Research capacity of Australian and New Zealand emergency medicine departments

Abstract

Background: Large, multicentre studies are required in emergency medicine to advance clinical care and improve patient outcomes. The Australasian College for Emergency Medicine clinical trials network is available to researchers to assist with facilitating large, multicentre research. However, there is no current information about the research capacity of emergency departments (EDs) in Australia and New Zealand. Methods: All EDs accredited for emergency medicine training in Australia and New Zealand were eligible to participate. Research leads or ED directors were invited via email and telephone to complete a survey. Data were collected regarding the presence of a research lead; their research experience; available research resources including colleagues, funding, departmental paid research time; publications; and research culture. Results: One hundred and twelve responses were received on behalf of 122 (84%) sites (10 satellite plus main) from a possible 143 sites with all types of hospitals and regions represented. Research leads were identified at 66 (59%) sites; 32 (29%) had a director of emergency medicine research. A wide range of research was underway. Ninety-six sites (66%) contributed data to multicentre projects. Twenty-one centres (17%) were highly productive with multiple resources (skilled colleagues, funding, staffing), a positive research culture and high-volume output. Sixty to seventy centres (50-58%) had limited resources, experienced an unsupportive research culture and authored manuscripts infrequently. Paid time for research directors was associated with increased research outputs. Discussion: ACEM sites have the capacity to undertake large multicentre studies with a varied network of sites and researchers. While some sites are well equipped for research, the majority of EDs had minimal research output.

Rethinking consent processes for research in emergency departments

“…In contrast, RAs are generally paid to focus on research goals. Only 28% of EDs currently have access to RAs, 4 and an increase in this percentage would almost certainly raise the quality and quantity of ED research while reducing the burden of research on clinicians.…”

“…Additionally, patient visits are unscheduled, adding to the complexity of managing limited ED resources. In Australia and New Zealand, much emergency medicine research depends on volunteer labour from clinical and other ED staff (as well as medical students 4 ), and clinicians can be hard‐pressed to enrol patients while observing hospital flow targets. Where dedicated research staff are available, they still lack an established relationship with patients (such as may exist in other hospital departments), adding to the difficulty of recruitment 5 .…”

“…Where dedicated research staff are available, they still lack an established relationship with patients (such as may exist in other hospital departments), adding to the difficulty of recruitment 5 . Given these barriers to participant recruitment, it should not be surprising that emergency physicians often labour under a lack of evidence‐based research, 4 with a high proportion of clinical practice guidelines based on low‐level evidence, evidence from related specialities or expert opinion 6 . Low‐level clinical evidence leads to inconsistencies in practice, with substantial consequences for patient outcomes and healthcare costs 7…”

Translation of the geriatric emergency department intervention into other emergency departments: a post implementation evaluation of outcomes for older adults

“…EDs provide a rich and complex landscape in which to undertake innovation research, such as with the GEDI model [ 9 ]. Innovation research studies provide clinicians with new and exciting ways to potentially improve the efficiency and effectiveness of ED healthcare delivery [ 10 ].…”