allowing for flexibility to maximize patient enrollment regardless of the study focus. In this project, we seek to be leaders in SIREN and train junior investigators for future leadership roles in multicenter emergency care clinical trials.