It’s happened in places like Coaticook, Senneterre and Rivière-Rouge. In recent years, more and more rural emergency services have been shut down, especially owing to nursing staff shortages. But according to Richard Fleet, emergency medicine physician and researcher at the VITAM sustainable health research centre affiliated with Université Laval, the solution partly lies beyond hospital walls.

One in five Canadians live in a rural environment, and they are three times more likely than people living in urban areas to succumb to their injuries following a severe trauma. Even so, there is very little scientific literature on rural emergencies. Dr. Fleet, who is also the director of the emergency medicine research and innovation chair (Chaire de recherche et d’innovation en médecine d’urgence), has made it his mission to document the inequalities in access to health care services between urban centres and outlying areas and, most importantly, address the situation.

Going full-scale

He believes that to create change, the community must be mobilized around a hospital within an innovation ecosystem where citizens, researchers, healthcare workers, creators, users, entrepreneurs and decision-makers join forces to improve the health of the population. And that led to the founding of Living Lab Charlevoix. The closure of the Baie-Saint-Paul ER between 4 p.m. and 8 a.m. in summer 2021 was an opportunity for the living lab to demonstrate its relevance.

Rooted in empathy, the design thinking method encourages the search for innovative solutions to keep emergency services available 24 hours a day. Nurses shared their thoughts on their working conditions, their quality of life and the ways to avoid closure. In the end, they agreed to self-managed 12-hour shifts to reduce compulsory overtime. Not only was closure avoided, additional means, like tasking non-nursing staff with disinfection and administrative duties and promoting the nursing profession in schools, were put in place to prevent the situation from recurring.  

How many lives were saved? Richard Fleet can’t say exactly, but the impact has been significant. All it took was listening to people and empowering the community. Dr. Fleet now hopes to replicate the learnings elsewhere in Québec.   (in French only)