Research Proposal: Emergency Room Waiting Time in Canadian Hospitals

This research proposal addresses the critical issue of emergency room waiting times in Canadian hospitals. The study aims to identify the causes of prolonged wait times, assess their impact on patients and families, and explore potential solutions. The proposal outlines a mixed-methods approach, combining quantitative and qualitative data collection through surveys of patients and hospital staff, as well as a review of existing literature. The research questions focus on understanding the factors contributing to long wait times, the effects on patients, and strategies for improvement. The methodology involves the use of both sequential exploratory and sequential explanatory mixed methods to ensure a comprehensive analysis. Ethical considerations are also addressed, ensuring the protection of participants' rights and privacy. The ultimate goal of the research is to provide actionable insights that can help Canadian hospitals reduce emergency room wait times and improve patient care.

Running head: RESEARCH PROPOSAL: EMERGENCY ROOM WAITING TIME
RESEARCH PROPOSAL: EMERGENCY ROOM WAITING TIME
Name of the Student
Name of the University
Author Note

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Table of Contents
Literature Review............................................................................................................................2
Introduction......................................................................................................................................3
Research questions.......................................................................................................................3
Research Purpose.........................................................................................................................3
Research Hypothesis....................................................................................................................4
Methodology....................................................................................................................................4
Research focus.............................................................................................................................4
Alternative mixed methods strategy............................................................................................5
Analysis of mixed method design................................................................................................6
Discussion of proposed mixed method design............................................................................8
Steps to be followed.....................................................................................................................9
Ethical considerations................................................................................................................10
Conclusion.....................................................................................................................................10
References......................................................................................................................................12

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Literature Review
The various available researches on the topic of emergency room issues across various
hospitals in Canada significantly point to the negative impact it has on the patients and their
families. According to Innes et al. (2015) taking care of patients that visit the emergency rooms
of hospitals is necessary as it can take time for them to receive further medical attention. It
becomes very important that patients are cared for in the emergency room prior to getting proper
treatment on being admitted. However, the significant gap that remains in the literature is related
to the paper not being able to properly evaluate the actual required roles of the hospital staff in
providing emergency room care. Hospitals in Canada are witnessing a significant rise in
emergency room waiting time. It is estimated that one in three Canadians had to wait for hours
and longer in just their last hospital visits. Almost 40% of Canadians said that they would not
have required further medical assistance if they had readily available medical providers (Are
Extreme Hospital Wait Times Failing Canadians, 2019).McAlister et al. (2016) opine that one of
the largest causes of emergency room waiting time length is the longer periods of time for which
the inpatients occupy the bedspacing. It is important to note that longer duration of wait at the
emergency rooms can negatively affect the health of the patients. As opined by Kaushal et al.
(2015) hospitals in Canada need to approach the problems through proper research. This could
help them to form better strategies to effectively treat a large number of patients at the ER itself.
It was found that one of the main challenges that existed in the emergency room and ED services
was that thy focus on getting the patient out as soon as possible rather than providing
compassionate care. It was seen that many are using the term “failure to cope” in answer to the
longer waiting times at hospitals (Webster et al., 2015). The major limitations of the literatures is
that they do not provide significant conclusions in regards to the effective techniques that can be

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used to reduce emergency waiting times. The literatures vary in their point of views when putting
forward the issues and provide conflicting conclusions. Hence, the identified gap is in relation to
the lack of effective gathered implications.
Introduction
The following is a research proposal that is focused towards deriving essential
implications in regards to the topic of emergency room waiting time in the hospitals of
Canada.The proposal puts forward how various methods would be chosen, utilized and their
effectiveness in gathering significant outcomes from the study.
Research questions
 Why are Canadian hospitals affected by extreme emergency room waiting times?
 How much are the patients and their families being affected due to the emergency room
waiting times in Canadian Hospitals?
 How can Canadian hospitals effectively reduce emergency room waiting times?
 What are the future prospects of Canadian hospitals in regards to the identified issues?
Research Purpose
It has been seen in the recent years that Canadian hospitals are witnessing fast increasing
emergency department wait times. The issue is significantly large and is already being discussed
across the media and various public and medical forums (Webster et al., 2015). The purpose of
the research will be to find out the most significant reasons behind the emergency wait times
across hospitals in Canada. A significant objective of the research would be to understand
exactly how much the patients and their families are affected due to the longer waiting times in

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emergency. The study will further focus on finding the ways in which the identified challenges
could be addressed by the hospitals across the country.The study will eventually focus on
garnering significant implications that can help in the effective addressing of the issues related to
emergency wait times.
Research Hypothesis
The research hypothesis that would be tested through the study will be that the hospitals
of Canada can work together with the families of patients to reduce the longer waiting times
across the emergency rooms.
Methodology
Research focus
The focus of the research would be to find out why Canadian hospitals are facing issues
in relation to longer emergency waiting times and how are these factors affecting the patients and
their families (Shamian et al., 2016). The study will focus analyzing these aspects to find out
exactly how the longer waiting times can effectively be reduced. The variables that would be
considered for the research will be Canadian hospitals, emergency rooms, waiting times and
patients.Since the research is based on hospital environment, a large number of the participants
will be patients and hospital staffs. The research would be based in Canada.
Hence, all the data gathered would be exclusively from the hospitals and other medical
institutions that are situated in the country. The research will take the help of surveys to gather
data related to the excessive wait times that patients are having to face across the various
Canadian hospitals. A sample size of 50 will be considered for the research 30 respondents

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would be selected among people that have recently visited Canadian hospitals for medical
reasons or are frequent visitors, being either patients or their families. 20 of the respondents
would be selected from among the staff members of the various hospitals across the country.
Especially, the staffs that work in the emergency departments would be given more preference.
A questionnaire would be made with questions that would specifically be made to gather
essential insight into the conditions of the emergency departments and the experiences of the
patients. The study would also rely on qualitative data gathered from various relevant books,
journals and articles that have discussed the subject of the research. The consulted literates
would help to further evaluate the topic of the research. Both quantitative and qualitative
research would be effectively utilized for the study. This will help to bring out essential
perspectives on the matter.
Alternative mixed methods strategy
The rationale for using mixed research methods is that it will help in the effective
utilization, evaluation and analysis of both the quantitative and qualitative aspects of the gathered
data. Mixed method research technique refer to methods that utilize both quantitative and
qualitative data to bring forward essential implications from a study. This methods helps to
create essential perspectives concerning the subject matter of the research. The research proposes
to utilize mixed research methods to enhance the effectiveness of the study.
Mixed methods help to balance the data that are gathered through research studies.
Systematic integration of the research methods contribute towards enhancing the effectiveness of
the various research studies that are undertaken. Similarly in this research mixed methods can
help to bring forward implications through integrated analysis of the subject matter (Walliman,

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2017). The implications that can be gathered through the usage of mixed method techniques
might not be possible through the utilization of other research strategies.
Two types of research strategies are considered for being used in the research study. The
two types of research methods can be used as alternative mixed methods. The two methods being
considered are sequential exploratoryand sequential explanatory mixed methods. In sequential
exploratory research, the focus in on both qualitative and quantitative data collection. At first the
data is collected from qualitative sources. Later, it is followed by quantitative data collection
methods. The purpose of the usage of the method is to research effectively a given phenomenon
and explore the factors related to it. In the sequential explanatory mixed research technique
quantitative data is collection is followed by qualitative data collection. Both the collected data
are effectively analyzed to gather significant outcomes. The purpose of this type of research is to
use qualitative research for assisting in providing explanation to the findings gathered from
quantitative study (Doyle, Brady& Byrne, 2016).These two methods are proposed as they can be
used to effectively answer the research questions that have been considered. The questions
require to be answered through definitive ways that can actually highlight the issues that are
present across the emergency rooms of the hospitals. Exploratory sequential research would help
to effectively test the hypothesis that has been selected for the research. Explanatory research can
help in better explaining the primary data that would be gathered through the surveys. It can be
seen that both these sequential methods can be very effective mixed method approach towards
analyzing the subject matter. Explanatory sequential focuses more on assisting the primary
research through the existing literatures that are present (Guetterman, Fetters& Creswell, 2015).
On the other hand sequential exploratory research can be used to compare the quantitative and
qualitative data that are gathered in regards to a study.

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Analysis of mixed method design
The mixed method research that will be most suitable for the study is explanatory
research technique.The explanatory sequential research method would be utilized for gaining the
best outcomes from the research study. This is because in this research the simultaneous analysis
of the primary and the secondary data are possible (Subedi, 2016). This research technique will
rely on positive factors and contribute towards gaining effective outcomes from the study. It can
be seen that the research technique can influence the outcome of the results in many ways.
Firstly, the research technique can provide an effective framework through which the research
can be undertaken.
Secondly, the sequential explanatory method will be crucial in creating an essential
balance between the qualitative and quantitative data that will be utilized in the study.The basic
difference between the sequential explanatory and the sequential exploratory methods are that
the first technique focuses on collectively analyzing the two forms of data, the second analyzes
the data separately. This causes the two forms of data to be treated differently by the two
variations of mixed method research. The explanatory methods will be more effective in the case
of this research as it will be treating the qualitative and the quantitative methods collectively
(Berman, 2017). The research questions are focused towards aspects that need to be evaluated
through the usage of both quantitative and qualitative data. In this case their simultaneous
analysis would be effective towards productive outcomes. The explanatory sequential research
can be used to determine the balanced understanding of the research. It is important to note that
this form of research can help to understand the views of the respondents from the survey sample
in the light of the actual recorded factors from the various literatures. A comparative
understanding of the research topic can be made. This can contribute greatly towards the better

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analysis and evaluation of all the essential data that are gathered. The exploratory sequential
research method will provide greater stability to the research framework that is to be used in the
study.
Timing, weighting, mixing and theorizing strategies
In accordance with the research questions, the most important identified issues are longer
waiting times in the emergency rooms of the Canadian hospitals, the potential risk issues that can
affect the patients and their families and the reduction of wait time in emergency rooms. It can be
said that for analyzing the longer waiting times in Canadian hospitals quantitative analysis and
data from respondents would be required. Hence, for this part survey is required and will be used
accordingly. The part involving the risk factors that can affect the patients and their families need
to be supported through the collection of qualitative data. Hence, for this relevant literatures need
to be consulted. Thus survey and literature would be required to support different parts of the
study.
Timing: This refers to the amount of time that would need to be taken for each data collection
methods.
 Qualitative- data collection would require the consultation of significant literatures. In
order to complete this a time of 2 weeks would be required
 Quantitative- 50 respondents would be provided with survey questionnaire. The survey
conducted would be online. For all the 30 respondents that are either patients and family
members or hospital staffs a total of 3 weeks would be considered
Weighting and mixing: Weighting means providing priority to either qualitative or quantitative
data in research studies (Almalki, 2016). Special weightage will be provided to each type of data

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whether quantitative or qualitative. Much importance will be applicable to quantitative data as
through this the essential views of the concerned public can be gathered. Quantitative data will
also be important as through the consultation of the relevant researches, the contextual evidences
for the subject matter can be gathered. The weightage of both the quantitative and qualitative
data would be same. An important aspect of the study will be that apart from the separate
analysis of the quantitative and qualitative evidences, the study will incorporate a combined
analysis of the surveys and the literatures (McCusker&Gunaydin, 2015). The advantage will be
that all the significant perspectives would be effectively analyzed though more than one
discussions.
Theorizing: This refers to the theoretical perspectives that would be utilized for guiding the
research. As mentioned the sequential explanatory research method would be used. The theory
that would guide the research is explanatory research theory. The theory is based on describing
all aspects related to the study in detailed manner.
Steps to be followed
The first step that would need to be taken is the gathering of data that will be required for
the analysis. The primary data would be gathered first as it is more important. Various hospitals
would be considered and the hospitals that face the most problematic conditions with regards to
the long waiting times in the emergency rooms would be selected. Moving forward, the survey
respondents would be selected. The questionnaire would be made in the first week. Non-
probability sampling techniques would be utilized for the survey sample. The data would be
gathered over a course of 3 to 4 weeks. Secondly, the secondary data would be gathered. The

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most important literary works would be selected on the basis of their relevance to the subject.
More importance would be given towards understanding the importance of the literatures that are
in the context of Canada. Thirdly, the significant gaps that are present in the literatures would be
considered before proceeding. The literatures would be consulted also on the basis of their
timeliness. Hence, only research literatures that have come out in the recent years would be
consulted. The various implications that have been derived from the other literary sources would
be recorded in accordance with their significance. The primary data would be analyzed
separately and the secondary data would be analyzed separately. The combined analysis of the
data would take place subsequently. The implications that are gathered would be presented
through the research.
Ethical considerations
The research would be done without any instance of data manipulation. No kind of force
would be given on the respondents to provide information that are more favorable. The study
will not consider asking any confidential personal information to the respondents. Moreover, any
information provided by the respondents will not be disclosed to the public. The research would
not any unethical means to gather any information (Hedgecoe, 2017). All the information would
be gathered ethically and through legally recognized sources. The participation would be
voluntary and no participants would be forced to take part in the survey. No form or financial
data of the respondents would be collected. The study will be made completely through legal
means. By no means would any form of illegal data be utilized. No form of external pressure
would be exerted on the participants. The research would be undertaken by giving much
importance to the ethical standards of researches that are established.

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Conclusion
The research proposal was made to highlight all the essential aspects that would concern
the further research of the subject matter. The aims, objectives, questions and purpose of the
research are provided. The methodologies that would be used in the research process have been
essentially discussed. All necessary precautions, resource and techniques would be utilized to
make the research an important work in the light of the problem that is being discussed. The
issues related to the long waiting hours in the hospitals of Canada would be thoroughly analyzed
and evaluated from the study. The usage of the mixed method technique as pointed out
previously will provide essential stability to the research framework. The research would be
important towards determining the effectiveness of the methods towards understanding the
subject matter.

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References
Are Extreme Hospital Wait Times Failing Canadians?. (2019). Retrieved from
https://www.besthealthmag.ca/best-you/health/hospital-wait-times/
Berman, E. A. (2017). An exploratory sequential mixed methods approach to understanding
researchers’ data management practices at UVM: Integrated findings to develop research
data services. Journal of escience librarianship, 6(1), 7.
Doyle, L., Brady, A. M., & Byrne, G. (2016). An overview of mixed methods research–
revisited. Journal of research in nursing, 21(8), 623-635.
Guetterman, T. C., Fetters, M. D., & Creswell, J. W. (2015). Integrating quantitative and
qualitative results in health science mixed methods research through joint displays. The
Annals of Family Medicine, 13(6), 554-561.
Hedgecoe, A. (2017). Scandals, ethics, and regulatory change in biomedical research. Science,
Technology, & Human Values, 42(4), 577-599.
Innes, K., Jackson, D., Plummer, V., & Elliott, D. (2015). Care of patients in emergency
department waiting rooms–an integrative review. Journal of advanced nursing, 71(12),
2702-2714.
Kaushal, A., Zhao, Y., Peng, Q., Strome, T., Weldon, E., Zhang, M., &Chochinov, A. (2015).
Evaluation of fast track strategies using agent-based simulation modeling to reduce
waiting time in a hospital emergency department. Socio-Economic Planning Sciences, 50,
18-31.

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McAlister, F. A., Bakal, J. A., Rosychuk, R. J., & Rowe, B. H. (2016). Does reducing inpatient
length of stay have upstream effects on the emergency room: exploring the impact of the
general internal medicine care transformation initiative. Academic Emergency
Medicine, 23(6), 711-717.
Shamian, J., Kerr, M. S., Laschinger, H. K. S., & Thomson, D. (2016). A hospital-level analysis
of the work environment and workforce health indicators for registered nurses in
Ontario's acute-care hospitals. Canadian Journal of Nursing Research Archive, 33(4).
Subedi, D. (2016). Explanatory sequential mixed method design as the third research community
of knowledge claim. Am J Educ Res, 4(7), 570-577.
Walliman, N. (2017). Research methods: The basics. Routledge.
Webster, F., Rice, K., Dainty, K. N., Zwarenstein, M., Durant, S., &Kuper, A. (2015). Failure to
cope: the hidden curriculum of emergency department wait times and the implications for
clinical training. Academic Medicine, 90(1), 56-62.
Webster, F., Rice, K., Dainty, K. N., Zwarenstein, M., Durant, S., &Kuper, A. (2015). Failure to
cope: the hidden curriculum of emergency department wait times and the implications for
clinical training. Academic Medicine, 90(1), 56-62.
McCusker, K., &Gunaydin, S. (2015). Research using qualitative, quantitative or mixed methods
and choice based on the research. Perfusion, 30(7), 537-542.
Almalki, S. (2016). Integrating Quantitative and Qualitative Data in Mixed Methods Research--
Challenges and Benefits. Journal of Education and Learning, 5(3), 288-296.