Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada
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Emergency departments (EDs) are key entry points to hospital care, and issues of overcrowding and poor patient flow have become a priority in Canada. Studies have sought to determine factors that influence ED wait times in an effort to improve patient flow. We sought to identify the impact of factors such as patient age, triage level, comorbid factor level and sex to determine their effects on length of stay (LOS) and the role that they play in the ED and in an inpatient setting. ⋯ Continued efforts to further reduce ED LOS are crucial, because this has the potential to influence outcomes, efficiency of EDs and succession to inpatient status, which may affect costs to the health care system. Patient-specific factors need to be considered when formulating and refining policies and processes to improve patient flow.
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Case Reports
Patient advocacy by rural emergency physicians after major service cuts: the case of Nelson, BC.
Efforts at cost containment through regionalization have led to reduced services in several rural emergency departments (EDs) in Canada. As a result, questions have been raised about patient safety and equitable access to care, compelling physicians to advocate for their patients. ⋯ We describe our experience of patient advocacy after major service cuts at Kootenay Lake Hospital in Nelson, BC. Despite mixed results, we suggest increased physician involvement in patient advocacy.
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Aboriginal people are substantially more likely to be injured or die in motor vehicle crashes (MVCs) than the general population. However, research examining MVCs among Canadian Aboriginal populations is limited. We examine trends and gaps in the Canadian literature and suggest priorities for future research. ⋯ This review indicates that rates of death, hospital admission and injury related to MVCs are twice as high among Aboriginal populations than the general Canadian population, which highlights a major public health concern. Priorities for future research should include examination of the social environment, more rigorous methods and collaborative research in partnership with Aboriginal communities.