Grant: Travel Awards - Institute Community Support

Canada has the longest average emergency department (ED) waiting time in the developed world, and Quebec has the longest waiting time among all Canadian provinces. A critical proportion of patients presenting at EDs are potentially experiencing conditions that could have been avoided if they had received continuous and timely primary care. With the increasing availability of electronic medical record (EMR) data, it has become feasible to collect a large amount of data about patients presenting to ED. This study uses ED data from one of the largest EDs in Montreal before and after relocation. Data were collected in the years 2012-14 (Vic site) and 2014-16 (Glen site). The appealing advantage of this 'natural study setup' is that major organizational and infrastructural components were likely not affected by the move of the hospital, however, certain components may have changed which would allow for an evaluation of the effect of these changes on various outcomes. Objective:1. To identify relevant factors in the emergency care setting (patient, process, time predictors, and care level) that are associated with work- and patient-flow 2. What fraction of ED admissions is potentially avoidable by having continuity of primary care and what is the view point of ED staff about the factors associated with the change in ED waiting time at the new site. Design: Sequential Explanatory Mixed Methods Setting: ED EMR data. Participants: EMR data 2012-16, key informant interviews of 15 ED staff. Primary and secondary outcome measures: Patient waiting time in ED, associated factors and perceptions of ED staff about the difference in ED waiting time and care at the new site. Results and conclusions:1) To characterize an ED patient sub population that would potentially benefit from enhanced primary care access and use 2) To visualize what has changed after the move of ED sites in one comprehensive illustration.