PP19 Advances in community paramedicine in response to COVID-19

Abstract

BackgroundAlready well situated in the community, paramedics work collaboratively with other community partners to ensure patients receive the services that they require and the high quality in-home and in-community care they deserve. The ongoing COVID-19 pandemic has highlighted the prevalence of social inequities in Canada, particularly in already marginalized groups, and the importance of social connectedness and caregiver wellbeing solutions. We sought to explore innovations in community paramedicine programs across Canada in response to COVID-19.MethodsWe conducted a scoping literature review of community paramedicine publications since 2020, with a focus on Canadian context, and undertook semi-structured interviews with key informants to capture innovations that may not be well represented in the literature.ResultsA total of 22 studies, combined with 26 grey literature sources were identified through the literature search. We interviewed ten stakeholders from diverse community care and community paramedicine settings across Canada to further explore each element of the conceptual framework. A conceptual framework (Figure 1) was developed to categorize the literature and findings into themes, namely: leveraging technology (e.g., virtual consultations, remote monitoring); responding to COVID-19 (e.g., mass testing and vaccination); addressing social needs (e.g., home visits, helping patients with groceries); caring for vulnerable populations (e.g., providing palliative care at home). These innovations were united in the idea of collaborating with other health care professionals and agencies, while facilitating care and case management coordination.ConclusionsThe COVID-19 pandemic has highlighted the essential collaborative care role community paramedicine programs can provide to patients in their homes or communities. Community paramedicine programs have evolved to meet the needs of their communities. These programs have demonstrated their ability to support public health measures, provide home and community-based care, and most importantly, collaborate with other health care professionals in coordinating and providing care to Canadians regardless of social circumstances.

Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives

“…The results of our study suggest that the Irish General Practice community may be unaware of the evidence and thus wider possibilities of ‘Community Paramedicine’ in both chronic disease management and in addressing gaps in primary care provision. For instance, research from Canada demonstrated that Community Paramedic programs can act as primary care extenders and met the needs of vulnerable populations 24 . In Ontario, a Paramedic-led community-based program for older adults living in subsidized housing was found to be cost effective, lowered blood pressure and was associated with improved functional independence 40 , 41 .…”

“…A number of recent reviews have detailed the evolving role of paramedics in the delivery of primary care through collaborative partnerships with general practitioners, practice nurses and multidisciplinary teams, aimed at providing care in the community closer to home 21 – 23 . This is particularly true where paramedics provide access to primary healthcare in settings where it would otherwise not be available or delayed, such as in rural and isolated communities, and with populations that have historically faced barriers in accessing healthcare, such as those experiencing homelessness 21 , 24 . Paramedics have already undertaken roles in primary care assessment and onward referral, health promotion, vaccination, chronic disease monitoring and management, palliative care and urgent primary care 23 .…”

Emerging Concepts in the Paramedicine Literature to Inform the Revision of a pan-Canadian Competency Framework for Paramedics: A Restricted Review

“…While the ongoing COVID-19 pandemic has increased virtual care and telehealth delivery by paramedic services [34,35], we still lack a clear understanding of the role of paramedics as virtual care providers, primary care extenders, and facilitators of virtual care visits. The COVID-19 pandemic further emphasized the benefits of keeping people out of hospital if they can be cared for at home or in their community [34].…”

Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives

“…A number of recent reviews have detailed the evolving role of paramedics in the delivery of primary care through collaborative partnerships with general practitioners, practice nurses and multidisciplinary teams, aimed at providing care in the community closer to home [21][22][23] . This is particularly true where paramedics provide access to primary healthcare in settings where it would otherwise not be available or delayed, such as in rural and isolated communities, and with populations that have historically faced barriers in accessing healthcare, such as those experiencing homelessness 21,24 . Paramedics have already undertaken roles in primary care assessment and onward referral, health promotion, vaccination, chronic disease monitoring and management, palliative care and urgent primary care 23 .…”

“…The results of our study suggest that the Irish General Practice community may be unaware of the evidence and thus wider possibilities of 'Community Paramedicine' in both chronic disease management and in addressing gaps in primary care provision. For instance, research from Canada demonstrated that Community Paramedic programs can act as primary care extenders and met the needs of vulnerable populations 24 . In Ontario, a Paramedicled community-based program for older adults living in subsidized housing was found to be cost effective, lowered blood pressure and was associated with improved functional independence 40,41 .…”