Abstract
BackgroundIn 2015, a national research agenda was established for Dutch prehospital EMS to underpin the evidence base of care delivery and inform policymakers and funders. The continuously increasing demand for ambulance care and the reorientation towards the role of EMS in recent years may have changed research priorities. Therefore, this study aimed to update the Dutch national EMS research agenda.MethodsA three-round online Delphi survey was used to explore and discuss different viewpoints and to reach consensus on research priorities (i.e., themes and special interest groups, e.g. patient types who require specific research attention). A multidisciplinary expert panel (n = 62) was recruited in the field of prehospital EMS and delegates of relevant professional organizations and stakeholders participated. In round one, fifty-nine research themes and six special interest groups (derived from several resources) were rated on importance on a 5-point scale by the panel members. In round two, the panel selected their priority themes and special interest groups (yes/no), and those with a positive difference score were further assessed in round three. In this final round, appropriateness of the remaining themes and agreement within the panel was taken into account, following the RAND/UCLA appropriateness method, which resulted in the final list of research priorities.ResultsThe survey response per round varied between 94 and 100 percent. In round one, a reduction from 59 to 25 themes and the selection of three special interest groups was realized. Round two resulted in the prioritization of six themes and one special interest group ('Vulnerable elderly'). Round three showed an adequate level of agreement regarding all six themes: 'Registration and (digital) exchange of patient data in the chain of emergency care'; 'Mobile care consultation/Non conveyance'; 'Care coordination'; 'Cooperation with professional partners within the care domain'; 'Care differentiation' and 'Triage and urgency classification'.ConclusionsThe updated Dutch national EMS research agenda builds further on the previous version and introduces new EMS research priorities that correspond with the future challenges prehospital EMS care is faced with. This agenda will guide researchers, policymakers and funding bodies in prioritizing future research projects.
Highlights
In 2015, a national research agenda was established for Dutch prehospital Emergency medical services (EMS) to underpin the evidence base of care delivery and inform policymakers and funders
Patient transport remains an important part of the provided service in all types of EMS systems, EMSs are evolving into an extended role of providers of prehospital advance care [10, 11] These changes have led to different types of ambulance care like medium care ambulances and psychiatric ambulances, the introduction of different types of prehospital care professionals like physician assistants and nurse practitioners, and the introduction of point of care testing, for example ultrasound and troponin tests [12,13,14,15,16,17]
The study was commissioned by the Dutch National Sector Organization for Ambulance Care (AZN) and executed by an independent party, namely the research department of emergency and critical care of the HAN university of Applied Sciences, Nijmegen, the Netherlands to reduce the risk of bias in the inclusion of experts and the analysis of the data
Summary
In 2015, a national research agenda was established for Dutch prehospital EMS to underpin the evidence base of care delivery and inform policymakers and funders. Vloet et al Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2021) 29:162 problems and comorbidities, for health problems that could be treated in the primary care [1,2,3,4,5,6] As part of this increasing number of ambulance deployments there is a significant number of patients that received ambulance care without conveyance [7,8,9]. Delivery of evidence-based prehospital care is increasingly complex due to a limited body of scientific knowledge available for the prehospital setting [20]. This knowledge comes from research with serious limitations due to limited funding and research capacity, and methodological limitations such as difficulties to randomize and blind interventions and assess patient outcomes [21]. Research in the prehospital setting is often challenging from an ethical perspective due to the context of urgency, time limitation and out-of-hospital locations of care delivery [22]
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