research proposal emergency management

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Main Research Proposal- D.E.A.R. - Disaster and Emergency- Assistance and Relief - A Comprehensive Disaster and Emergency Management System

A proposal to develop Disaster Management System to leverage latest technologies. - Floods - Bushfires

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zijadin krasniqi

Applications of information technologies offer new opportunities for integrating and improving the exchange of information between institutions that manage natural disasters and emergency services. New studies of information technology and communication have opened opportunities for significant improvements in the integration and coordination of emergency services. Data integration is the problem of combining data, which are found in various sources; as a result of advances in the information technology there is also data warehouse in order to ensure the user with a unified view of these data, the problem of designing systems for data integration is important in today's applications. Considering the development of Information Technology, emergency management is seeking modelling data from various sources, by coordinating activities between institutions and government agencies. Today, more than ever the need to establish an institutional system to coordinate all resources and capabilities that are available to be prepared to react in a coordinated and planned way in case of natural disasters and other incidents is requested. During recent years, a development of a diverse information and communication technology have proposed alternatives for managing natural disasters to the national and regional level. Information technology has become a base for the development of many information systems today. In most areas of life has become very difficult to keep communications, institutional liaison or international communications without extensive use of information technology.

Vijayan G U R U M U R T H Y Iyer

IRJET Journal

Disaster management necessitates near-realtime information distribution in order to deliver emergency services to individuals as soon as possible. With the rapid progress of information and communication technologies (ICT) , real-time data may be easily gathered from a variety of sources. Information and communication technology implementations at various stages of disaster management are investigated. Existing solutions are investigated, as well as the investigation of incorporated new networks, services, and applications in the field of information and communication technology. Various evacuation mechanisms are investigated. Following a comparison of several ICT-based technologies, the evacuation model is developed. This article looked at essential terminologies, issues in disaster management from a technological standpoint, and numerous sorts of disasters, ICT tools that can be utilized in disaster response and management, with Web 2.0 being the most recent technology that harnesses the power of social media and social networks. The analysis closes by recommending the implementation of an effective E-Government infrastructure that supports various disaster-related ICTs.

Implications of Globalization

Muthu Ramachandran

Challenges and Issues

Social, Humanities, and Educational Studies (SHEs): Conference Series

Krishna S Pribadi

baluku innocent muke

Nadir Bouchama

2010 IEEE Sensors

Hideki Sunahara

Mehmet ALKAN

Disasters are the events which have negative effects on the life. Turkey generally is subject to large scale natural disasters due to negative effects of its geological, topographical and climactic characteristics. The loss can be minimized by working and measurements which should be taken before, during and after the catastrophe. The work which should be done before and after a disaster is examined in "Design and Development for Disaster Management Information System". The primary mission of the Disaster Management is to reduce the loss of life and property. To be ready for rescue in every case is possible by very well organization before the disaster. Large earthquakes that occurred in 1999 in Turkey revealed the need to review the concept of disaster management, Law No. 5902 was put into practice in our country, a new model of disaster management. This model is referred to as 'Integrated Disaster Management System', for the prevention of damage caused by the disaster and emergency situations early detection of hazards and risks, disaster losses that may occur before the measures to be taken to prevent or minimize, effective intervention and coordination in disaster and emergency situations in an integrated manner to ensure the execution of the work and the aftermath of a disaster requires improvement. In this study, for the disaster recovery and reconstruction efforts aim to make a disaster management information system design and develop via using relational database schemas. The data needed for this study were primarily post-disaster. Then, selected as a pilot area Eregli Sofular Village, in Eregli District Temenler Village in Çaycuma District introduced. The data used in the studies were identified and added to the system software.

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• 5 Research Topics for Emergency Management Students

Students enrolled in emergency management classes, with the intent to complete the degree, have the opportunity to explore a wide variety of incident command systems; learn about hospital preparedness; and become more familiar with response agencies at the federal, state and local levels. In order to complete the program, most emergency management students are required to research, write and submit a  thesis project  that correlates closely with the area of study.

Resource:  Top 10 Online Emergency Management Degree Programs 2015

These are 5 research topics appropriate for emergency management students:

1. A critical analysis of the 2001 anthrax attacks

The anthrax attacks, often delivered via postal services, were traumatic events in 2001 shortly after the 9/11 attacks. Because the United States was still on high alert from that incident, new protocol was quickly established to handle anthrax and other forms of bioterrorism. These procedures, in hindsight, may not have been the most effective means for dealing with this calamity. An emergency management student could research the real-life situations and responses of the crisis teams in 2001, detailing how these incidents would be better handled in today’s society of improved and more experienced crisis teams.

2. Procedures specific for urban search and rescue

With terrorist attacks focused mainly on cities and with the density of populations and buildings in cities, urban searches and rescues can be complicated and difficult. Victims could be on the upper floors of tall buildings, trapped inside interior rooms or even along a side street or alley that is nearly impossible for rescuers to access. In most of these situations, time is of the utmost importance, so urban areas must have thorough and implementable plans of attack in the event of such an emergency. This project could research some cities’ plans and possibly propose changes to their current methods.

3. Humanitarian disaster relief

Many nations rely on humanitarian relief following natural disasters, such as a hurricane or drought. In these instances, there are often projects that raise funds and supplies, or sometimes the governments of more prosperous nations step in to provide aid. Sometimes the delivery is nearly impossible, often because of the state of the area after the disaster or because those who need the aid the most are not easily accessible. This research project could examine recent disasters that have required humanitarian relief by analyzing the process of obtaining supplies and physically delivering those items.

4. Personal preparedness for terrorism and disasters

Many people are unprepared should a natural disaster, or even an act of terrorism, come to them. While it is not necessary or practical for the average citizen to have a panic room or bomb shelter at his or her residence, there are steps that individuals can take to be more prepared if a disaster should occur. This research project could examine typical types of disasters and the provide protocol for the types of supplies people should have on hand and what their reactions should be during such a disaster.

5. Protocol for water rescues

Although not one of the most typical types of rescues, saving people from a river, lake or ocean can present many unusual obstacles. From the difficulty of locating a person who may be drowning or on a raft in the vast ocean to physically rescuing the person when another boat or a helicopter are the only options, water rescues require clear procedures in order to be successful. An emergency management student could research and create the best protocol for each of these situations, especially for a coastal town that may face the problem.

Students hoping to fulfill their requirements for a degree in emergency management will likely need to complete a thoroughly researched project. Although there are many different topics that will meet this requirement, especially dealing with disaster relief and national attacks, these are a few possibilities for the project.

Additional Resource:   50 Most Affordable Schools for an Emergency Management Degree 2015

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• v.3(6); 2022 Dec

Research priority setting in emergency care: A scoping review

Julia crilly.

1 Department of Emergency Medicine, Gold Coast Hospital and Health Service, Queensland, Gold Coast Australia

2 School of Nursing and Midwifery, Griffith University, Gold Coast Queensland, Australia

3 Menzies Health Institute Queensland, Griffith University, Gold Coast Queensland, Australia

Ya‐Ling Huang

4 Faculty of Health (Nursing), Southern Cross University, Queensland, Gold Coast Australia

Michelle Krahe

5 Office of the Pro Vice Chancellor (Indigenous), Griffith University, Meadowbrook Queensland, Australia

Daniel Wilhelms

6 Department of Emergency Medicine, Local Health Care Services, Central Östergötland Linköping, Sweden

7 Department of Biomedical and Clinical Sciences, Linköping University, Sweden

Ulf Ekelund

8 Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund Sweden

Erika Hörlin

Jessica hayes, gerben keijzers.

9 Faculty of Health Sciences and Medicine, Bond University, Gold Coast Queensland, Australia

10 School of Medicine, Griffith University, Gold Coast Queensland, Australia

Associated Data

Priority areas for emergency care research are emerging and becoming ever more important. The objectives of this scoping review were to (1) provide a comprehensive overview of published emergency care priority‐setting studies by collating and comparing priority‐setting methodology and (2) describe the resulting research priorities identified.

The Joanna Briggs Institute methodological framework was used. Inclusion criteria were peer‐review articles available in English, published between January 1, 2008 and March 31, 2019 and used 2 or more search terms. Five databases (Scopus, AustHealth, EMBASE, CINAHL, and Ovid MEDLINE) were searched. REporting guideline for PRIority SEtting of health research (REPRISE) criteria were used to assess the quality of evidence of included articles.

Forty‐five studies were included. Fourteen themes for emergency care research were considered within 3 overarching research domains: emergency populations (pediatrics, geriatrics), emergency care workforce and processes (nursing, shared decision making, general workforce, and process), and emergency care clinical areas (imaging, falls, pain management, trauma care, substance misuse, infectious diseases, mental health, cardiology, general clinical care). Variation in the reporting of research priority areas was evident. Priority areas to drive the global agenda for emergency care research are limited given the country and professional group‐specific context of existing studies.

This comprehensive summary of generated research priorities across emergency care provides insight into current and future research agendas. With the nature of emergency care being inherently broad, future priorities may warrant population (eg, children, geriatrics) or subspecialty (eg, trauma, toxicology, mental health) focus and be derived using a rigorous framework and patient engagement.

1. INTRODUCTION

1.1. background.

The provision of emergency care is a feature of all countries and is an effective strategy to reduce the global burden of disease 1 ; yet demand for this service is increasing at rates exceeding population growth. 2 Emergency care is variably organized between countries. 3 It can be situated within an emergency medical services (EMS) system, a comprehensive, coordinated, and integrated system of care for patients suffering acute illness and injury. 4 The EMS system can encompass hospital emergency departments, primary health care, first aid and first responder services, medical retrieval services (domestic and international), helicopter aeromedical services, fixed‐wing aeromedical services, and publicly funded ambulance (predominantly road‐based) services. 4 Many countries do not have hospital‐based emergency medicine as a specialty. 3 Recognition as a specialty can vary 5 but generally requires a unique field of action, a defined body of knowledge, an active research program and a rigorous training program. 6 The benefits of such professional specialization include the capacity and capability to deliver high‐quality care that requires extensive knowledge. 3

1.2. Importance

Identifying clinically meaningful research priorities in the context of the emergency care system (of which prehospital care is an important part of the continuum) 7 can be useful in guiding where further research in evidence‐based care is needed, support rationale when seeking competitive research funding, and mitigate research waste. Mitigating such waste begins with ensuring that research is undertaken in areas that are relevant to the users of research (clinicians, patients, and policy makers) and does not simply represent the specialized interest of researchers. 8 Although substantial funding for research is available, it is insufficient for the demand, and thus some form of prioritization is inevitable. Developing a shared agenda is an important step in ensuring future research has the necessary relevance. Understanding the current landscape of research priority setting can guide future efforts to strategically align research in emergency care to support a high‐quality, timely, and accessible health care system. 7 Furthermore, assessing the priority‐setting process against an established framework, can assist in guiding where and how the process and reporting can be improved.

1.3. Goals of this investigation

The objectives of this scoping review were to (1) provide a comprehensive overview of published emergency care priority setting studies by collating and comparing priority‐setting methodology and (2) describe the resulting research priorities identified. It builds upon previous priority‐setting work specific to the emergency care arena with the intention to map available evidence, highlight themes in research priority questions, explore the reasons for any differences, 9 and guide future research directions.

2.1. Design

The methodological framework articulated by the Joanna Briggs Institute (JBI) 10 guided this scoping review. The development of the JBI approach has been underpinned by earlier work of others including Arskey and O'Malley. 11 Scoping reviews may be conducted as the first step in a larger project or they can serve as a standalone initiative. They are used to synthesize research evidence often involving mapping of existing literature in a given field in terms of its nature, features, and volume. The JBI framework 10 details 9 stages of the review process: (1) defining and aligning the objective(s) and question(s); (2) developing and aligning the inclusion criteria with the objective(s) and question(s); (3) describing the planned approach to evidence searching, selection; (4) searching for the evidence; (5) selecting the evidence; (6) extracting the evidence; (7) charting the evidence; (8) summarising the evidence in relation to the objective(s) and question(s); and (9) consulting information scientists, librarians, and/or experts (throughout).

2.2. Inclusion and exclusion criteria

The eligibility criteria for this review are described in Table  1 and aligned with the specified population, concept, and context. 10 Included were studies where the population was focused on people involved with emergency care, there was an explicit aim to identify research priorities in emergency care, and the context was the emergency care setting. Exclusion criteria were editorials, literature review papers, discussion papers, commentaries, conference abstracts, anonymous articles, articles where authorship was unclear, articles with military focus, and articles focused on emergencies in the context of disasters. The search was limited to peer‐reviewed articles that were available in English, published between January 1, 2008 and March 31, 2019.

Article eligibility criteria

Excluded: editorials, literature review papers, discussion papers, commentaries, conference abstracts, anonymous articles, articles where authorship was unclear, articles with military focus, articles focused on emergencies in the context of disasters.

2.3. Search strategy

A comprehensive 3‐step search strategy was supported by a health librarian in consultation with the research team. 10 Search terms and synonyms relating to emergency care and research‐priority setting were used. In step 1, an initial search of the Ovid MEDLINE database was conducted. An example of this search strategy is provided in Supplementary Material S1 . In step 2, a second search was undertaken using search terms and keywords customized for each database: EMBASE, CINAHL, Ovid MEDLINE, Scopus, and AustHealth. The search for eligible articles included the following terms and synonyms: ED/EDs, emergency department/s, emergency room/s, accident and emergency, ER/s, emergency medicine, emergency nursing, emergency care, prehospital, paramedicine, ambulance , OR A&E ; AND research ; AND priority . Activation of “smart text” and automatic word variation options (unlimited truncation operators such as emergenc*) during searches ensured that word combination options including US and UK spelling variations and plural terms were detected. In step 3, reference chaining was conducted on all included articles.

2.4. Selection of sources of evidence

The EndNote bibliographic software package 12 was used to manage all references and any duplicates were removed. Two authors (JC and YLH) independently screened titles and abstracts for inclusion based on criteria. A third author (DW) moderated where an agreement was not initially achieved. Full‐text articles of studies were independently screened by 2 authors (JC and YLH) and disagreements were moderated by another author (GK). The Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) flow diagram 13 was used to present the search decision process (Figure  1 ).

Flow diagram of process to identify eligible studies in this scoping review. EC, emergency care.

2.5. Data extraction process

Study characteristics from articles were extracted by 2 authors (YLH and JH) into a data extraction form. Data extracted included study author(s), year of publication, study location, clinical setting, the objective of the study, participant population, study design, description of research priority‐setting approach, and priority area outcomes. Initial extraction was cross‐checked against original articles (by YLH for the data extracted by JH and by MK for all articles) with differences resolved through discussion and consensus agreement between 2 authors (YLH and MK). Two authors (YLH and MK) independently extracted data to appraise the quality of the studies. Assessment differences were discussed among reviewing authors to reach a consensus.

2.6. Appraisal

There is currently no single gold‐standard approach to appraising the quality of research priority‐setting studies; however, principles of good practice have been proposed. 14 , 15 , 16 Each of the identified studies were appraised using the REporting guideline for PRIority SEtting of health research (REPRISE). 17 The REPRISE framework contains 32 items organized into 10 domains that are used to critically appraise studies for context and scope, governance and team, the framework for priority setting, stakeholders/participants, identification and collection of priorities, prioritization of research topics, output, evaluation and feedback, translation and implementation, and funding and conflict of interest. As this framework was specifically designed with health research prioritization in mind, it could identify issues that may otherwise have been overlooked by traditional quality appraisal tools.

2.7. Synthesis

A descriptive synthesis to summarize the study characteristics and priority‐setting methodology and identify research priority areas was conducted. Prehospital and ED were considered separate emergency care settings. Study characteristics data are also reported. The research domains were pragmatically created via a process of generation, discussion, review, and refinement with experienced emergency care researchers (JC, YLH, MK and GK) with consensus from other authors. This information was used to produce an evidence map grouped by research domains and research themes (see Supplementary Material S2 for full details). Data were imported into Kumu 18 to create an interactive evidence gap map of the findings.

3.1. Study characteristics

A total of 1045 titles and abstracts were initially screened, followed by 195 full‐text articles. As a result, 45 studies met inclusion criteria for this review. Study characteristics for all included studies are presented in Table  2 . In total, 5638 participants were included; 5 (11%) studies did not report the number of participants. Most studies were undertaken in the United States ( n  = 30; 67%) and 5 (11%) involved more than 1 country. Eleven studies (24%) reported having consumer (ie, patient communities and advocacy groups, health consumers) involvement in the priority‐setting process and most studies ( n  = 24; 53%) included a multidisciplinary (ie, representatives from > 1 professional group) participant population. Other participant cohorts were drawn from specific groups (ie, emergency physicians, emergency nurses, patients); the stakeholder population was not explicit in 2 studies. In most studies, the primary study setting was the ED ( n  = 36; 80%). This was followed by prehospital ( n  = 7; 16%), hospital ( n  = 1; 2%), or the combined prehospital and ED ( n  = 1; 2%) environment. Priority‐setting methods included nominal group technique (NGT, including modified NGT) ( n  = 18; 40%), Delphi (including modified Delphi) ( n  = 13; 29%), consensus ( n  = 8; 18%), cross‐sectional surveys ( n  = 4; 9%), and a combination of survey and modified Delphi technique ( n  = 2; 4%).

Characteristics of included studies

Other topic areas are defined in Supplementary Materials, S2 .

Abbreviations: ED, emergency department; EMS, emergency medical services; HIV, human immunodeficiency virus; HPP, Hanlon Process of Prioritisation; NGT, nominal group technique; NIH, National Institutes of Health; NR, not reported; SAEM, Society for Academic Emergency Medicine; SDM, shared decision making; STI, sexually transmitted infection; SUD, substance use disorder.

a Method is described as a modified technique.

3.2. Appraisal

The comprehensiveness of reporting of research priority‐setting studies varied. None of the studies fulfilled all items of the REPRISE framework, ranging from 18 to 30 of the 32 items (Table  3 ). All studies described the geographical scope, health area (ie, condition, health care delivery or system), target audience, the broad area of research, type of research question, methods for collecting initial priorities, number of research questions/topics, and the approach to formulating research priorities. Most studies described the characteristics of stakeholders or participants (87%), engagement of and inclusion criteria for stakeholders (95%), and the methods for collating and categorizing topics/questions (98%) or modifying priorities (66%). Only 13 studies (29%) described how priorities were fed back to stakeholders and whether feedback was addressed/integrated, 5 studies (11%) stated the frameworks of priority‐setting used, and only 5 (11%) outlined a strategy or action plan for the implementation of priorities. No studies described the strategy or plan to evaluate impact (ie, implementation, integration in decision making, funding allocation), nor did they outline their budget/cost of completing the priority‐setting study, including whether participants were reimbursed.

Appraisal of comprehensiveness of reporting

3.3. Research priorities

Across all studies, key research priority areas were identified; these are described in more detail later in the article. The research priorities were mapped into 14 research themes (pediatrics, geriatrics, nursing, shared decision making, general workforce/process, imaging, falls, pain management, trauma care, substance misuse, infectious disease, mental health, cardiology, and general clinical care) within 3 overarching research domains (emergency care populations, emergency care workforce and processes, and emergency care clinical areas). Figure  2 provides an evidence map synthesizing the characteristics of the 45 research priority‐setting studies included in this scoping review. An interactive evidence gap map of the findings can be accessed online.

Evidence gap map synthesizing the characteristics of 45 research priority‐setting studies included in this scoping review. Studies are distributed by research domain and research theme ( y ‐axis) and the number of participants involved in each study ( x ‐axis). The shape of each icon is associated with the priority‐setting methodology and the color with the emergency care setting. The numeric value associated with each icon indicates the number of studies. Studies that did not provide participant sample size are included in the not reported (NR) column. NGT, nominal group technique.

3.3.1. Domain 1: Emergency care population

Twelve studies (7 from the United States, 2 from Australia and New Zealand, 1 from United States and Canada, 1 from Europe, 1 from United Kingdom and Ireland) specifically focused on identifying pediatric‐specific priority areas. Research priority themes that emerged from these studies included the following: (1) optimal management of clinical conditions including injury, respiratory, seizures, sepsis, mental health, fever, asthma, toxicology, special needs/disparities/culture; (2) best practices for pain control, ventilation, medication administration, antibiotic stewardship, illness recognition, protocol adherence, communication, monitoring, sedation, assessing competency, training, cardiopulmonary resuscitation, spinal immobilization, risk stratification; (3) outcomes of interest–mortality, safety, effectiveness, efficacy, impact of media; (4) patient/family involvement regarding adherence; and (5) use of data linkage, biomarkers, clinical markers, devices, technology, simulation, decision support, machine learning, and registry development.

Two studies (both from the United States) specifically focused on identifying geriatric‐specific priority areas. The research priority theme that emerged from these studies focused on screening and management in terms of how (ie, what tools/algorithms/models of care), who (ie, pharmacists, nurses), what (ie, falls, medication management, substance abuse, mental health, behavioral), and why (ie, outcomes – reduce: length of stay, admission, re‐presentation).

3.3.2. Domain 2: Emergency care workforce and process

Two studies (1 from the United States, 1 from the United Arab Emirates) specifically focused on identifying nursing‐specific priority areas. Research priority themes that emerged from these studies included the following: (1) impact of and ways to improve workplace processes (triage, waiting times, length of stay, within‐ and between‐agency); (2) how to improve certain practices (end of life, resuscitation, drug misuse, deteriorating patient, mental health, behavioral disturbance, children, older people); (3) enhancing the practice of nursing (education, research, skill mix, ratios, nurse‐initiated care); and (4) addressing workplace stressors (eg, violence, burnout).

Shared decision making

Two studies (both from the United States) specifically focused on identifying shared decision making (SDM) priority areas. Research priority themes that emerged from these studies included the following: (1) what SDM tools/information is available and used; (2) how is SDM best applied in the ED setting, and how often; (3) who – varied target groups for SDM (clinician – undergraduate, training, permanent), patient (broad or targeted for a clinical condition, high uncertainty, low evidence); and (4) why – what is the effectiveness of SDM (impact on patient‐oriented outcomes, clinician use) and engagement of stakeholders in SDM development.

General workforce/process

Six studies (2 from United States, 1 each from Norway, the Netherlands, South Africa, Canada) focused on general workforce/processes priorities. Research priority themes that emerged from these studies included the following: (1) what is the impact of ED staff well‐being (burnout, resilience) on outcomes (patient, clinician – at varying levels, department, economic); (2) what are the best strategies (organizations and individual) to support clinician well‐being and resilience; (3) considerations of the prehospital provision of care (what, who, how, training, skill maintenance, cost); (4) the impact of and decision making regarding prehospital care (time‐sensitive treatments provided; transport vs non‐transport; handover; use of protocols); (5) database development to support treatment decision making; (6) emergency care research in developing countries – considerate of local context; requires collaboration and resourcing; focused on an area of need to support services and care delivery;(7) the role of patients and family in preventing errors; and (8) identifying and implementing structures and processes to improve the safety of clinical practice.

3.3.3. Domain 3: Emergency care clinical areas

Six studies (all from the United States) focused on imaging research priority areas. Research priority themes that emerged from these studies included the following: (1) gender‐specific investigation into clinical areas (cancer, pulmonary embolism, abdominal pain, renal colic, heart disease, brain, back pain); (2) best use of data to support service delivery (data linkage, SDM, accuracy, decision support, feasibility); (3) appropriateness of imaging considering cost, value, guideline driven; (4) prioritizing populations (considerations of disposition, geographical location, time, mode of arrival); (5) risk of frequency of imaging exposure considering: gender, age, trauma, chronicity, end of life; (6) curriculum development and impact on clinicians and patients; and (7) competency regarding mode of imaging, career stage, the role of simulation.

One study from the United States focused on fall‐specific research priority areas. The research priority theme that emerged from this study was the structure (sex, vulnerability, living arrangements, screening tool use), process (screening, admission location, medication reconciliation), and impact on outcomes (falls – future/recurrent, morbidity, mortality).

Pain management

One study from the United States focused on pain management research priority areas. The research priority theme that emerged from this study was gender‐specific considerations regarding interventions (pharmacological and non‐pharmacological), that consider underlying (acute/chronic) conditions, response (tolerance, side effects, misuse), and lifespan.

Trauma care

Two studies (both from the United States) focused on trauma care research priority areas. Research priority themes that emerged from these studies included (1) hemorrhage‐related interventions – control, testing; (2) time‐sensitive and novel/innovative testing capability; (3) differences in outcomes considerate of age and geographical location; and (4) staffing model considerations (training, skill mix, capability) for various trauma‐related scenarios.

Substance misuse

Two studies (both from the United States) focused on substance misuse research priority areas. Research priority themes that emerged from these studies included the following: (1) best practice approaches to screening and referral; (2) care continuity between ED and other departments (social services, community services); (3) individualized risk factors and care; (4) care considerations of gender and other subgroups (eg, age, pregnancy, LGBTQ – lesbian, gay, bisexual, transgender, and queer); (5) risk factors, severity, screening, referral, motivators, outcome considerations among ED patients; (6) role of digital technology in supporting tailored interventions; and (7) the effectiveness of interventions.

Infectious diseases

One study from the United States focused on infectious diseases research priorities. Research priority themes that emerged from this study included (1) clinical foci (human immunodeficiency virus and sexually transmitted infections); 2) acceptance (patient and staff) of screening in the ED, including consent processes; (3) measures to improve effectiveness (including cost‐effectiveness) and efficiency (with technology, ancillary staff); and (4) data capture approaches to inform surveillance, screening, interventions, and outcomes.

Mental health

Two studies (both from the United States) focused on mental health research priorities. Research priority themes that emerged from these studies included (1) process improvement opportunities (triage, screening, roles); (2) consideration of patient‐specific outcomes; (3) consideration of service outcomes (ED re‐presentation, length of stay, adverse events, delirium); (4) treatment options (medications, location of care); and (5) clinical foci (substance use disorder, delirium, psychosis, dementia).

One study (from the United States) focused on cardiology‐specific research priorities. Research priority themes that emerged from this study included (1) consideration of sex‐specific differences in detection and management of heart disease and (2) considering patient‐ rather than disease‐specific outcomes.

General clinical care

Five studies (3 from Australia, 1 from the United States, 1 from South Africa) focused on general clinical research priority areas. Research priority themes that emerged from these studies included the following: (1) clinically and patient important areas of focus: populations (pediatrics, geriatrics), presentation (resuscitation, trauma, behavioral disturbance, critical care), illness (infectious disease; toxicology; neurological; respiratory; gastrointestinal; oncology; ear, nose and throat), service (ultrasound, drug trials, competence, crowding, alignment of ED and national priorities, mass casualty, rural retrieval, quality improvement, continuity of care between and within hospitals); (2) appropriateness of prehospital practices and policies on patient outcomes; (3) workforce considerations: recruitment, retention, competence; and (4) identifying the best ways to screen, assess, support, and improve the design of research into cerebral injury, acute/chronic pain, mental health, and substance use disorder in the ED.

4. LIMITATIONS

This study was limited to peer‐reviewed literature published in English, potentially limiting complete ascertainment from grey literature and studies from countries where researchers publish non‐English language articles. Priorities are likely to be context specific and may vary according to the health care system, priority‐setting method used, and participants included in studies, making discrete inferences difficult. The many special interest areas within emergency care made it challenging to comprehensively present the depth of research priority areas and, as such, we may have missed research prioritization activities that were not emergency care specific but included emergency care themes. However, our broad approach (as also taken by others) 9 does enable maximum impact.

Our review was guided by the JBI framework 10 using independent screening and moderation for article selection at the title and abstract and full‐text stages in an effort to enhance the transparency of decision‐making process. This review did not perform a pilot testing of screeners. Instead, before the screening, the screeners had meetings to discuss and clarify their understandings of inclusion and exclusion criteria of this review. For subsequent scoping reviews, we recommend the use of further process enhancements that includes undertaking pilot testing of random sample of 25 titles and abstracts so that when 75% or greater agreement is achieved, the team can start screening. 19

5. DISCUSSION

This scoping review provides a significant summary of research priority‐setting studies in emergency care. Aligning with the purpose of scoping reviews, 10 our discussion is framed in terms of understanding where gaps in the evidence exist to inform future research and can be used by any special interest group as a foundation for next steps.

All studies identified were from middle‐high income country settings. This may highlight the existence of a dedicated research infrastructure enabling the articulation of priorities in particular populations, areas, and topics. Most of the studies originated in the United States, a country that has a health structure different from that in many other countries. This concentrated view of priority areas provides impetus to understand and discuss priority areas more broadly within our emergency care community. The priorities of a country's primary research funding mechanisms influence on research priority studies was not investigated in our review and warrants consideration in future research.

Although a wide range of priority areas were identified in the heterogeneous studies, some basic patterns can be identified. Of the studies reviewed, the contexts they broadly relate to included population groups (pediatrics, older persons), high‐risk clinical conditions (eg, infectious diseases, trauma, mental health), and issues affecting workforce/processes of care. They also reflect areas of special interest and special skills emerging within emergency medicine and areas where trainees are pursuing dual fellowships or further postgraduate education (eg, pediatrics, geriatrics, anesthetics, toxicology, addiction medicine, forensic medicine, ultrasound, education, prehospital, and retrieval medicine). 20 This trend toward special interest/subspecialization is similarly reflected in emergency nursing (eg, with emergency nurse practitioners, 21 early pregnancy, 22 geriatrics 23 ) and paramedicine (eg, low acuity response, 24 and critical care 25 ). Already formally established in the United States and United Kingdom, 20 subspecialization may become the new norm according to some authors. 26 Thus, this review may help inform subspecialization pathways and will help mature broader emergency medicine programs with the research required to advance the overall specialty and subspecialty. The benefits of subspecialization would help drive advances in knowledge, patient outcomes, and technology. 20 Whether generalist, special interest, or subspecialty, the development of a research program, with set priority areas, is, nevertheless, integral. With the recognized nature of emergency care being inherently broad, future priorities, therefore, may warrant population (eg, children, geriatrics) or subspecialty (eg, trauma, toxicology, mental health) focus and be derived using a rigorous framework and patient engagement.

This review of research priority‐setting literature has revealed a research agenda that has been heavily driven by expert clinical opinion, potentially generating priorities that do not encompass patient concerns. So, there is the possibility that unconscious bias and certain agendas may be reflected in the priorities presented. The need for consumer/patient input into the priority‐setting processes is thus instrumental. The patient voice (or lack thereof) in setting research agendas has been noted elsewhere. 9 In the health care (including health research) agenda, there has however been a move toward more patient‐centered care to minimize the mismatch between the research interests of patients and researchers. More inclusive research priority‐setting processes have the potential to generate a more relevant research agenda and thus reduce waste in research.

This study has identified some shortcomings regarding the quality/rigor of priority‐setting processes in emergency care research. The narrowness of the fields in which the priorities were set make it challenging to specify overarching key questions in emergency care. Future priority‐setting processes should be guided by supporting principles, 14 , 15 which include considerations for before and after the priority‐setting exercise. 16 Indeed, the impact of the priority‐setting research warrants consideration. Although this can be difficult to measure as it can take some time to determine, it is helpful to ascertain if and how research/practice/patient outcomes in that priority area have changed.

In conclusion, it is evident that research priorities for emergency care vary widely and are context specific. Based on our review, the contexts they broadly relate to included population groups (pediatrics, older persons), high‐risk clinical conditions (eg, infectious diseases, trauma, mental health), and issues affecting workforce/processes of care. We recommend future research focuses on these key findings, and a set of internationally agreed research priorities would be of enormous value. It is important to note that the priorities synthesized in this study predominantly reflect those of high‐ and middle‐income countries and that patient populations were underrepresented. To further inform global emergency care research directions there is a need for patients, disciplines, and countries that are not yet represented to be involved in priority development using a rigorous framework.

AUTHOR CONTRIBUTIONS

The authors contributed to this manuscript in the following ways: Study concept and design (Julia Crilly, Gerben Keijzers, Daniel Wilhelms, Ulf Ekelund, Michelle Krahe, Ya‐Ling Huang); acquisition of the data (Ya‐Ling Huang); analysis and interpretation of the data (Julia Crilly, Ya‐Ling Huang, Michelle Krahe, Daniel Wilhelms, Ulf Ekelund, Gerben Keijzers); drafting of the manuscript (Ya‐Ling Huang, Michelle Krahe, Julia Crilly); statistical expertise (Michelle Krahe); critical revision of the manuscript for important intellectual content (Julia Crilly, Ya‐Ling Huang, Michelle Krahe, Daniel Wilhelms, Ulf Ekelund, Erika Horlin, Jessica Hayes, Gerben Keijzers).

CONFLICTS OF INTEREST

The authors have no competing interests to disclose.

Supporting information

SUPPORTING INFORMATION

ACKNOWLEDGMENTS

We wish to thank Sarah Thorning, Health Librarian, from the Gold Coast Health library for her time supporting and advising on early screening processes required for this review.

Crilly J, Huang Y‐L, Krahe M, et al. Research priority setting in emergency care: A scoping review . JACEP Open . 2022; 3 :e12852. 10.1002/emp2.12852 [ CrossRef ] [ Google Scholar ]

Supervising Editors: Julie Stilley, PhD; Faheem Guirgis, MD.

Meetings: Aspects of this work were presented at the Gold Coast Health 2022 Emergency Care Research Symposium, 11th August, 2022, and Gold Coast Health and Partners Research Showcase, 8th November, 2022, held on the Gold Coast, Australia.

Funding and support : By JACEP Open policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.

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The Engine that Drives Research & Innovation

At Stanford University’s Department of Emergency Medicine, pursuing knowledge is a collaborative effort. An ecosystem of resources propels faculty, fellows, and residents to advance innovation, and attendings benefit from a reduced clinical shift load that enables them to engage in research.

Learn about the three pillars of our research enterprise:

• Stanford EM Partnership Program (STEPP)

Clinical Research Unit

Specialized support staff, stanford emergency medicine partnership program.

The Stanford Emergency Medicine Partnership Program (STEPP) is a structured system for sourcing, evaluating, and executing partnerships between the Stanford Department of Emergency Medicine and external innovators. A team of emergency medicine physicians oversees a multi-stage application process that ensures alignment and fit between the department and the applicant’s mission, operations, needs, and viability.

Applicants are drawn mostly from industry-funded researchers focused on key areas of technological advancement, including:

• Medical devices
• Digital health
• Artificial Intelligence
• Health care at home
• Remote patient monitoring

Following an initial screening call, applicants face an in-depth interview from subject-matter emergency medicine physicians with experience in relevant areas such as AI or traumatic brain injury. Most of the physicians on the team also have a strong background in innovation and business development.

The screening process is similar to those used by venture capitalists, and assesses multiple variables including the quality of the research team; the product’s scope, uniqueness, and application in the emergency medicine landscape; and evidence of a strong business model.

Less than 6% of applicants progress to a partnership with the Department of Emergency Medicine. For the few who do, Stanford’s world-class researchers provide ongoing guidance on study execution and evaluation.

The wide range of applicants ensures that STEPP’s core group of faculty is immersed in acute care technology. And while the team is focused on innovations to improve care, they are looking for a solution, not the only solution. STEPP also gravitates toward newer or smaller companies where a partnership with Stanford can have a large impact.

Collaborators to date include:

• BrainScope: Decision support for traumatic brain injury
• Shyld AI: AI-enabled infection prevention
• Prenosis: AI-based biomarker discoveries
• PyrAmes: Continuous blood pressure monitoring

Stanford’s Department of Emergency Medicine created the Clinical Research Unit (CRU) to convene a team focused on advancing the science of precision emergency medicine while ensuring patient safety and data integrity.

Clinical research comprises studies that enroll human participants in Stanford emergency settings, typically within the adult and pediatric emergency departments (EDs). Because clinical research demands unique planning, implementation, collaboration, and follow-up, the CRU provides specialized support to researchers and liaisons with hospital departments and leadership. A research manager and four coordinators provide support on human subject research throughout the lifecycle of a study, on the project management side (assisting with protocol development, budgeting, contracts, and IRB and regulatory submissions) as well as on the operational side (workflow development and implementation, screening and enrolling patients, training and informing nurses and staff). CRU staff work across multiple studies and can look for areas of collaboration, overlap, or challenges.

Recent and upcoming clinical studies explore:

• Mild TBI assessment
• Sepsis diagnosis and treatment 
• Vaccine effectiveness
• Cardiac high-sensitivity troponin
• Stroke and neurological emergencies
• Wearable vital signs monitoring
• AI-based biomarkers
• Antimicrobial stewardship

Faculty, fellows, and residents receive assistance in securing research funding from staff with expertise in federal grants, industry funding, seed grants, budgeting, post-award reporting, manuscript writing, and project management. Staff can quickly apply lessons learned from one grant to the next, helping faculty avoid potential roadblocks. The support team also liaises with Stanford’s Research Management Group to create clear pathways for physician researchers. A unique grant submission intake process rapidly identifies areas of needed administrative support so researchers are left free to fully immerse themselves in scientific discovery.

Researchers work closely with Stanford’s Quantitative Science Unit comprising 40+ experts, many of whom have PhDs in data science. Researchers can also partner with Stanford’s Emergency Department Data Analytics Committee, which uses informatics and machine learning to conduct research, monitor care quality, and employ artificial intelligence and machine learning via electronic health records. Medical editor consultants are also on hand to assist with grant writing and reporting and in-department data experts assist with data cleaning and sorting.

Faculty attend scientific writing workshops and fellows are provided an annual two-day research workshop in addition to their Master’s program. An emergency medicine intranet catalogs information on funding opportunities, data science, writing, editing, and publishing, medical editors, working with the institutional review board (IRB), and more.

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2024 Higher Education Research Award Funding

Requests for proposals closes july 5, 2024..

The FEMA Higher Education Program seeks to support initiatives that narrow the gap between research and practice in Emergency Management Through the solicitation of multidisciplinary and applied research proposals, this program aims to address complex challenges and offer actionable recommendations to advance the discipline and profession of emergency management.

Focus areas of proposals may encompass, but are not limited to, the following:

• Strengthening Preparedness: Research helps in understanding various aspects of emergencies, including their causes, patterns, and potential impacts. This knowledge enables emergency managers to better prepare for and mitigate the effects of disasters. For example, research might identify vulnerable populations or regions prone to certain types of disasters, allowing for targeted preparedness efforts.
• Enhancing Response Efforts: By studying past emergencies and response strategies, researchers can identify what works well and what doesn't. This leads to the development of more effective response plans, protocols, and tactics. For instance, research might reveal the most efficient ways to allocate resources or communicate with the public during crises.
• Innovating Technologies and Techniques: Research drives innovation in emergency management technologies and techniques. This could involve developing new tools for disaster prediction, early warning systems, or advanced search and rescue methods. By staying at the forefront of technological advancements, emergency managers can improve their ability to respond to emergencies swiftly and effectively.
• Addressing Emerging and Evolving Threats: As new threats emerge, such as pandemics or cyberattacks, research helps in understanding these challenges and developing appropriate response strategies. For instance, research on infectious diseases can inform public health policies and interventions to mitigate the spread of pathogens.
• Building Resilience: Research contributes to building resilience in communities and infrastructure systems. By studying how different communities and systems respond to emergencies, researchers can identify factors that contribute to resilience and develop strategies to enhance it. This might involve promoting community engagement, strengthening critical infrastructure, or fostering social cohesion.
• Guiding Policy and Decision-Making: Emergency management research provides evidence-based insights that can inform policy development and decision-making at various levels of government and within organizations. Policymakers rely on research findings to allocate resources, set priorities, and enact legislation aimed at reducing risks and enhancing preparedness and resilience. This focal area can include research or projects that seek to better understand the position of different stakeholder groups, research that drives better decision-making, cross-sectoral governance, etc.
• Facilitating Continuous Learning and Adaptation: Research facilitates learning from past experiences and adapting strategies accordingly. By analyzing both successes and failures in emergency management, researchers and practitioners can continuously improve their approaches and better anticipate and address future challenges. This focal area includes after action review, debriefing practices, improving the instruction of emergency management, and other related topics.
• Addressing Underserved and Vulnerable Populations: This area focuses on understanding and addressing the unique challenges faced by underserved populations during emergencies. This focal area aims to identify vulnerabilities and disparities to develop targeted strategies for equitable preparedness, response, and recovery efforts. It considers socio-economic, cultural, and accessibility factors to ensure inclusivity and resilience in emergency management.

Award Highlights

• Available funds will support awards up to $10,000 for up to one year of performance.
• an academic appointment at an accredited college or university.
• If funded, the Pl must demonstrate IRB approval for the research project.
• a multidisciplinary research team (This team must be able to support the research and roles must be clearly outlined in advance).
• Climate Resilience
• Emergency Management Workforce
• Peer reviewers will evaluate the quality of research design, emphasizing a clear contribution to the practice of emergency management, and editorial quality of the proposal.
• Funding for awarded projects will be provided through firm-fixed price contracts.

Awardees are required to have a current Unique Entity ID with SAM.GOV.

To receive payment, awardees must submit a professional-quality final research report that must be at least 20 - pages, double-spaced, formatted to APA guidelines, and meet citation and copyright requirements. A letter of approval or exemption from a university based Institutional Review Board, must also be submitted.

Awardees must submit monthly progress reportsand actively participate in quarterly progress calls.

Accepted final reports will be posted to the FEMA Higher Education website.

Proposals must follow the research award template provided. Submit proposals to [email protected] by midnight July 5, 2024.

• Research Proposal Template