The challenges of measuring quality-of-care indicators in rural emergency departments: a cross-sectional descriptive study

Abstract

P roviding equitable quality emergency care to rural citizens in a vast country with limited financial and human resources is a great challenge. Twenty percent of Que-bec's population lives in rural regions, 1 and rural emergency departments in the province receive an average of 19 000 visits per year. 2-6 Given the limited access to diagnostic services, family doctors and other specialists in rural areas, rural emergency departments constitute an essential safety net for the rural population. 2-4,7 Furthermore, in an effort to limit the inherent costs related to emergency departments in rural regions, several Canadian provinces have reduced or regional-ized these services. 8-10 As a result, numerous hospitals have been forced to reduce services or to close altogether. 11 The impact of this situation on the quality of care is not well known. Timely attempts to measure and monitor quality of care in rural emergency departments are thus warranted. The publication Development of a Consensus on Evidence-Based Quality of Care Indicators for Canadian Emergency Departments 12 takes us a step closer to this objective. This document, which was published in 2010, was created by a panel of 24 Canadian experts including managers, clinicians, emergency medicine researchers, health information specialists and government representatives. The selected indicators are related to interventions for life-threatening conditions often treated in emergency departments, Background: Evidence-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.