Embedding research in the emergency department

The emergency medicine research team at Barts Health NHS Trust recently won the Royal College of Emergency Medicine and NIHR award for making an outstanding contribution to NIHR portfolio studies across a three-year period from 2020-2022.

Here, Senior ED Research Nurse in that team, Raine Astin-Chamberlain, on the left in the image next to emergency medicine consultant Dr Ben Bloom, explains how the team has worked to embed research as part of clinical care, some of the challenges of recruiting in the emergency setting, and some advice for those who may be thinking about research as a career.

Given how busy emergency units are, how do you make time and space for research, and ensure that non-research staff working in those settings support research?

Embedding research practices into everyday work of the department is essential. The harder it is for a member of the clinical team to recruit to a study the less likely they are to do it. We have tailored our approach to research involvement to make it as easy as possible for the clinical teams.

Our screening and consent procedures are research nurse-led and after the introduction of electronic prescribing at our trust, we implemented bespoke clinical trial drug prescriptions into the electronic prescribing system. By doing this we are endeavouring to make participating in research part of clinical care without additional burdening the already busy clinical teams.

What does winning the award mean to you and the team, and could you say a bit more about it?

We believe all patients should be given the opportunity to participate in research and strive to adopt studies and trials that represent our diverse population. Since 2020, our team has delivered 34 NIHR Portfolio studies, recruited more than 6000 patients, supported five doctors through the NIHR Associate PI Scheme and contributed or authored 35 peer-reviewed papers. We are delighted to have been given this award, which highlights how fundamental research is in the development of effective care for patients, and the importance of supporting clinical research delivery in the emergency department (ED).

What is the best thing about conducting research in an emergency setting?

ED research, like the emergency department, is fast-paced and always changing. We run a wide-ranging portfolio of research in the department across all age groups and specialities. On any given day, the team can be recruiting patients into our trauma, cardiology, orthopaedic, or mental health studies. No day is ever the same and there is always an opportunity to innovate and improve patient care.

Could you outline some of the challenges?

Time and capacity are the main challenges. Our clinical staff are busy and already stretched with the demands of the department, we are conscious to not add to their mental or physical load when conducting research in the department. Then there are our patients, they are not expecting to attend a hospital that day let alone being part of research. They are often distressed and in pain, this can make consent conversations tricky, but we feel it’s important that all patients are provided access to research in the department.

How did you get into emergency research?

I have worked as a nurse in ED for the past 10 years but my passion for ED research began in 2014 when I was involved in research trials alongside my clinical role. It inspired me to complete a Master’s and apply for a secondment to the ED research team at my previous NHS trust. I joined the ED research team here at Barts Health NHS Trust in 2019.

Research, for me, is about looking at the big picture: finding the answers to clinical questions and improving the quality of care we provide to our patients. The work we do here has a significant and lasting impact on the delivery of emergency care across the world and I feel privileged to be part of the research we conduct.

What would you say to someone considering a career in emergency research?

Try it! Clinical secondments are wonderful opportunities to ‘try out’ research without committing to a permanent role or leaving clinical practice.