Research Priorities for Nursing and Allied Health: A Priority‐Setting Project Using a Partnership Approach

ABSTRACT

Background

Research priorities guide research activities, funding and resources within health services. To ensure that research efforts are meaningful and impactful, it is vital that organisational research agendas reflect the priorities of both healthcare consumers and staff, alongside broader national and international research frameworks. This paper outlines a research priority‐setting project conducted across two hospitals in Western Australia, aimed at identifying shared research priorities through a collaborative and inclusive approach.

Aim

To identify the top ten nursing and allied health research priorities for two hospitals in Western Australia.

Methods

A modified James Lind Alliance Priority Setting Partnership approach was used, involving health services users, nurses, allied health professionals, and community members in a co‐design approach across three phases. In phase 1, four community conversations were conducted to elicit an initial set of research topics. This data‐informed phase 2, a survey to collect diverse views from a wider participant pool. In phase 3, a pre‐selected sample of potential research priorities was discussed in a consensus workshop to reach a group consensus of the top ten research priorities. Qualitative data was analysed using multi‐step thematic analysis, and quantitative data was analysed using descriptive statistics.

Results

A total of 67, 151 and 18 people participated across study phases 1, 2 and 3, respectively, comprising nurses, allied health professionals, healthcare users, carers, and interested community members. The top ten research priorities reflected three areas: healthcare systems re/design (streamlining care; access to healthcare; patient journey and quality of care), workforce needs (workforce well‐being, retention and adequate staffing; workforce training), and specific health issues and needs (dementia and delirium; mental health; caring for carers; Aboriginal and Torres Strait Islander health; palliative care and elderly people).

Conclusion

The research priorities identified in this study for two hospitals in Western Australia reflect the strong desire of nurses, allied health professionals, healthcare users and community members to improve structural issues in healthcare systems. This includes how healthcare systems are designed and integrated with each other, how workforce needs affect service delivery, and a greater focus on holistic service provision for specific health issues and needs.

Patient or Public Contribution

Healthcare consumers were an integral part of this study. Healthcare consumers were involved in the design of the study, the conduct of the study, and the review of the data analysis.

1. Introduction

Healthcare research is essential for generating new knowledge that drives improvements in healthcare services and promotes positive outcomes for patients and communities (Wensing and Ullrich 2023). As frontline providers, nurses and allied health professionals (AHPs) are well positioned to lead and participate in research that advances care delivery and clinical practice (Bridges et al. 2020; Hopia and Heikkilä 2019; Ives Erickson and Pappas 2020; Lee et al. 2020). However, it is estimated that up to 85% of medical research funding is wasted due to low‐priority research topics, poor study design, and limited consumer involvement (Bleijenberg et al. 2018). One strategy to address this is the establishment of research priorities that are contextually relevant and informed by stakeholders.

Traditionally, research priority‐setting has been determined by policymakers, governments, and professional bodies, often through top‐down approaches aligned with national agendas (Davis et al. 2019; Hopia and Heikkilä 2019). In recent years, however, countries such as Switzerland, Canada, and the United Kingdom (UK) have developed comprehensive research agendas for healthcare professionals that demonstrate and acknowledge the need for greater engagement with healthcare providers, patients, carers, and the public in shaping research priorities. In the UK, for example, the NHS Chief Nursing Officer's Strategic Plan for Research emphasises the active involvement of nurses, patients, and carers in priority‐setting processes (National Health Service 2021). Similarly, the Allied Health Professions Strategy for England was developed through extensive consultation with AHPs, service users, carers, and community stakeholders (National Health Service 2022). These national agendas for research reflect a broader international shift toward inclusive and collaborative research agenda development.

One established approach to consumer and clinician co‐design in priority‐setting is the James Lind Alliance (JLA) Priority Setting Partnerships (PSPs), originally developed in the UK. The JLA facilitates collaboration between patients, carers, and clinicians to identify and prioritise research uncertainties (James Lind Alliance 2021). Its structured methodology involves patient and clinician steering groups to identify research uncertainties and determine a consensus‐based top 10 list of research priorities (James Lind Alliance 2021). However, reviews on the use of the JLA for nursing and allied health focus on specific speciality areas, conditions, or treatments with limited application to these broader professional groups, particularly at the health service organisation level. To date, only two studies have applied JLA methods to the broader nursing professional group (Janerka et al. 2023; Mörelius et al. 2022), highlighting its underuse in nursing and allied health settings.

Engaging clinicians and consumers in research priority‐setting is essential to ensure research aligns with the needs of specific communities and practice contexts (James Lind Alliance 2021). Such approaches enhance the relevance, implementation, and impact of evidence‐based interventions (Baltussen et al. 2016; Lin et al. 2023). This is particularly important as healthcare and research priorities often vary according to geographic, cultural, and economic contexts (Lin et al. 2023; Poh et al. 2022). However, not all countries have established national research priorities for nursing or allied health, resulting in inconsistent local guidance for research planning and limited opportunities for coordinated investment in priority research areas.

In response, researchers have conducted studies to identify specific nursing research priorities across regions, including Australia, Asia, Europe, Africa, and the Americas. These studies identified key research priority areas, such as health policy, administration, leadership, documentation (Al‐Yateem et al. 2019; Aungsuroch et al. 2019; Fossum et al. 2022), patient‐centred care, education, staffing, support, and vulnerable populations (Al‐Yateem et al. 2019; Aungsuroch et al. 2019; Fossum et al. 2022; Janerka et al. 2023), communication (Mörelius et al. 2022) and mental health and well‐being (Chipps et al. 2021; Mörelius et al. 2022). However, only two of these studies incorporated consumer perspectives, both of which were conducted in the metropolitan area of Perth, Western Australia (Janerka et al. 2023; Mörelius et al. 2022). Notably, despite being undertaken in the same geographic region, the studies reported differing research priorities. Mörelius et al. (2022) identified access to services, mental health and psychological well‐being, and communication as top priorities, while Janerka et al. (2023) highlighted patient and family‐centred care, education and training, and efficient processes. These differences suggest that research priorities may differ even within a single region, reinforcing the need for ongoing, context‐specific, and inclusive research agenda‐setting processes.

Allied health research priority‐setting studies have been undertaken in Australia, Northern Ireland, and the Republic of Ireland. These studies have primarily focused on models of care, evaluation of general practice, and specific interventions (Davis et al. 2019; McKenna et al. 2014). As with nursing, healthcare consumer engagement was limited, with only one study incorporating service user perspectives (Davis et al. 2019). Despite the growing emphasis on interdisciplinary collaboration, only two studies could be identified, including both nursing and allied health professional group research priorities (Jarman et al. 2023; Molassiotis et al. 2020). Key limitations of priority‐setting studies to date are a focus on specific clinical areas, for example, major trauma and thoracic malignancies.

While previous research has identified a diverse range of research priorities, they also underscore a persistent gap: the absence of an integrated research priority‐setting process that actively engages both clinicians and consumers across nursing and allied health. Notably, previous priority‐setting exercises conducted across different hospitals in Western Australia have revealed varying research priorities, reflecting differences in patient populations, service delivery models, and organisational needs. This intra‐regional variation highlights the importance of context‐specific approaches and reinforces the need for further research to develop coordinated, stakeholder‐informed priorities that are relevant to local healthcare settings. Addressing this gap is critical to shaping research agendas that are relevant, equitable, and capable of driving sustainable improvements in health systems and outcomes.

2. Aim

The aim of this research project was to identify the top 10 nursing and allied health research priorities from the perspective of community members who access these health services (health service users, carers, family members) and from the perspective of nurses and AHPs who provide these health services at two metropolitan hospitals in Western Australia.

3. Methods

3.1. Study Design

This study applied an adapted JLA PSP approach (James Lind Alliance 2021) and comprised three phases: (i) community conversations, (ii) a survey, and (iii) a consensus workshop (Figure 1). The JLA PSP approach has been used extensively in various health fields and emphasises an equal partnership of researchers and community members (James Lind Alliance 2021, 2023). The adapted version of the JLA PSP approach applied in this study has been successfully used in other research priority‐setting studies and proved both feasible and effective (Mörelius et al. 2022). The key difference between the original JLA PSP approach and this study's adapted approach lies in phase one, which comprised community conversations rather than a survey. This approach enabled direct, face‐to‐face engagement with participants for the identification of research priority areas and ensured that the healthcare consumer voice was equally represented at the start of the project. These conversations facilitated the creation of a survey that was then distributed to all stakeholders in phase 2. Another difference is that research priorities that were identified by participants were not excluded if researchers established that there was sufficient evidence available in these areas—a phase referred to as ‘establishing research uncertainties’ in the original JLA PSP approach.

FIGURE 1.

Multi‐phase study design used to reach consensus on the top 10 research priorities.

3.2. Participants

This study involved two groups of eligible participants. First, healthcare users (HCU) ≥ 18 years, defined as community members who accessed healthcare services at the included hospitals in the past two years (patients); family members, friends, or carers of patients; and community members with an interest in improving healthcare services. Second, healthcare providers (HCP), comprising nurses and AHPs who practised at the included hospitals within the past two years.

3.3. Phase 1: Community Conversations

Four community conversations were conducted between August and November 2023 using an abridged version of the World Café method, to create open conversations around questions of importance to a specific topic (Sweeden et al. 2011). A decision to conduct separate community conversations for healthcare users and healthcare providers was made in consultation with the Western Australian Health Translation Network (WAHTN) Consumer and Community Involvement Program (CCIP), to prevent power imbalances and protect participants' privacy.

Recruitment of healthcare users was facilitated through WAHTN CCIP. Further, healthcare users were recruited via the hospital's consumer advisory committees, the university's consumer representative network, and through flyers placed in areas frequented by patients, such as hallways and waiting rooms across both hospitals. Recruitment of healthcare providers was conducted via invitation emails to all nursing and allied health staff at both hospitals. Additionally, flyers were placed in areas frequented by staff, such as staff rooms and kitchens.

The community conversations involved an open discussion of potential research priorities, which aimed to collect diverse and in‐depth perspectives from people with a lived experience of accessing healthcare and clinicians working in nursing and allied healthcare professional roles. Following a presentation of the study aim and design, participants were divided into small groups of 3 to 10 members, with discussions facilitated by the researchers and CCIP representatives using guiding questions (Table 1). The guiding questions were developed collaboratively by the research team and members of the CCIP to ensure the questions were clear, understandable and met the study aims. After the first workshop, the questions were reviewed by members of the research team (MW & LW) and CCIP representatives to identify potential changes; however, no changes were required.

TABLE 1.

Phase 1 guiding questions used during community conversations with healthcare users (HCU) and healthcare providers (HCP).

HCU	1. How could the hospital better support you and your family's health needs? 2. Based on your experiences at [hospital names], what have you encountered that could be addressed through future research? 3. Are there any other topics related to adult nursing and allied health, outside of your personal experiences, that could be further researched and/or investigated?
HCP	1. How could the hospital better support you in serving the community's health needs? 2. Based on your professional experiences at [hospital names], what have you encountered that could be addressed through future research? 3. Are there any other topics related to adult nursing and allied health, outside of your personal experiences, that could be further researched and/or investigated?

During phase one, three participants, whose primary language was not English, were provided with an interpreter. The interpreter was employed by a professional organisation and matched with the requirements specified for the project. There were no issues with communication identified during the session from participants or the interpreter. The interpreter received payment for their time and contribution.

Data were collected by scribes in phase 1. These scribes were members of the research team (EG, LC, LG, MW), the CCIP (IL), or staff of the collaborating hospital service (KB, HJ, LC). Subsequently, the handwritten data were transcribed by a research member who was present at all community conversations (MW). Transcripts, including verbatim quotes from participants, were checked for accuracy by members of the research team (EG, MW) in consultation with the scribes. Transcripts were coded manually and inductively, using NVivo V.12 software. An inductive coding approach was used to identify all research priority areas that were proposed by participants by assigning individual codes to each priority area. Subsequently, these individual codes were sorted and collated into codes and sub‐codes if they fell into similar topic areas, following the approach to thematic analysis by Braun & Clarke (Braun and Clarke 2021). The coding process and development of codes were conducted as a team with regular discussions. A structured report summarising the main findings from phase 1 was disseminated to all community conversation attendees via the CCIP. The report contained information about the project aims, data collection and analysis methods, preferred research priority areas from phase 1 (list of topics, examples, and anonymous direct quotes), the planned next steps (phases 2 & 3) and participation opportunities. Participants were invited to provide feedback; however, no feedback was received.

3.4. Phase 2: Survey

The phase two survey was developed following the community conversations in Phase 1 with the aim of eliciting input from a wider participant pool. The survey included three screening questions to identify the participant group (nurse, allied health professional, healthcare user, other) and currency of practice, four demographic questions, seven open‐ended questions about potential research priorities, and five multiple‐choice questions to assess participants' agreement with research areas that were proposed in Phase 1. To support face and content validity, the survey questions were reviewed by all research team members, and revisions were made via consensus to ensure clarity of wording and a comprehensive representation of topics that were identified during community conversations. Survey participants could propose new research areas (across seven open‐ended questions) and indicate their agreement or disagreement with a list of research areas that were developed in Phase 1 (across five multiple‐choice questions).

The survey was advertised to healthcare users via social media (e.g., Facebook) and via posters displayed at both hospitals. Further, relevant organisations supported the advertisement through dissemination in their own networks, including the hospital's consumer advisory councils and numerous consumer organisations (e.g., Carers WA, WAHTN CCIP, Cancer Council WA, Neurological Council WA). Advertisement to healthcare providers involved emails to all nursing and allied health staff at both hospitals, including one reminder email and posters displayed in hallways, staff rooms, and staff kitchens at both hospitals.

Survey responses were collected between December 2023 and March 2024, using Qualtrics software. Data was exported to Excel for manual cleaning and imported to SPSS V.29 and NVivo V.12 for further analysis. Demographic data and multiple‐choice questions were analysed in SPSS V.29 using descriptive statistics. Responses to open‐ended questions were analysed in NVivo V.12 using a multi‐step manual coding approach. First, survey responses were coded inductively according to themes that emerged from the data. Second, phase 1 and phase 2 codes were collated (merged, subdivided, and allocated to categories) to create a combined set of codes and sub‐codes. Finally, codes and sub‐codes across phases 1 and 2 were pre‐selected for discussion at the consensus workshop (phase 3) if themes raised in phase 1 were also raised in phase 2, either in free‐text responses or by confirming that the topic was relevant via multiple‐choice selection.

3.5. Phase 3: Consensus Workshop

A consensus workshop took place in March 2024 with HCU and HCP representatives. To recruit participants for the workshop, the advertising approaches used in phases 1 and 2 were reproduced. Additionally, previous phase 1 participants received a personal email invitation. Workshop participants were divided into five small groups with a group facilitator and a scribe at each table. A mix of healthcare consumers and healthcare professionals was achieved for all tables except one, which only contained healthcare professionals. The JLA supports an adapted Nominal Group Technique for choosing research priorities. This approach aims is to reduce the likelihood of undue influence of an individual or subgroup and encourages the participation of less assertive members, ensuring there is no hierarchy among participants and that all views and experiences are considered equally.

The Nominal Group Technique is a well‐established and documented approach to decision‐making in a variety of fields, particularly in health and social research (Manera et al. 2019). In this process, each participant was given a set of cards with one research priority area per card. Participants were asked to individually select their top 10 priorities by discarding cards that they perceived as less relevant, and to add new priorities if they felt something was missing. Next, each group was supported by facilitators to reach a group consensus through discussing their personally selected priorities with other group members. This stage took around an hour to achieve with open discussion and resorting of the cards to reflect priorities. The workshop leads (LW & MW) were mindful of potential issues, including the possibility that some participants may be more vocal than others, some may prefer to reflect in silence, and that some participants were not used to working together. The aim of the leads and the facilitators on each table was to ensure fairness, accountability and transparency and the principle of equal involvement of patients, carers and clinicians.

Once each group reached a consensus, research team members collated the top priorities of each of the five groups on a whiteboard and identified the most frequent priority areas across groups. These priority areas were then discussed with all workshop participants to reach a consensus on the top ten priorities. This stage took around 30 min for consensus to be reached.

3.6. Ethical Considerations and Data Management

Ethical approval for this study was granted by Edith Cowan University's human research ethics committee on 06/07/2023 (2023–04580‐WHITEHEAD), and the site approval was granted by the Sir Charles Gairdner and Osborne Park Hospitals Group (QI50323). All participants received a detailed study information letter and had the opportunity to ask questions prior to consenting to participate. Participation was voluntary and written consent was provided by all participants. Data from phases one and three were de‐identified at the earliest point feasible, and phase two data were non‐identifiable at the point of collection. All data was handled and stored in a secure manner in accordance with current National Health and Medical Research Council (NHMRC) guidelines and will be stored for seven years, after which time data will be destroyed in a secure manner as per Western Australian University Sector Disposal Authority (WAUSDA) guidelines. Phase one and three participants received honorariums (healthcare users) and thank you gifts (healthcare providers) in accordance with WAHTN CCIP best practice recommendations and hospital policies.

3.7. Trustworthiness

Trustworthiness during data analysis was ensured through data triangulation and researcher triangulation (Tobin and Begley 2004). The team involved in collecting the data included consumers, the research team, and healthcare professionals. The analysis was conducted by the research team comprising five nurses, a midwife, and a speech pathologist. In phase 1, the research team analysed data from the community conversations, bringing together findings from different sessions. In phase 2, one team member (MW) completed the initial survey analysis, which was then reviewed and discussed collaboratively by the research team. Team members engaged in regular meetings and accessed a secure shared site to review the data throughout the process. In phase 3, the analysis occurred in real time during the consensus workshop, allowing participants to engage directly in interpreting and refining the research priorities. The research priorities selected for discussion at the workshop were based on findings from phases 1 and 2 and were agreed upon by consensus within the research team.

4. Results

4.1. Participants

During phase one, a total of 67 people participated in four separate community conversations (Table 2), comprising two groups of healthcare users (total n = 18) and two groups of healthcare providers (total n = 49). In phase two, a total of 151 valid survey responses were collected, including nurses (n = 69, 45.7%), AHPs (n = 43, 28.5%), patients (n = 24, 15.9%) and other healthcare users (n = 15, 9.9%)—such as carers, family members, volunteers, and medical scientists. In phase three, eighteen people participated in the consensus workshop, with most participants in this phase identifying as healthcare providers (n = 13, 72%).

TABLE 2.

Study participant numbers across phases 1, 2 and 3.

	Phase 1: Community conversations (n, %)	Phase 2: Survey (n, %)	Phase 3: Consensus workshop (n, %)
Total healthcare users, of which	18 (26.9)	39 (25.8)	5 (27.8)
Patients	*	24 (15.9)	1 (5.6)
Family members, friends, or carers of patients, or interested community members	*	15 (9.9)	4 (22.2)
Total healthcare providers, of which	49 (73.1)	112 (74.2)	13 (72.2)
Nurses	*	69 (45.7)	*
Allied health professionals	*	43 (28.5)	*
Total participants	67	151	18

^*Information not available for this phase.

4.2. Phase 1: Community Conversations

Across all four community conversations, a total of 49 individual research priority areas were proposed by participants, which were merged during analysis into 39 codes. For example, the proposed priority area, rural and remote healthcare, was merged into the code access to healthcare and telehealth, capturing issues on healthcare access across urban and rural areas. Codes were allocated to one of three inductively derived categories that summarised individual codes thematically: (i) healthcare system (re)design (14 codes), specific health issues or needs (18 codes), and workforce needs (7 codes) (Figure 2). The first category, healthcare system (re)design, is related to the overall structure, processes and integration of healthcare systems. For example, this category included the code access to healthcare, which collated participants' statements about the accessibility of services in person or via telehealth in urban, rural, and remote areas. The second category, specific health issues or needs, collated participants' statements about specific health issues (e.g., lymphedema) and the needs of specific groups of people (e.g., those with a disability). The third category, workforce needs, comprised statements about issues and needs of nurses and AHPs, such as adequate staffing levels and workforce training.

FIGURE 2.

Process of research priority setting across study phases 1, 2 and 3, sorted by coding categories (number of codes at the conclusion of each phase displayed).

4.3. Phase 2: Survey

Of 191 submitted survey responses, 151 were eligible after data cleaning. Forty responses were excluded from analysis because they did not meet the eligibility criteria (n = 33) or were not clearly identifiable as survey test responses (n = 7). Female participants were overrepresented (n = 123, 84.2%) compared to male and other participants (Table 3). Among healthcare users, patients made up 61% (n = 24) of respondents, with the remaining respondents identifying as carers, family members, volunteers, medical scientists, and consumer advocates (n = 15, 38.5%). Among healthcare providers, there was a greater representation of nurses (n = 69, 61.6%) compared to AHPs (n = 43, 38.4%). Overall, survey participants' median age was 42.0 years (IQR = 21), with healthcare users being older on average (Mdn = 47.0) than healthcare providers (Mdn = 40.5). Survey respondents included Aboriginal and Torres Strait Islander people (n = 2, 1.4%), people with a disability and/or complex health needs (n = 16, 11.6%), and people with linguistic diversity (n = 7, 5.1%) and/or cultural diversity (n = 24, 17.4%).

TABLE 3.

Characteristics of survey participants (phase 2).

Variable (valid n)	Healthcare providers (n = 112)		Healthcare users (n = 39)		Total (n = 151)
	n	%	n	%	n	%
Gender (n = 146)
Female	95	85.6	28	80.0	123	84.2
Male	11	9.9	6	17.1	17	11.6
Other or undisclosed	5	4.5	1	2.9	6	4.2
	Mdn	IQR	Mdn	IQR	Mdn	IQR
Age (n = 130)	40.5	20	47.0	22	42.0	21
Participant type (n = 151)
Nurse	69	61.6	—	—	69	45.7
Allied health professional	43	38.4	—	—	43	28.5
Patient	—	—	24	61.5	24	15.9
Other	—	—	15	38.5	15	9.9
Years of practice experience (HCP n = 101)
≤ 10	45	44.6	—	—
11–20	23	22.8	—	—
21–30	18	17.8	—	—
> 30	15	14.9	—	—
Participant attributes (n = 138)
Aboriginal or Torres Strait Islander	1	1.0	1	3.0	2	1.4
Disability or special health needs	3	2.9	13	9.4	16	11.6
Linguistic diversity	6	5.7	1	3.0	7	5.1
Cultural diversity	20	19.0	4	12.1	24	17.4

Manual inductive coding of qualitative survey responses yielded 67 initial codes for phase 2 only. Data from phases 1 and 2 were then combined, allocating all codes to one of the three previously identified categories and merging overlapping or similar codes, yielding a set of 40 codes. For example, dementia was raised in phases 1 and 2 and delirium was raised in phase 2 only, which was combined into a single code dementia and delirium. Of these, 22 themes were raised across both phases 1 and 2 (either via free‐text or multiple‐choice selection) and were pre‐selected for discussion at the consensus workshop (Figure 2). For example, the theme pain and chronic pain was raised in phase one but not raised at all in phase 2 and therefore removed from the pre‐selection. This final selection at the end of phase two was confirmed by consensus in the research team to prevent less popular priorities from being excluded at this point, and allowing for in‐depth discussion at the consensus workshop. The possibility for participants in phase 3 to raise new items that felt missing from the pre‐selection of 22 themes ensured that in this final phase, research priorities could have been re‐included.

4.4. Phase 3: Consensus Workshop

The consensus workshop resulted in a selection of the top ten research priorities across the categories healthcare system (re)design (3 priorities), specific health issues or needs (5 priorities) and workforce needs (2 priorities) (Figure 2). Within this top ten list, priorities were not further ranked. Table 4 provides an overview of each research priority, including indicative research topics and exemplary participant quotes.

TABLE 4.

Top ten research priorities.

Research priority	Indicative research topics	Exemplary participant quotes
Access to healthcare	Efficient healthcare access and referral pathways Impact of delays in healthcare access on patients' health and healthcare systems Availability of health services in the community Feasibility of providing specialist services in rural/remote areas Equity of healthcare provision across jurisdictions Innovative healthcare access via telehealth and hybrid models	“GP [general practitioner] services are becoming harder to access and so expensive in this time where food and other essentials are so expensive. People are leaving their conditions too long because the GP is too busy, too expensive, does not care, is running an hour late or cancels appointments with little to no notice—leading to sicker people or those who attend ED [emergency department] when not required. Fixing the community health and state of GP services will lessen the burden of the tertiary hospitals.” (Nurse, P2:129)
Patient journey and quality of care	Patient journey through the hospital and community health services Patients' experience of care provided by nurses/allied health professionals in meeting their needs Impact of tailoring care routines in hospitals to the needs of patients Ideal timing and access to rehabilitation Impact of holistic, patient‐centred care and continuity of care models Review of patient complaints	“I would like research on the long‐term impact of positive/negative healthcare experiences (on trust, recovery, etc.).” (Healthcare User, P1A:T2) “The clinic should not revolve around the surgeons—that's disrespectful and possibly negatively impacting health outcomes for the patient (e.g., ministroke, constipation) which all increases things like falls risks [and] … mortality.” (Allied Health Professional, P2:62)
Streamlining care	Efficiency of patient admission and discharge, including transition back into the community Effective transitions between health services Impact of un/successful information sharing across services and duplication of care Efficiency of interprofessional collaboration Technological innovations to streamline flow of patients and information Transition of children into adult health services Effectiveness of national programs such as the National Disability Insurance Scheme (NDIS), MyAgedCare and the Medicare App	“Many hospitals these days have multi‐disciplinary teams managing a patient case. This seems to be a good idea from a medical viewpoint but the communication to the patient is seriously lacking. Different team members may see the patient and give a partial explanation and, in the end, a very ill patient, perhaps on high pain killer doses, has no idea what is happening. These medical teams need to have strategies in place to communicate with patient and next of kin. [We need] research how effective these teams actually are.” (Community Advisory Council Member, P2:97) “Communication is a problem! E.g., being unnecessarily wheeled off for a treatment that was already cancelled … If documentation is correct, this could impact shorter stay, less repeat care, less confusion, shorter discharge.” (Healthcare User, P1B:T2)
Aboriginal and/or Torres Strait Islander Peoples	Effective engagement and healthcare access for Aboriginal and/or Torres Strait Islander Peoples Quality of care for Aboriginal and/or Torres Strait Islander Peoples Inclusion of remotely living populations in research	“We had an Aboriginal [Health] Day here. But no one told the Indigenous person to attend. So, it's not ‘did‐not‐attend’, it's lack of communication. We need research into ‘did‐not‐attend’.” (Healthcare Provider, P1C:T1)
Caring for carers	Clarity around involvement of carers, including carer rights, guardianship and power of attorney Needs of carers, including time off, support, and effective communication with health services	“My concerns are: What is the expanded role of carers? … If carers have rights, how do you manage this when carers change?” (Carer Representative, P1B:T2) “Carers should have time off as well … There should be [a] replacement care service.” (Healthcare User, P1B:T2)
Dementia and delirium	Care for people with dementia or delirium Efficient communication strategies Specialist units/wards/teams Impact of environment on dementia/delirium	“[We should research] delirium, cognitive decline and how this often worsens when elderly patients are in the unfamiliar hospital environment.” (Allied Health Professional, P2:103)
Mental health	Complex trauma, intergenerational trauma Impact of hospital stay on mental health Efficient strategies to reduce anxiety Efficiency of dedicated mental health areas within emergency departments	“[Relating to] mental health: [there is a] high incidence of code blacks, long stays in ED [emergency department], high use of chemical and mechanical restraints, [and] healthcare experiences [that are] traumatising patients” (Nurse, P2:90)
Care of the older person including palliative care	Survivorship End of life care, including dedicated teams Voluntary assisted dying, including impact on staff providing this type of care	“Research is required to continue to focus on addressing frailty and frailty syndromes and to look at better ways to continue to service this population.” (Allied Health Professional, P2:85) “In the palliative care cohort … Ask patients what matters to them? e.g., dying at home. Focus on comfort care rather than treatment for life limiting illnesses.” (Nurse, P2:78)
Workforce training and scope of practice	Effective continuous professional development to ensure up to date knowledge and skills Culturally safe practice Scope of practice and job profiles Leadership succession planning	“Whether nursing staff with extended skills, e.g., cannulation, improve patient experience and bed flow.” (Healthcare User, P2:110) “The impact of nurse led clinics on patient outcomes. Nurses have unique skills and can practice autonomously when required; we need the opportunities to be able to do this.” (Nurse, P2:54)
Workforce well‐being, retention and adequate staffing	Workforce well‐being and retention strategies Impact of night shifts on staff health (including mental health, sleep and hormonal changes) Impact of staff exposure to abusive behaviour Equal opportunity and inclusivity of diverse staff Resilience and burnout Sufficient and safe staffing levels	“I would like … research to shine the light on the modern practices of healthcare and how they have lost sight of the patient and their families … occasionally you find one good person in the team, but they often have no power in the greater system—and it is these good people … who end up leaving … Without caring and great leadership, you have a system … [of] economic rationalism instead of prevention and early intervention.” (Healthcare User, P2:140) “Issue of nurses leaving the profession and nurses feeling valued. Staff shortages and use of agency staff impact on quality and safety.” (Healthcare User, P1B:T1)

Note: Participants are identified by their group allocation (e.g., Allied Health Professional), study phase (e.g., P2 = Phase 2) and participant number, where possible (e.g., 28). Community conversation and workshop participants are further identified by their small‐group table (e.g., T2 = Table 2), and—in the case of community conversations—event number (four community conversations: 1A, 1B, 1C, 1D).

Access to healthcare was ranked a top priority in this study. Participants highlighted the need for efficient access to services and referral pathways. The second priority area, patient journey and quality of care, highlighted the need for individualised, holistic care. This priority included the provision of services that reflect the values of person‐centred care to engender trust, reflect the routines and priorities of service users and promote continuity of care. The third priority, streamlining care, highlighted the importance of efficiency in services in relation to flow through the system, transitions between services, including between hospital and community and between child and adolescent services and adult services. The next five priority areas were related to the provision of culturally relevant care for specific population groups and people living with specific conditions. In this study, five priority groups, Aboriginal and Torres Strait Islander Peoples, carers, people living with dementia and delirium, people living with mental health needs and palliative care and older adults were all highlighted as priority groups.

5. Discussion

Research priority setting with consumers and clinicians supports the vision to align and direct resources for health research with priority areas of need. Transparency of reporting on the process used to generate the priorities is important in legitimising and adding credibility. We used a priority‐setting partnership process to identify the top 10 nursing and allied health research priorities for a metropolitan health service involving two tertiary hospitals. Partnering with consumers and clinicians was key to ensuring that the research priorities were of direct relevance to health service users and staff. The project aligned with national and international standards for stakeholder involvement in research (National Health and Medical Research Council 2024; James Lind Alliance 2021). We sought to create a diverse representation of consumers and clinicians to ensure that the perspectives of multiple population groups were captured.

The top ten priorities identified indicate a strong focus on the provision of clinical care, on ensuring that population groups are recognised and included in care and the importance of supporting and maintaining the workforce.

In relation to access to healthcare, participants highlighted the need for efficient access to services and referral pathways. Having timely access to healthcare professionals when a person needs it is crucial to preventing, treating, and managing health conditions (Australian Institute of Health and Welfare (AIHW) 2020). In Australia, half (50%) of patients who did not see a general practitioner (GP) when they needed to, stated that this was related to not being able to book an appointment, and nearly half of patients (45%) reported that they could not see a specialist when they needed to because of the cost associated with this (AIHW 2020).

This priority area also highlighted the value placed on equity of access to services for those in rural and remote areas, community settings and access to innovative models of delivery. The World Health Organisation (WHO) states that equity of access to health services is central to universal health coverage and that too many people, especially the most vulnerable and marginalised people in our societies, cannot access the care they need due to economic, geographic, epidemiological, or cultural barriers (WHO 2024a). The Australian Institute of Health & Welfare (2020) reported that patients with high health needs were over three times more likely than those with low health needs to report there was a time that they needed to see a GP but did not go and 3.6 times more likely to report the same scenario in relation to visiting a specialist. Key to progressing research and practice change are the identification of barriers followed by the development of evidence‐based solutions to progressively expand access, while ensuring the highest possible quality of care. The evidence supports the need for health systems that are integrated and resilient (WHO 2024b), providing effective access to primary healthcare and timely access to secondary and tertiary care. Health promotion and preventive services reduce the burden of disease and safe and effective surgery saves lives. These align with the Sustainable Development Goals (SDG) target 3.8, which focuses on achieving universal health coverage, including access to quality essential health care services.

The patient journey and quality of care, the second priority area highlighted the need for individualised, holistic care. This priority included the importance of person‐centred care, trust and the provision of services that acknowledge the routines and priorities of service users in order to promote continuity of care. Multiple sources of evidence demonstrate that receiving person‐centred healthcare services is correlated with improved quality of life for patients with chronic diseases (John et al. 2020) and overall health outcomes or self‐management behaviours (Havas et al. 2017; John et al. 2021). Patient‐centred care supports patients to engage in their care, but there is still work to be done in the provision of person‐centred care to meet diverse needs (Raymundo et al. 2021) and limitations in healthcare providers' ability to provide culturally safe care (Harrison et al. 2019).

The third priority area, streamlining care, included the efficiency of services to enhance patient flow and service transition. Similar studies have acknowledged the need for research about systems and processes to support patient care, particularly nursing documentation, technology, and informatics (Janerka et al. 2023; Aungsuroch et al. 2019; Lusmilasari et al. 2020). This area of focus creates multiple opportunities for research into staff and process‐related efficiency issues at the micro (e.g., individual), meso (e.g., department), and macro level (e.g., organisation).

Five priority areas related to the provision of culturally safe care for specific population groups and people living with specific conditions. Specific population groups are often highlighted by funders as priority groups, but not often highlighted in priority‐setting studies. In this study, five priority groups, Aboriginal and Torres Strait Islander Peoples, carers, people living with dementia and delirium, people living with mental health needs and palliative care, and older adults, were all highlighted as priority groups. The specific areas of research highlighted as priority areas for each population group varied. The focus of the research topics in each group differed and cannot be grouped together in terms of the focus of the specific research areas prioritised for each group. Collectively, though, there is much evidence that there are pervasive gaps in service delivery to socio‐economically disadvantaged populations, including Aboriginal and/or Torres Strait Islander Peoples, culturally and linguistically diverse (CALD) populations, and people living in rural and remote settings. These challenges require system‐wide and targeted policy‐level intervention to further improve service delivery that requires effective and functional local health service coordination, sectoral integration, and the improvement of healthcare providers' ability to provide culturally safe care (McCullough et al. 2021; Mengistu et al. 2023; Napier et al. 2017).

Recognition of the needs of the workforce in relation to well‐being and retention, and the value of training was highlighted in the last two priority areas. The need for support included education and training for nurses and AHPs, clinical support, efficient processes, and optimal staffing. Ongoing professional development is essential in fostering evidence‐based practice to maintain and improve clinical care (Sapri et al. 2022). Participants in our study identified the importance of staff being supported to ensure they are up to date in their knowledge and skills, that they are able to provide culturally safe care, and that there is leadership succession planning.

Staffing was a priority for participants, including sufficient and safe staffing levels and equal opportunity and inclusivity. In relation to research, the participants described the need for studies into what safe and optimal staffing looked like in hospital settings and the impact of these on patient care. The well‐being of staff was described as a priority area for research into the impact of night shifts on staff health, the impact of exposure to abusive behaviour, and resilience and burnout were highlighted. This priority area resonates with the global estimate of a projected shortfall of 10 million health workers by 2030 (WHO 2024c). Healthcare workers report high levels of stress and burnout (WHO 2024d). Increases in absence from work and the unprecedented number of nursing strikes are symptoms of the current state of health systems. These reactions have been highlighted as reflective of staff shortages, low pay, inadequate and unsafe working conditions, extraordinarily stressful environments, and a lack of needed workplace safeguards (WHO 2024d). At least a quarter of health and care workers reported anxiety, depression, and burnout symptoms between January 2020 and April 2022, and no significant reductions have been observed since (WHO 2024d).

A critical reflection on the outcomes of this study is the observation that an evidence base does exist on the areas highlighted by healthcare consumers and staff. For example, research exists on issues related to recruitment and retention of staff and the mediating effect of education, skill mix, patient acuity, and well‐being. Understanding how the existing data from primary and secondary research studies on the priority areas identified in this study will be important. Any research projects or health service changes resulting from this study need to acknowledge and incorporate existing evidence relating to the priority areas identified.

The identification of the top ten priorities for nursing and allied health research is an important step, but also the start of a journey. The next steps relating to how to take the priority areas forward to inform and shape the research agenda are critical if the voices of healthcare consumers, nurses and AHPs are to be acknowledged and shape future research.

5.1. Dissemination and Impact

Dissemination of the results will increase the reach of the information and require targeted approaches to ensure that potential funders and researchers are aware of the priority list and have access to this information. A dissemination plan has been created, identifying relevant audiences, how to reach them, and how the research team can support the dissemination process. The research priority list has been shared with the leadership team at the organisations involved, and in principle, agreement is in place, ensuring that research supported within the organisation will align and address priority areas identified in this study. This will include applications for organisational funding as well as external grant applications. The top ten priorities have been presented to a health consumer body, and once the publication is available, dissemination to a wider network of consumer groups, peak bodies, and funders will be pursued. We will work with organisations to disseminate the findings through newsletters, websites, presentations at conferences and workshops and mainstream and social media. Care will be taken to ensure information is written in language accessible to everyone with an interest in the findings, not just those with a research or health background. We are aware that whilst the top 10 priorities contain topics that matter to patients, carers and clinicians, they are not developed as research questions that researchers and funders can instantly use. Further work will be required by the research team, after the “Top 10” are published, to identify research questions that meet research funder requirements. This work will progress shortly, involving stakeholder workshops that include healthcare consumers and clinicians. The group will identify: What are the questions that need to be addressed; details of the patient group, intervention, comparator and proposed outcomes; why the question is important; what the existing evidence is and if the question is specific to a condition, or more broadly applicable. For each research question, the group will explore if there is a need for primary research and where there is a need for a systematic review or scoping review.

Communication of the outcomes to key stakeholders, including researchers, healthcare organisations, and external funders, will enable planning and future research to be coordinated and directed to areas of high priority.

5.2. Strengths and Limitations

A strength of this study is the deliberate democracy approach that created a discursive approach to elicit research priorities. Deliberating research priorities helps to ensure that multiple perspectives are considered and fosters an understanding of the views of others (Safaei 2015). This study sought to enhance the legitimacy of the research priority‐setting process by harnessing the power of deliberation.

The study had several limitations. Whilst the sample size was comparable to or larger in comparison with other studies on research priority setting, the sample does reflect a sub‐population of a larger body of consumers and clinicians. The three‐phase approach did allow for inclusion of consumers and clinicians at each stage and offered an online participation option for those unable to take part in face‐to‐face meetings. It is important to remain open to the possibility that the consumer and clinician populations who participated may not adequately represent the broader population. Detailed information on the consumer experience of healthcare, for example, whether someone had experience of emergency care, scheduled surgery, or medical care, was not collected. Information on the relationships of family members or carers was not sought, for example, whether they were primary carers. We did not document the area of work or speciality focus of healthcare professionals. The response rate is unknown as the distribution relied on snowball sampling with the recruitment information shared across organisations and on social media platforms with the aim of reaching diverse consumer and community groups and nurses, and AHPs. Participants self‐selected to be involved in the study, which may introduce response bias and, along with the study being conducted in one geographical area, the generalisability of results may be limited. A greater number of clinicians than consumers participated in the survey, which may bias the results toward the clinician perspective. A steering group was not set up for this study, and this may have helped to further balance the representation of consumers and clinicians. Priority topics identified from this research were broad and will require further exploration in the development of specific research questions.

6. Conclusion

This study identified the top 10 priorities for research in nursing and allied health services in an Australian health service. Involving consumers and clinicians in the process has informed a research agenda based on key priorities that are of direct relevance to health service users and staff. Involving stakeholders at the very beginning of the research process and deciding what needs to be researched also fosters the democratisation of research. This study provides guidance on how to involve key stakeholders effectively, inclusively, and transparently.

Access to healthcare was a top research priority, followed by the patient journey and quality of care. The priorities are reflective of those reported internationally and are underpinned by the goal of research improving the provision of clinical care. The priorities will inform strategic planning and research funding of nursing and allied health professional research at the organisational level.

Author Contributions

All authors have satisfied the conditions for authorship. Marina Weckend: conceptualisation, methodology, investigation, analysis, visualisation, project administration, writing (original draft, review and editing); Lucy Gent: conceptualisation, methodology, investigation, funding acquisition, writing (review and editing); Erin Godecke: methodology, investigation, analysis, writing (original draft, review and editing); Linda Coventry: conceptualisation, methodology, investigation, writing (review and editing); Gemma Doleman: conceptualisation, methodology, investigation, writing (original draft, review and editing); Amanda Towell‐Barnard: methodology, investigation, writing (review and editing); Lisa Whitehead: conceptualisation, methodology, investigation, analysis, project administration, funding acquisition, writing (original draft, review and editing).

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1: jan70190‐sup‐0001‐DataS1.docx.

Weckend, M. , Gent L., Godecke E., et al. 2026. “Research Priorities for Nursing and Allied Health: A Priority‐Setting Project Using a Partnership Approach.” Journal of Advanced Nursing 82, no. 5: 5444–5456. 10.1111/jan.70190.

Data Availability Statement

The datasets collected and analysed in this study are not available to the public due to ethical constraints to protect the anonymity of participants. The data that support the findings of this study are available from the corresponding author upon reasonable request.