Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

Abstract

IntroductionEmergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations.Methods and analysisTo develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures.Ethics and disseminationThis protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

Quality of work life of rural emergency department nurses and physicians: a pilot study

“…The study described here constitutes a preliminary step in a larger study designed to develop a portrait of all EDs in rural Quebec [ 10 , 11 ]. This pilot study had two objectives.…”

Comparison of access to services in rural emergency departments in Quebec and British Columbia

“…Whether the differences in access reflect the implementation strategies associated with this updated guide awaits further study. 37 …”

The Quebec emergency department guide: A cross-sectional study to evaluate its use, perceived usefulness, and implementation in rural emergency departments

“…The study constituted one component of a larger evaluative and descriptive study of rural EDs in Quebec and the use of the QEDMG. 12,20 Data were collected from directors of professional services (DPS), directors of nursing services (DNS), head nurses (HN), and emergency department directors (EDD). Eligible participants who worked in a rural hospital in the province of Quebec were 18 years of age or older and had worked full-time in their current position for a minimum of 6 months.…”

“…[5][6][7][8][9][10] Recent studies suggest that rural EDs provide limited services, and an average of 300 patients per year/facility require interfacility transfers often on an urgent basis to access diagnostic services and definitive care at urban referral centres often hundreds of kilometres away. [11][12][13][14] Appropriate care for the specific and significant needs of rural populations requires optimization of rural emergency services. 1,4,[15][16][17] Yet, there are no recent established standards on what services they should provide.…”