The core components of Community Paramedicine – integrated care in primary care setting: a scoping review

Abstract

Background Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 – June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality. Results From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi‐agency collaboration, (c) Patient‐centred prevention and (d) Outcomes of programme: cost‐effectiveness and patients’ experiences. Conclusion The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.

Exploring how paramedics are deployed in general practice and the perceived benefits and drawbacks: a mixed-methods scoping study

“…Much of the existing literature focuses on which additional skills may be needed by paramedics to work autonomously and safely in general practice and other community settings. [7][8][9] However, this research is largely descriptive and there are several assumptions, such as paramedics reducing GP workload and costs, which have not been tested empirically.…”

Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

“…All participants highlighted the diversity of multi-agency collaboration. Collaboration has been de ned as one of the keys to the success of the Community Paramedicine programs (5,49). The CNPs spoke about the multidisciplinary team and its social and cultural context with the possibilities to learn from each team member.…”

“…The health services are tailored to the needs of the population, contributing to the comprehensiveness of care (2). There is an urgent need to create new healthcare models in the primary care setting to decrease the pressure on the home-care workers (3,4) Internationally, community paramedicine is community-engaged, patient-centered preventive care, including multi-agency collaboration, and has many forms of programs as an integrated part of the primary care setting (5). To work as a community paramedic means that the paramedic steps out from the traditional emergency role providing patient assessment and non-emergency care with allied prehospital health care providers.…”

“…In some prehospital jurisdictions, paramedics work seamlessly with the allied health care professions, providing to patients well-organized and high-quality care. (4)(5)(6)(8)(9)(10)(11).…”

Community paramedicine—cost–benefit analysis and safety with paramedical emergency services in rural areas: scoping review protocol

“…4 The core areas for community paramedicine can be summarised into four main areas: emergency medical response, multiagency collaboration, patient-centred prevention and establishment of education and development programmes. 5 Strengths and limitations of this study ► There are limited studies that link cost-benefit analysis and safety concerning community paramedicine in rural areas. ► Through a wide overview, which includes a search on published literature on the topic, gaps in our knowledge base can be revealed.…”