ArticleCMAJ open
The challenges of measuring quality-of-care indicators in rural emergency departments: a cross-sectional descriptive study.
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- Evaluating age-friendly emergency care quality in Iranian hospitals.BMC emergency medicine · 2026Article
- Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study.BMC research notes · 2017Article
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15 authors.
Géraldine LayaniResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Richard FleetResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Renée DallaireResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Fatoumata K TounkaraResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Julien PoitrasResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Patrick ArchambaultResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Jean-Marc ChaunyResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Mathieu OuimetResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Josée GauthierResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Gilles DupuisResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Alain TanguayResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Jean-Frédéric LévesqueResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Geneviève Simard-RacineResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Jeannie HaggertyResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
France LégaréResearch Chair in Emergency Medicine Université Laval - Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (Layani, Fleet, Dallaire, Tounkara, Archambault, Tanguay), Lévis; Department of Family and Emergency Medicine (Fleet, Poitras, Archambault); Intensive Care Division (Archambault), Department of Anesthesiology, Université Laval, Québec; Department of Family and Emergency Medicine (Chauny), Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal; Department of Political Science (Ouimet), Université Laval, Québec; Health Care Services Systems Analysis and Evaluation Directorate(Gauthier), Quebec Public Health Institute, Université du Québec à Rimouski, Rimouski; Department of Psychology (Dupuis), Université du Québec à Montréal, Montréal, Que.; Centre for Primary Health Care and Equity (Lévesque), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Emergency Medicine (Simard-Racine), Centre de santé et de services sociaux de La Matapédia, Amqui; McGill Chair in Family and Community Medicine Research (Haggerty), St. Mary's Hospital Centre and McGill University, Montréal; Department of Family Medicine and Emergency Medicine and Knowledge Transfer and Health Technology Assessment Group, Centre hospitalier universitaire de Québec Research Centre (Légaré), Evaluative Research Unit, Université Laval, Québec, Que.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence-based indicators of quality of care have been developed to improve care and performance in Canadian emergency departments. The feasibility of measuring these indicators has been assessed mainly in urban and academic emergency departments. We sought to assess the feasibility of measuring quality-of-care indicators in rural emergency departments in Quebec.
methodsWe previously identified rural emergency departments in Quebec that offered medical coverage with hospital beds 24 hours a day, 7 days a week and were located in rural areas or small towns as defined by Statistics Canada. A standardized protocol was sent to each emergency department to collect data on 27 validated quality-of-care indicators in 8 categories: duration of stay, patient safety, pain management, pediatrics, cardiology, respiratory care, stroke and sepsis/infection. Data were collected by local professional medical archivists between June and December 2013.
resultsFifteen (58%) of the 26 emergency departments invited to participate completed data collection. The ability to measure the 27 quality-of-care indicators with the use of databases varied across departments. Centres 2, 5, 6 and 13 used databases for at least 21 of the indicators (78%-92%), whereas centres 3, 8, 9, 11, 12 and 15 used databases for 5 (18%) or fewer of the indicators. On average, the centres were able to measure only 41% of the indicators using heterogeneous databases and manual extraction. The 15 centres collected data from 15 different databases or combinations of databases. The average data collection time for each quality-of-care indicator varied from 5 to 88.5 minutes. The median data collection time was 15 minutes or less for most indicators.
interpretationQuality-of-care indicators were not easily captured with the use of existing databases in rural emergency departments in Quebec. Further work is warranted to improve standardized measurement of these indicators in rural emergency departments in the province and to generalize the information gathered in this study to other health care environments.
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