Lessons Learned from ICU Research During a Pandemic: A Multisite Qualitative Study to Inform Research Innovation

Abstract Purpose Emergency conditions such as the COVID-19 pandemic pose complex scientific and ethical challenges for researchers, which must be addressed to optimise efficiencies in trial conduct. Our purpose was to examine key factors essential to creating an agile system responsive to the rapidly changing research and clinical environment and to understand how we might learn from this unique experience to bolster research capacity in future pandemics.Methods Our evaluation employed robust qualitative descriptive methodology which comprises an approach for gathering information directly from those experiencing an event or process and flexible application of theoretical frameworks to assist in the analysis. Data was collected through individual interviews of key research stakeholders and our thematic analysis was informed by the Consolidated Framework for Implementation Research (CFIR).Results Over 17 months, we interviewed 64 participants across four research sites. Our findings uncovered key challenges in each of the 5 constructs of the CFIR: the outer setting, the inner setting, intervention characteristics, individual characteristics and rapid implantation processes which were put in place to allow crucial research to happen under extenuating circumstances.Conclusion Our data demonstrate the pandemic-magnified shortcomings of a precarious research infrastructure both in local ICUs and at the national level. Focusing investment on more efficient research platforms and administration, considering research and data sharing capacity and patient and family experience in protocol development, building a robust research workforce, and revamping the funding architecture at all levels are important lessons to promote seamless delivery of critical care research in pandemic conditions.