Human factors in prehospital research : lessons from the PARAMEDIC trial

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, pp. 562-568. ISSN (print) 1472-0205

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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.

Item Type: Article
Additional Information: This work was supported by the National Institute for Health Research’s Health Technology Assessment programme [project number 07/37/69].
Uncontrolled Keywords: human factors, prehospital, clinical trials, cardiac arrest, mechanical chest compression
Research Area: Health services research
Primary care and other community based clinical subjects
Faculty, School or Research Centre: Faculty of Health, Social Care and Education (until 2017)
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Depositing User: Katrina Clifford
Date Deposited: 10 Feb 2016 10:59
Last Modified: 18 Sep 2017 10:50

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