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Emergency Health Services Translating Research Into Practice

Emergency Health Services Translating Research Into Practice. Andrew Travers MD MSc FRCPC Staff Physician, QE-II Emergency Provincial Medical Director Emergency Health Services Halifax, Nova Scotia. Conflict of Interest. No reported financial conflicts of interests to declare.

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Emergency Health Services Translating Research Into Practice

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  1. Emergency Health Services Translating Research Into Practice Andrew Travers MD MSc FRCPC Staff Physician, QE-II Emergency Provincial Medical Director Emergency Health Services Halifax, Nova Scotia

  2. Conflict of Interest • No reported financial conflicts of interests to declare. • Contributing Author • Cochrane Collaboration • Airway Review Group • International Liaison Committee on Resuscitation E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  3. Acknowledgements Dalhousie Division of EMS Dalhousie University • Dave Petrie MD • Ed Cain MD • Jan Jensen ACP • Dave Urquhart • Corinne Burke E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  4. Out-of-Hospital Medicine Prehospital Medicine Paramedicine Evidence-Based Medicine EBP, EBID, EBG, etc. E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  5. What on *&^%$# earth is ‘knowledge translation’? E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  6. http://www.cihr-irsc.gc.ca/e/29418.html Knowledge translation is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system. Jay Walker 0100 Sept 12 2008 E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  7. Knowledge Translation • Knowledge Translation (KT) is a method by which all healthcare stakeholders can bridge the gaps that exist between current knowledge / evidence and current practice. • For each stakeholder there are different gaps. E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  8. Knowledge Translation W5HO W5 H O E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  9. Who What How Observe Where Why When E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  10. Anticipation New Guidelines Integration Processes of Care Optimization Implementation System-Wide Collaboration Multidisciplinary Communication CPR Knowledge Translation E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  11. Objectives described. Clinical questions described. Application to patients described. Scope & Purpose Completed Target users defined. Piloted among users. Editorial Independence Stakeholder Involvement Rigour of Development Applicability Systematic searches. Clear selection criteria. Clear procedure for Updating. Clarity & Presentation Specific & unambiguous. Different Mx options considered.

  12. Scope & Purpose Weaknesses Includes individuals from relevant groups. Editorial independent from funding. Conflicts of interest recorded. Editorial Independence Stakeholder Involvement Rigour of Development Applicability Formulation methods clearly described. Explicit link between evidence & recommendation. Expert external review. Key review criteria for monitoring and auditing. Clarity & Presentation Key recommendations easily identifiable. Application support tools.

  13. PEP: Other Weaknesses • Minimal peer review & auditing. • Ensuring that protocols remain up to date. • Minimal funding of infrastructure. • Lack of publications from the EBP3O initiative. • A contemporary and generalizable method of ‘grading’ evidence is lacking. E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  14. Scope & Purpose Future Development Patient preferences and views sought. Editorial Independence Stakeholder Involvement Rigour of Development Applicability Consideration of side effects, benefits, risks. Discussion of organisational barriers. Application costs considered. Clarity & Presentation E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  15. PEP: Other Future Directions • Creation and linkage of ‘online’ and ‘didactic’ basic and advanced EBP course for paramedics with input into the EB3P0. • ‘Evidence mapping’. • Linkage of protocol compliance/performance with evidence evaluation process. • Integration/adaptation into ILCOR, Cochrane, etc. • Movement of paramedics into these domains. E H S t r a n s l a t i n g r e s e a r c h i n t o p r a c t i c e

  16. Include paramedics early – “content experts”. • A collaborative, community based model is feasible. • Standardised/adaptable prehospital ‘grading’. • Optimize evidence search & appraisal process. • Address the needs/input of the end-user(s). • Catalogue prehospital guidelines and share them. Closing Remarks

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