The long-term goals of developing research within the specialty of emergency medicine include the following: (1) to continue to improve the quality and quantity of emergency medicine research to ultimately improve emergency patient care; (2) to maximize the research potential of emergency health care professionals to develop new emergency research talent and enthusiasm; and (3) to establish the academic research credentials of the specialty of emergency medicine to become competitive for federal research funding, and further improve emergency patient care. This article addresses the process by which the infrastructure for emergency medicine research can be developed at academic medical centers and provides recommendations. The roles of the academic chair, research director, senior researcher, and departmental faculty are discussed.
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1. The chief should secure an institutional commitment to the department's research efforts. The earliest point at which this commitment can be illustrated is during the recruitment process for a new chief. As part of the recruitment package, candidates for the chief's position should typically ask for specific support for research activities. At the least, these requests should include adequate laboratory space for research activities, adequate salary support to ensure recruitment and retention of high-quality faculty, adequate nonclinical time to conduct research, a significant amount of discretionary funds that can be used to foster research efforts, seed money for all new research faculty members, support for technical personnel for research, and institutional help in recruiting doctorate-level researchers. The best time to secure such an institutional commitment is during negotiations for a new position rather than after the contract has been signed. 2. To establish collaborations, institutional researchers must be made aware of the department's efforts. Emergency medicine research productivity should be publicized and promoted. Researchers from other departments should be invited to present their research findings to the department of emergency medicine, and the reciprocal opportunity to present emergency medicine research to other departments should be sought. Emergency medicine should be represented in institutional research conferences, paper presentations, and seminars on grant funding. The emergency medicine department should try to identify the availability of shared equipment and space in other department laboratories, and make equipment in the emergency medicine laboratories available for use by others. Research expertise in other departments should be used. In clinical research, it is crucial that emergency medicine be actively involved in any research that involves ED patients. Investigators from other departments who desire to do emergency medicine clinical research should be required to formally collaborate with an emergency medicine research faculty. We would not try to do research involving ICU patients without having the “buy-in” of the ICU team, and in the same way other physicians should not assume they can do research involving ED patients without having the “buy-in” of ED faculty. This involvement is necessary to define our research environment. It also ensures an adequate and accurate interpretation of ED data, allows scientific and ethical scrutiny of a project to be done involving our patients, and provides input into the feasibility and the possible limitations of data collection in our practice setting. Residents can also benefit from research collaboration with other departments. Residents from other specialties can be invited into the department's research laboratories or clinical research settings, and arrangements can be made to allow emergency medicine residents to work in the laboratories or clinical setting of another department. Such sharing of knowledge and resources helps to bring emergency medicine more solidly into the institutional research community. Collaborative efforts with researchers in other departments should be encouraged and promoted. Collaborative research should be actively promoted for researchers at all levels. Within an institution, emergency academicians have a “tendency towards academic isolation.” 2 Because of clinical hours that do not necessarily correspond to those of other institutional researchers or research resources, many emergency physicians do not develop the special skills needed to engage in collaborative multidisciplinary research. As suggested by the distribution of Emergency Medicine Foundation (EMF) advanced research grant awards, many emergency researchers have successfully engaged in collaborative endeavors with basic scientists. 3 Similar successful collaboration with established clinical researchers is also essential because many novice emergency researchers have little formal training or experience in the research methodologies of clinical trials. 3. The ED should be represented on key institutional research committees. A potential stumbling block for implementation of many emergency research protocols occurs when those protocols are reviewed by various research committees with no emergency medicine perspective. For instance, the IRB members often have little familiarity with standard emergency medicine practice, making it difficult for them to judge the appropriateness or safety of proposed research protocols. An emergency medicine researcher is an important information source, and can provide the IRB members with the background needed to fairly evaluate the quality of the proposal in question.