{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:18:23Z","timestamp":1765887503359,"version":"3.48.0"},"reference-count":48,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,4,3]]},"published-print":{"date-parts":[[2013]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>Emergency Department Management Guide<\/jats:italic>\n                      , a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the\n                      <jats:italic>Guide<\/jats:italic>\n                      recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>Emergency Department Management Guide<\/jats:italic>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This protocol has been approved by the CSSS Alphonse\u2013Desjardins 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-002961","type":"journal-article","created":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T18:11:38Z","timestamp":1367431898000},"page":"e002961","source":"Crossref","is-referenced-by-count":10,"title":["Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol"],"prefix":"10.1136","volume":"3","author":[{"given":"Richard","family":"Fleet","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Universit\u00e9 Laval, L\u00e9vis, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Archambault","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Universit\u00e9 Laval, L\u00e9vis, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"France","family":"L\u00e9gar\u00e9","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Knowledge Transfer and Health Technology Assessment of the CHUQ Research Centre (CRCHUQ), Unit\u00e9 de Recherche \u00c9valuative, Universit\u00e9 Laval, Quebec, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Marc","family":"Chauny","sequence":"additional","affiliation":[{"name":"D\u00e9partement de m\u00e9decine familiale et de m\u00e9decine d'urgence, Centre de recherche de l'H\u00f4pital du Sacr\u00e9-C\u0153ur, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Fr\u00e9d\u00e9ric","family":"L\u00e9vesque","sequence":"additional","affiliation":[{"name":"Direction des syst\u00e8mes de soins et services, Institut national de sant\u00e9 publique du Qu\u00e9bec, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Ouimet","sequence":"additional","affiliation":[{"name":"D\u00e9partement de science politique, Pavillon Charles-De Koninck, Quebec, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Dupuis","sequence":"additional","affiliation":[{"name":"D\u00e9partement de psychologie, Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie","family":"Haggerty","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, St. Mary's Research Centre, McGill University, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Poitras","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Universit\u00e9 Laval, L\u00e9vis, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Tanguay","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Emergency Medicine, Universit\u00e9 Laval, L\u00e9vis, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genevi\u00e8ve","family":"Simard-Racine","sequence":"additional","affiliation":[{"name":"Departement of Emergency Medicine, CSSS de La Matap\u00e9dia, Qu\u00e9bec, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9e","family":"Gauthier","sequence":"additional","affiliation":[{"name":"Direction de l'analyse et de l'\u00e9valuation des syst\u00e8mes de soins et services, Institut national de sant\u00e9 publique du Qu\u00e9bec, Universit\u00e9 du Qu\u00e9bec \u00e0 Rimouski, Rimouski, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,4,29]]},"reference":[{"key":"2025121510423972000_3.4.e002961.1","first-page":"CD005314","article-title":"Interventions for increasing the proportion of health professionals practising in rural and other underserved areas","volume":"1","author":"Grobler","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121510423972000_3.4.e002961.2","first-page":"CD003798","article-title":"Specialist outreach clinics in primary care and rural hospital settings","volume":"1","author":"Gruen","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121510423972000_3.4.e002961.3","unstructured":"Institut canadien d'information sur la sant\u00e9. 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