Prioritizing clinical and nonclinical issues for emergency department quality assessment studies

There is a need at both the emergency department and national level for a systematic method to prioritize clinical and nonclinical areas for research and quality assessment. A method has been developed and applied that allows frequently presenting diagnoses and management issues to be rated in terms of morbidity generated, efficacy of (optimal) clinical intervention, discrepancy between optimal and current treatment, and the impact of an evaluative intervention study on improving care. Also, a summary research priority score was derived. When this method was used by physicians, nurses and administrators at the Johns Hopkins Hospital Adult Emergency Department, a reasonable level of agreement between the three responding groups emerged.