Shaping the future of post-collision response
Research funded by The Road Safety Trust is helping to answer some of the most pressing questions in post-collision care, recently identified by a coalition of experts who came together to host the UK’s first Road-Injury Priority Setting Partnership.
A Priority Setting Partnership (PSP) connects people with real-life experience - such as patients, carers and healthcare professionals - to decide what questions future research should try to answer.
In November, IMPACT - the Centre for Post-Collision Research - held a face-to-face PSP in Edinburgh, at the Royal College of Surgeons, as part of its ongoing work to improve outcomes for those affected by road traffic collisions.
This work has included the award-winning EXIT project, which has revolutionised the extrication techniques applied to casualties following road traffic collisions, as well as the ongoing Bystander project, which aims at understanding and empowering the role of bystanders at the scene of road collision.
Both of these projects have benefited from funding from The Road Safety Trust, whose Deputy Chief Executive, Paul Steinberg, attended the PSP.
Speaking after the event, Paul said: “Priority Setting Partnerships are a proven way of putting people with lived experience at the heart of research. By bringing this approach into road safety, we can ensure focus on the questions that matter most following a collision, so that future research improves practice, reduces harm and ultimately saves lives.
“Post-collision response is a key part of the Safe System. Using a PSP to shape the research agenda will only strengthen our collective efforts to move towards Vision Zero.”
The PSP process
As part of the PSP, the IMPACT team - who recently won a Prince Michael Award - invited those with lived experience to submit a potential research question through an online survey. An expert panel analysed the questions, producing a shortlist of 23 which were taken forward to the workshop.
Following lengthy discussions, the workshop concluded with a consensus on what the Top Ten questions would be for research to answer - a set of questions constructed by, and agreed on, by a diverse range of people who will either be developing, using or impacted by the research.
Three of the questions feature the role of bystanders:
Can using technology, such as mobile apps, video calls, or live coaching, help people give better first aid and improve outcomes for those injured in road traffic collisions, when compared to just using a phone call for guidance?
What are the most effective ways to teach and support bystanders to provide first aid after road collisions (including community training, telemedicine and digital tools) and how can the benefits of these approaches be measured?
What urgent treatments work best for people trapped after a collision, and how can non-medical responders safely provide them?
Research funded by the Trust and being carried out by IMPACT is currently seeking to decrease the morbidity and mortality associated with road trauma by rigorously considering the role of the bystander, including professional bystanders, in the post-collision phase of care.
Working with key stakeholders this project will further understanding of the immediate post-collision phases of trauma, demonstrate the value of early triage and enable key interventions.
Utilising evidence-based medicine will ensure the scientific validity of the findings and facilitate translation to impact: ultimately resulting in a coherent, joined-up, supported strategy for the enablement of bystander and non-clinician care following road traffic trauma.
Kerry Dungay, who led on the PSP workshop for IMPACT, said: “This process has provided a robust framework for bringing together a diverse range of voices with lived experience, adding depth, nuance and authenticity to this space, enabling us to set both the research agenda and pathway to meaningful change for the years ahead.”
Other priorities and next steps
As well looking at the role of bystanders, the PSP outlines eight further research priorities:
After a road traffic collision, which types of deaths could potentially be avoided with the right help at the right time - and when are those critical moments where quick action can make the biggest difference?
What are the most reliable signs, at the scene of a road traffic collision, for spotting hidden life-threatening injuries such as internal bleeding or brain trauma?
How can police, fire and medical teams work better together at the scene of a road traffic collision to speed up rescue and improve patient outcomes, and what training or systems support this best?
What crash details should automatically be sent from a vehicle after a collision to help emergency services respond faster and more accurately, without sending false alerts?
What kind of training, tools and guidelines help emergency call handlers (dispatchers) better recognise serious injuries from road traffic collisions and send the right help quickly?
In road traffic collisions, how do factors such as age, gender, and background influence the types of injuries people get and the care they receive, and what can be done to reduce inequalities?
What does a ‘successful recovery’ after a road injury really mean, and are researchers measuring what matters most to patients?
Full details will be provided in an upcoming report, which will focus on several key areas, including: dissemination and awareness, engagement and partnerships, implementation and monitoring and cultural change and sustainability.
Beyond that, the challenge for IMPACT, as well as other organisations, to start researching the questions.
The IMPACT team is also encouraging stakeholders to play their part by highlighting these key research questions to policymakers, raising public awareness, and joining research efforts when possible.
Professor Tim Nutbeam, IMPACT lead and Devon Air Ambulance doctor, said: “What was most striking about the day was the energy in the room and the shared recognition that this work really matters.
“The Priority Setting Partnership has provided a clear and credible mandate for research focused on the moments after a collision where timely action can make the greatest difference.
“The challenge now is translation. As we have always done at IMPACT, we look forward to working closely with collaborators, partners, funders and policymakers to turn this research agenda into high-quality, meaningful studies, and then into changes in policy and practice at the roadside.
“By working together across the road safety community, we have a real opportunity not only to save lives, but to improve the quality of survival for those affected by road injury.”