RT Journal Article
SR Electronic
T1 The challenges of measuring quality-of-care indicators in rural emergency departments: a cross-sectional descriptive study
JF CMAJ Open
FD Canadian Medical Association
SP E398
OP E403
DO 10.9778/cmajo.20160007
VO 4
IS 3
A1 Géraldine Layani
A1 Richard Fleet
A1 Renée Dallaire
A1 Fatoumata K. Tounkara
A1 Julien Poitras
A1 Patrick Archambault
A1 Jean-Marc Chauny
A1 Mathieu Ouimet
A1 Josée Gauthier
A1 Gilles Dupuis
A1 Alain Tanguay
A1 Jean-Frédéric Lévesque
A1 Geneviève Simard-Racine
A1 Jeannie Haggerty
A1 France Légaré
YR 2016
UL http://www.cmajopen.ca/content/4/3/E398.abstract
AB 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.Methods: We 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.Results: Fifteen (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.Interpretation: Quality-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.