The Canadian National EMS Research Agenda: a mixed methods consensus study

Abstract

Introduction: Research is essential for the development of evidence-based emergency medical services (EMS) systems of care. When resources are scarce and gaps in evidence are large, a national agenda may inform the growth of EMS research in Canada. This mixed methods consensus study explores current barriers and existing strengths within Canadian EMS research, provides recommendations, and suggests EMS topics for future study. Methods: Purposeful sampling was employed to invite EMS research stakeholders from various roles across the country. Study phases consisted of 1) baseline interviews of a subsample, 2) roundtable discussion, and 3) an online Delphi survey, in which participants scored each statement for importance. Consensus was defined a priori and met if 80% scored a statement as “important” or “very important.” Results: Fifty-three stakeholders participated, representing researchers (37.7%), EMS administrators (24.6%), clinicians/ providers (20.7%), and educators (17.0%). Participation rates were as follows: interviews, 13 of 13 (100%); roundtable, 47 of 53 (89%); survey round 1, 50 of 53 (94%); survey round 2, 47 of 53 (89%); and survey round 3, 40 of 53 (75%). A total of 141 statements were identified as important: 20 barriers, 54 strengths/opportunities, 31 recommendations, and 36 suggested topics for future research. Like statements were synthesized, resulting in barriers (n 5 10), strengths/opportunities (n 5 24), and recommendations (n 5 19), which were categorized as time, opportunities, and funding; education and mentorship; culture of research and collaboration; structure, process, and outcome of research; EMS and paramedic practice; and the future of the EMS Research Agenda. Conclusions: Consensus-based key messages from this agenda should be considered when designing, funding, and publishing EMS research and will advance EMS research locally, regionally, and nationally.

The Canadian National EMS Research Agenda: Impact and Feasibility of Implementation of Previously Generated Recommendations

“…6,7 Nineteen recommendations for the future of Canadian EMS research were generated in the Canadian National EMS Research Agenda published in 2013 ( Figure 1). 4 Some of these Canadian recommendations were similar to those from other locations, including the development of research careers in EMS and the need for further funding. 8 In addition, some are known to have now been implemented, such as the National Registry of Emergency Medical Technicians Research Fellowship in the United States.…”

“…4 There were two recommendations with a median impact score of 4 and median feasibility score of 4 (#8 and #16), suggesting that the perceived impact of these recommendations was less than the eight highestimpact recommendations, but that they would be somewhat easier to implement with existing-or only minimal additional-resources.…”

“…Several countries have developed emergency medical services (EMS) research agendas, including the United States, Ireland, Australia, and, most recently, Canada. [1][2][3][4][5] Research agendas also exist for specific topics within EMS, including pediatrics and community paramedicine. 6,7 Nineteen recommendations for the future of Canadian EMS research were generated in the Canadian National EMS Research Agenda published in 2013 ( Figure 1).…”

Applying Hospital Evidence to Paramedicine: Issues of Indirectness, Validity and Knowledge Translation

“…33 This national collaborative project between paramedics, EMS operators, regulators, and physicians identifies barriers, opportunities, strengths, and priorities related to EMS. Paramedic competency assessment in initial and continuing education has been rigorously studied, 34 and national competency profiles are utilized in accreditation processes.…”

Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making

“…15 Structure: strengths and implementation strategies Several strengths exist in Canada to improve structures to enable EBP. Some Canadian EMS systems have dedicated research positions, which often provide local EBP expertise.…”