Bridging the Gap in Rural Emergency Care: A Scoping Review of Living Lab Hospitals and their Potential in Rural Healthcare

Abstract

Abstract Background. Rural Canadian hospitals are increasingly vulnerable to service reductions and emergency department closures, compromising the emergency care access for the 6 million residents (20% of the population) living in these areas. Current standards for rural emergency care in Canada are outdated, necessitating innovative, locally adapted solutions. The Living Lab concept, a collaborative, real-world innovation ecosystem involving patients, citizens, healthcare professionals, learners and researchers, may address this gap. In 2020, we initiated a rural Living Lab hospital project in Charlevoix, Québec, where no prior studies on such hospitals existed. Our research aims to assess the current state of literature on rural Living Lab hospitals. Objectives. Our specific goal was to examine and characterize the existing research on Living Lab Hospitals in rural settings while precisely identifying areas where further research is required. Methodology. Our scoping review was conducted through a structured five-stage process: [1] problem formulation, [2] literature search, across five databases: PubMed, MEDLINE, EMBASE, CINAHL, and Web of Sciences, [3] data evaluation and analysis, [4] data collection and summary, and [5] presentation. Results. A total of 212 studies from Embase, 134 from MEDLINE, 91 from CINAHL, 10 from Web of Science, and 4 from PubMed were initially part of our analysis. After eliminating 169 duplicate entries, our team scrutinized 282 titles and abstracts. Given our primary aim of identifying living labs based in rural hospital settings, only our original publication, “A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care”, was found. Conclusion: This scoping review indicates a stark research deficit on Living Lab hospitals in rural contexts, with only one relevant study identified. This highlights a critical need for further investigation into the adoption and impact of Living Lab models in rural healthcare. Given the risks faced by rural emergency services, it is vital to prioritize research in this area to improve and innovate care for vulnerable populations.