Department of Family Medicine and Emergency Medicine, Université Laval, Lévis, QC, Canada.
BMJ Open. 2013 Apr 29;3(4). doi: 10.1136/bmjopen-2013-002961. Print 2013.
Emergency 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.
To 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.
This 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.
急诊部门是居住在农村地区的人们的重要安全网。此外,这些地区出现了医疗服务获取方面的严重问题。为农村地区提供优质急诊护理服务所面临的挑战包括招聘和留用问题、缺乏先进的成像技术、缺乏专业支持以及严重依赖长途救护车运输。魁北克省卫生和社会服务部发布了新版《急诊部管理指南》,旨在改善急诊部管理并实现急诊护理和服务的人性化。该指南特别推荐了解决困扰农村急诊部的问题的解决方案。不幸的是,没有研究评估过所提出建议的实施情况。
为全面了解魁北克省所有农村急诊部,将从魁北克省卫生和社会服务部、魁北克创伤登记处以及急诊部和救护车服务管理人员的数据库中收集数据。将使用加拿大统计局的数据来描述人口和农村地区。为了评估 2006 年《急诊部管理指南》的使用情况及其各项建议的实施情况,将对急诊部管理人员进行在线调查和电话访谈。将对在农村急诊部工作的医生和护士的工作生活质量进行两次在线调查。将从数据库和患者病历中收集护理质量指标。将使用统计(描述性和推断性)程序对数据进行分析。
本方案已获得 CSSS Alphonse-Desjardins 研究伦理委员会的批准(项目 MP-HDL-1213-011)。研究结果将发表在同行评议的科学期刊上,并在一次或多次科学会议上展示。