Database of Health Workforce Innovations

It is critical that Canada’s rural Emergency Departments (EDs) remain open and staffed. It is of national interest to avoid unnecessary rural patient transfers to urban and tertiary care centres already at full capacity. Similarly, robust repatriation of patients back to their rural origin will optimize tertiary care capacity. Some rural regional hospitals have ICUs, in-situ ventilator capability, and a core generalist specialty service but require specific attention and support.

Rural Canadian resources are ill equipped for the pandemic. Rural EDs are much smaller and have limited human health resources making it difficult to mitigate staff illness, self-isolation/quarantine requirements and burn-out. The staffing models and service impacts are also different. Full scope rural family practice generalists cover multiple community roles simultaneously. In addition to ED coverage they provide office practice, inpatient and long-term care, maternity and obstetrics, OR assisting, chemotherapy, remote clinic oversight, Indigenous population outreach and transfer medicine to name a few.

Rural Canadian hospitals are now struggling with supply chains of basic medications (MDI, antibiotics, sedation agents), testing supplies and Personal Protective Equipment. Coupled with more prolonged testing turnaround times and fewer resources for managing and educating staff, there needs to be increased attention to rural access to care during the COVID19 pandemic.