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Human factors in prehospital research : lessons from the PARAMEDIC trial
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Pocock, Helen, Deakin, Charles D., Quinn, Tom, Perkins, Gavin D., Horton, Jessica and Gates, Simon (2016) Human factors in prehospital research : lessons from the PARAMEDIC trial. Emergency Medicine Journal, 33 (8). pp. 562-568. 26917497. doi:10.1136/emermed-2015-204916 ISSN 1472-0205.
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Official URL: http://dx.doi.org/10.1136/emermed-2015-204916
Abstract
BACKGROUND:
There is an urgent need to develop prehospital research capability in order to improve the care of patients presenting to emergency medical services (EMS). The Prehospital Randomised Assessment of a Mechanical compression Device In Cardiac arrest trial, a pragmatic cluster randomised trial evaluating the LUCAS-2 device, represents the largest randomised controlled trial conducted by UK ambulance services to date. The aim of this study was to identify and analyse factors that may influence paramedic attitudes to, and participation in, clinical trials.
METHODS:
Personal and organisational experience from this trial was assessed by feedback from a workshop attended by collaborators from participating EMS and a survey of EMS personnel participating in the trial. A work systems model was used to explain the impact of five interwoven themes-person, organisation, tasks, tools & technology and environment-on trial conduct including gathering of high-quality data.
RESULTS:
The challenge of training a geographically diverse EMS workforce required development of multiple educational solutions. In order to operationalise the trial protocol, internal organisational relationships were perceived as essential. Staff perceptions of the normalisation of participation and ownership of the trial influenced protocol compliance rates. Undertaking research was considered less burdensome when additional tasks were minimised and more difficult when equipment was unavailable. The prehospital environment presents practical challenges for undertaking clinical trials, but our experience suggests these are not insurmountable and should not preclude conducting high-quality research in this setting.
CONCLUSIONS:
Application of a human factors model to the implementation of a clinical trial protocol has improved understanding of the work system, which can inform the future conduct of clinical trials and foster a research culture within UK ambulance services.
TRIAL REGISTRATION NUMBER:
ISRCTN08233942.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Emergency Medicine Journal | ||||||||
| Publisher: | BMJ Group | ||||||||
| ISSN: | 1472-0205 | ||||||||
| Official Date: | August 2016 | ||||||||
| Dates: |
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| Volume: | 33 | ||||||||
| Number: | 8 | ||||||||
| Page Range: | pp. 562-568 | ||||||||
| Article Number: | 26917497 | ||||||||
| DOI: | 10.1136/emermed-2015-204916 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Adapted As: |
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