High quality healthcare research underpins quality patient care. It asks patient relevant questions and measures meaningful outcomes, uses appropriate study design and statistical analysis, along with open and transparent publishing methods. This enables clinicians to access, understand, and apply the findings to their patients and provide them the best possible care.
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However, it has been estimated that up to 85% of all research is of low quality, with poor research questions, inadequate designs and unnecessary duplication, costing ~$100 billion annually. This number is likely even greater as poor research then leads to low-value healthcare, such as unnecessary tests, procedures, and treatments.
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There have been international efforts to combat this crisis in research. However, there has been little to no focus on professional medical associations, such as specialty training colleges and their educators. All specialist doctors in Australia are trained through these Colleges, including in research skills and produce ~3,000 new fellows each year.
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Our review of 58 Australian and New Zealand specialist medical training colleges and their subspecialty divisions found that, while 55 require trainees to complete a project as their primary method of learning about research, the majority did not require formal research methods training, nor supervision by a research experienced supervisor. This is likely to be counterproductive, placing trainees at risk of conducting poor quality projects and producing fellows that may not appreciate how quality research contributes to positive patient care.
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Several other colleges in Australia and overseas have begun to question the value of the current system and have been calling for change. We do too.
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This study will inform a larger program of work that aims to improve this research training system and by understanding what is happening in practice; namely the quality of trainee experience and the quality of the research itself."
 

Everyday, clinicians in emergency departments make hundreds of decisions about the care of patients. Often these decisions are made in rapidly changing, time-pressured and complex conditions which can leave the clinician uncertain about the required tests and/or treatments.
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Clinical decision aids are research-based “tools” about patient care, tests, and treatments that can guide clinician’s decisions. Routine use of these tools has been found to benefit:
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1.patients by ensuring they receive the right care and reducing waiting time
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2.clinicians by assisting with reliable and research-informed decisions and,
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3.healthcare system by improving the value and efficiency of care i.e. ensuring patients receive the best care, at the right time, every time.
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Despite these benefits, clinical decision aids are underused. Research knowledge that is not used in clinical practice is a problem because it means that patients are not receiving the best care, at the right time, every time. A solution is to integrate clinical decision aids into the electronic health system for clinicians to use with the right patient, at the right time, every time. This can improve patient outcomes and increase the quality and reliability of the care provided by clinicians and the health service.
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Clinical decision aids are not currently integrated in the electronic health system at the Gold Coast Hospital and it is not known which “tools” emergency clinicians use and how regularly. Our research has two phases. Funding is sought for Phase 1 - a survey of clinicians’ current use of clinical decision aids, and an audit of medical records to check if these tools are recorded. The findings from Phase 1 will be used to inform Phase 2 - developing and testing the integration of clinical decision aids into the electronic health system for use by emergency clinicians."
 

Children sometimes present to an emergency department with severe illness which requires the insertion of a breathing tube into their windpipe and supporting their breathing with a mechanical ventilator (breathing machine). The insertion of the breathing tube is a high risk procedure due to both the severity of the child's illness and also the technical difficulty of inserting the tube. If the tube is not inserted successfully on the first attempt, there is an increased risk of the worsening of the child's condition and other serious complications.

End-of-life deciSionS in the EmergeNcy department and Intensive cAre: where is the Law? (the ESSENTIAL project)