Research
The Research on EMS and Systems Quality Lab conducts multidisciplinary research that focuses on improving emergency care delivery across the prehospital-to-hospital care continuum. Projects span clinical outcomes research, systems engineering, workplace safety and innovation in austere and operational environments.
Prehospital care and patient outcomes
This research program evaluates how prehospital clinical care and operational decisions influence downstream systems and patient outcomes. Projects focus on optimizing care in time-sensitive conditions and aligning EMS practices with evidence-based medicine while accounting for real-world system constraints.
Areas of investigation include:
- Prehospital airway management and resuscitation strategies.
- Hemorrhage control and blood product use.
- Medication use and downstream effects in vulnerable populations.
- Patient outcome follow-up and its impact on prehospital clinicians.
- Prehospital system of care in out-of-hospital cardiac arrest.
The lab specializes in out-of-hospital data considerations and linkages between EMS and hospital data.
Related publications
- Franczak S, Ginsburg AD, Carpenter KP, Bellolio F, Klassen AB, Mullan A, McGuire SS. Between crisis and comfort: Emergency medical services recognition and management of hospice patients: A cohort study. Journal of Palliative Medicine. 2026.
- McGuire SS, Brown CS, Palmer AK, Jeffery MM, Mullan AF, Stanich JA, Bower SM, Liedl CP, Rentz LC, Bellolio F. The downstream effects of prehospital opioid dosing in older adults: A retrospective cohort study. Academic Emergency Medicine. 2026.
- McGuire SS, Klassen A, Luke A, Rentz L, Liedl CP, Mullan AF, Sztajnkrycer MD. Providing performance feedback and patient outcome follow-up to emergency medical services (EMS) is associated with subsequent improved clinical performance. Prehospital Emergency Care. 2025.
- Moss D, Boorjian N, Mullan A, McGuire SS, Anderson J, Raukar NP. Retrospective analysis of disparities in timing of prehospital and emergency department pain management by sex and age. Western Journal of Emergency Medicine. 2025.
- Wanberg EJ, Scott G, Dostal KM, Mullan AF, McGuire SS. It's time to talk to emergency medical dispatchers: Survey study on performance feedback and patient outcome follow-up to EMDs. BMC Emergency Medicine. 2025.
Workplace violence, safety and risk mitigation
The Research on EMS and Systems Quality Lab leads a comprehensive research program that focuses on understanding, preventing and mitigating workplace violence in the prehospital setting and across emergency care settings. This research is conducted in collaboration with the Study of Aggression and Fostering Effective Response (SAFER) Lab.
Projects examine:
- Prevalence and risk factors for violence against EMS clinicians.
- Impact of risk reduction strategies, such as ballistic vests and de-escalation training.
- Predictive tools and dispatch-based risk identification.
- Longitudinal patterns of violence across the prehospital-to-hospital continuum.
- System-level interventions to improve staff safety, communication and preparedness.
This work supports the development of scalable, data-driven strategies to improve workforce safety and patient care environments.
Related publications
- McGuire SS, Wanberg EJ, Bellolio F, Gazley B, Mullan AF, Clements CM. Continuing violence from the out-of-hospital setting to the emergency department and hospital: A cohort study on longitudinal violence in health care. Annals of Emergency Medicine. 2026.
- McGuire SS, Arms KJ, Reiter DT, Liedl CP, Mullan AF, Phillips JP, Clements CM. Prehospital workplace violence (WPV) dispatch alerts: Anticipating behavior and preventing violence. Prehospital Emergency Care. 2025.
- McGuire SS, Bellolio F, Buck BJ, Liedl CP, Stuhr DD, Mullan AF, Buffum MR, Clements CM. Workplace violence against emergency medical services (EMS): A prospective 12-month cohort study evaluating prevalence and risk factors within a large, multistate EMS agency. Prehospital Emergency Care. 2025.
- McGuire SS, Bellolio F, Sztajnkrycer MD, Sveen MJ, Liedl CP, Mullan AF, Clements CM. Use of body armor by EMS clinicians, workplace violence, and racial and ethnic disparities in care. JAMA Network Open. 2025.
- McGuire SS, Lampman MA, Smith OA, Clements CM. Impact of workplace violence against emergency medical services (EMS). Prehospital Emergency Care. 2025.
Emergency care delivery in austere and operational environments
The lab conducts research in collaboration with private, federal and Mayo Clinic Military Medicine partners to evaluate emergency care delivery in austere, resource-limited and operational settings.
Projects focus on:
- Prolonged field care and decision-making in delayed transport environments.
- Telemedicine and remote clinical support for out-of-hospital care.
- Evaluation of novel diagnostics, monitoring tools and resuscitation technologies.
- Translation of military medical innovations into civilian EMS systems.
- Operational performance and care delivery in high-risk and constrained environments.
This work bridges military and civilian systems to improve care delivery in both domains.
Related publications
- Russi CS, McGuire SS, Klassen AB, Skeens KM, Arms KJ, Kaczmerick LD, Fullerton PJ, Radnothy LM, Luke A. Use of a head-mounted assisted reality, high-resolution telemedicine camera and satellite communication terminal in an out-of-hospital cardiac arrest. Mayo Clinic Proceedings: Digital Health. 2024.
- McGuire SS, Keim A, Blakeney CA, Brand SI, Klassen AB, Luke A, Maher SA, Wood JM, Sztajnkrycer MD. Immediate medical care rendered by U.S. law enforcement officers after officer-involved shootings — An open-access public domain video analysis. Prehospital and Disaster Medicine. 2023.
- McGuire SS, Klassen AB, Mullan AF, Sztajnkrycer M. A survey of tranexamic acid use by US tactical emergency medical support providers. Journal of Special Operations Medicine. 2021.