Milestones and Facilitators During the First Year of Development of a Successful Community Hospital ICU Research Program
CCCF ePoster library. Camargo M. Nov 7, 2018; 233444
Mercedes Camargo
Mercedes Camargo
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Abstract
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Introduction/Background

Critical care research has traditionally been conducted in academic centers. By participating in research, community Intensive Care Units (ICUs) can contribute to increased generalizability of research findings, expand the academic engagement of clinicians and improve patient outcomes. Several barriers can prevent community ICUs from conducting research or developing a research program. We identified lessons learned from the first year of development of a community ICU research program.



Objectives

To describe the milestones and facilitators in the first year of implementation of a robust community hospital ICU research program.



Methods

Screening and enrollment data was collected from research program inception. We tracked personnel involvement, in-kind and formal financial support. We identified facilitators through multidisciplinary discussion and consensus.



Results

We screened 869 ICU patients over 54 weeks, and enrolled 45 patients into two international, multicenter, investigator-initiated randomized control trials (RCTs), and 42 patients into a multicenter observational study. Clinical trial agreements and research ethics board approval were finalized for one additional multicenter RCT study and are in process for two multicenter RCTs and one stepped wedge cluster RCT, with three more studies in preparation for local startup. Within 13 months, the research coordinator position expanded from part-time to full-time to facilitate increased study participation. The support of senior leadership of the hospital, partnership with academic institutes and the Canadian Critical Care Trials Group were crucial to implementation of a new research program.  Facilitators included: alignment of research with the organizational strategic plan, presence of an existing small but positive organizational research culture and subsequent in-kind administrative support, research office space, and authorization of temporary funding for research pharmacy staff. Engagement and support from key stakeholders were imperative to ensure success during our first year: 1) two formally trained physician research champions acted as co-directors of the research program and local principal investigators of clinical trials; 2) eager and supportive intensivists and chief of staff provided in-kind financial support; 3) ambitious research coordinator with formal research and clinical training operationalized the research program; 4) academically oriented ICU pharmacist with extensive clinical experience provided invaluable pharmacy insight; 5) supportive pharmacy department allowed startup of clinical trials without formalized research funding; 5) enthusiastic ICU manager, nurses, allied health professionals, and hospital leadership and administration facilitated the successful implementation of the research program.



Conclusions                                                                                                                                               

As community hospitals strive to increase their research capacity, barriers to initiating and sustaining a successful research program exist. Support from academic institutions and engagement of key local stakeholders are crucial to ensuring successful implementation of a research program.


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