Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Acad Emerg Med. 2022 Aug;29(8):963-973. doi: 10.1111/acem.14496. Epub 2022 Jun 4.
The intersection of emergency medicine (EM) and palliative care (PC) has been recognized as an essential area of focus, with evidence suggesting that increased integration improves outcomes. This has resulted in increased research in EM PC. No current framework exists to help guide investigation and innovation.
The objective was to convene a working group to develop a roadmap that would help provide focus and prioritization for future research.
Participants were identified based on clinical, operation, policy, and research expertise in both EM and PC and spanned physician, nursing, social work, and patient perspectives. The research roadmap setting process consisted of three distinct phases that were time staggered over 12 months and facilitated through three live video convenings, asynchronous input via an online document, and a series of smaller video convenings of work groups focused on specific topics.
Gaps in the literature were identified and informed the four key areas for future research. Consensus was reached on these domains and the associated research questions in each domain to help guide future study. The key domains included work focused on the value imperative for PC in the emergency setting, models of care delivery, disparities, and measurement of impact and efficacy. Additionally, the group identified key methodological considerations for doing work at the intersection of EM and PC.
There are several key domains and associated questions that can help guide future research in ED PC. Focus on these areas, and answering these questions, offers the potential to improve the emergency care of patients with PC needs.
急诊医学（EM）和姑息治疗（PC）的交叉领域已被认为是一个重要的关注焦点，有证据表明，这种交叉领域的融合可以改善治疗效果。这导致了更多关于急诊 PC 的研究。目前还没有一个框架来帮助指导调查和创新。
旨在召集一个工作组，制定一个路线图，为未来的研究提供重点和优先级。
根据在 EM 和 PC 方面的临床、操作、政策和研究专业知识，确定参与者，并涵盖医生、护理、社会工作和患者的观点。研究路线图制定过程包括三个不同的阶段，历时 12 个月，并通过三次现场视频会议、在线文档的异步输入以及一系列针对特定主题的工作组小型视频会议来进行。
确定了文献中的差距，并为未来的研究确定了四个关键领域。在这些领域以及每个领域中的相关研究问题上达成了共识，以帮助指导未来的研究。关键领域包括在急诊环境中 PC 的价值必要性、护理模式、差异以及影响和疗效的衡量等方面的工作。此外，该小组还确定了在 EM 和 PC 交叉领域开展工作的关键方法学考虑因素。
在 ED PC 领域有几个关键的领域和相关的问题，可以帮助指导未来的研究。关注这些领域并回答这些问题，有可能改善对有 PC 需求的患者的紧急护理。
