What’s in a name? The confusion in nomenclature of low-acuity specialist roles in paramedicine.

Long, David; Clark, Michele; Lim, David; Devenish, Scott

doi:10.33151/ajp.13.3.518

Cited by 7 publications

(12 citation statements)

References 6 publications

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“…This variability in nomenclature may lead to a lack of consistency in approach and confusion to both internal and external stakeholders as to the role of a community paramedic. 13 Previous research has highlighted that there can be confusion about what community paramedics do in their role and this lack of consistent terminology only further contributes to this. 14 Literature outside of paramedicine has shown the value of providing evidence-based definitions of practice that differ from traditional models.…”

Section: Introductionmentioning

confidence: 99%

The definition of a community paramedic: An international consensus

et al. 2023

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Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A total of 94 community paramedicine experts were identified and 76 experts consented to involvement in this Delphi. Response rate ranged from 81.6% (Phase 1) to 63.1% (Phase 2). Participants expressed the importance of community paramedic definition having components attributed to primary health care, health promotion, chronic disease management and advanced clinical assessment. Participants expressed that these are essential components of the community paramedic skill set, which distinguishes the role from other frontline paramedics. A final consensus with 91% agreement on the definition of a community paramedic was achieved. The four-phase Delphi achieved consensus on the definition of a community paramedic as follows: A community paramedic provides person-centred care in a diverse range of settings that address the needs of the community. Their practice may include the provision of primary health care, health promotion, disease management, clinical assessment and needs-based interventions. They should be integrated with interdisciplinary healthcare teams which aim to improve patient outcomes through education, advocacy and health system navigation. The adoption of the global consensus on the definition of a community paramedic will enhance efforts to promote the value of this specialist role, enabling a better understanding of how a community paramedic contributes to the wider healthcare system. [Media: see text]

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Section: Introductionmentioning

confidence: 99%

The definition of a community paramedic: An international consensus

et al. 2023

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“…Today community paramedics have incorporated substantially more tasks than emergency medical response and transportation due to higher education and new healthcare organisation with a wide variation between countries and even within some countries 3. Although, there is currently no common consensus on the definition, role and tasks of community paramedics, the following definition proposed by the International Roundtable on Community Paramedicine (IRCP) has been widely cited: ‘Community paramedicine is a model of care whereby paramedics apply their training and skills in ‘non-traditional’ community-based environments, often outside the usual emergency response and transportation model’ 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…”

Section: Introductionmentioning

confidence: 99%

Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review

et al. 2022

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ObjectiveTo examine the current knowledge and possibly identify gaps in the knowledge base for cost–benefit analysis and safety concerning community paramedicine in rural areas.DesignScoping review.Data sourcesMEDLINE via PubMed, CINAHL, Cochrane and Embase up to December 2020.Study selectionAll English studies involving community paramedicine in rural areas, which include cost–benefit analysis or safety evaluation.Data extractionThis scoping review follows the methodology developed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We systematically searched for all types of studies in the databases and the reference lists of key studies to identify studies for inclusion. The selection process was in two steps. First, two reviewers independently screened 2309 identified articles for title and abstracts and second performed a full-text review of 24 eligible studies for inclusion.ResultsThree articles met the inclusion criteria concerning cost–benefit analysis, two from Canada and one from USA. No articles met the inclusion criteria for safety evaluation.ConclusionThere are knowledge gaps concerning safety evaluation of community paramedicine in rural areas. Three articles were included in this scoping review concerning cost–benefit analysis, two of them showing positive cost-effectiveness with community paramedicine in rural areas.

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“…Around the globe, the CP concept is visible in other contemporary paramedic models such as extended care paramedics (ECPs) in Australia, New Zealand and the United Kingdom, and mobile integrated healthcare (MIH) in the United States. Like community paramedics, ECPs treat lower acuity cases in the home or residential care facilities, with hospital avoidance being the primary focus (4). ECPs often play a vital role in dispatch centre triaging of calls to manage or reduce paramedic service demand by redirecting calls to alternative care pathways (5).…”

Section: Introductionmentioning

confidence: 99%

Community Paramedicine through Multiple Stakeholder Lenses Using a Modified Soft Systems Methodology

Martin

O’Meara²

2020

Australasian Journal of Paramedicine

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IntroductionCommunity paramedicine (CP) is an emerging model of care which expands paramedic scopes of practice to collaboratively support primary healthcare delivery in underserviced and disadvantaged communities. CP is a patient-centred holistic approach focussed on improving health outcomes, with success heavily reliant on integrative partnerships. This research aimed to identify key stakeholder perspectives about the value of CP in rural Australia.MethodsA workshop was conducted using a modified soft system methodology (SSM) that asked participants to consider the value of CP from the perspective of five key stakeholder groups. The 50 participants consisted of paramedics and volunteer ambulance officers, paramedic service executives, paramedic educators, Medicare Local representatives and a general practitioner. Participants were randomly allocated to five stakeholder groups: paramedic profession; Minister for Health and Ageing; consumers, chief executive and executive management team of an ambulance service; and healthcare professionals. The application of SSM placed the five groups into three broad categories of stakeholders: customers, actors, and owners.‘Customers’ in this context are patients, families and carers. ‘Actors’ are paramedics and volunteer ambulance officers, and ambulance service executives. The ‘owners’ are the Office of the Minister and those with the power to facilitate or block initiatives. Participants were allocated 15 minutes to brainstorm the question: “What can a community paramedic do for you to improve rural health provision?” Group views were verbally shared with all workshop participants and video recorded for analysis.ResultsThe ‘customers’ asked about CP from patient, family and carer perspectives, and were highly engaged with questions about how, when and where CP could operate. The paramedic and volunteer ambulance officer group of ‘actors’ battled to move beyond their emergency response mindset to articulate a clear CP vision. The executive management team responded from a strategic and risk management perspective focussing on patient safety and corporate image. They identified the need to form stakeholder partnerships. The ‘owners’ representing the Office of the Minister focussed on the holistic and wellness benefits of CP. The health professional group anticipated the CP role could provide collaborative care and support doctors.ConclusionsThe findings suggest many participants had a limited understanding of CP, which creates a barrier for implementation. Key benefits identified included a reduction in financial and physical burdens on the rural healthcare sector and improved outcomes for consumers. Active participation of stakeholders in the process of introducing CP programs, where people are comfortable questioning current practices and encouraged to explore new concepts and innovations, would enable a shared understanding of program aims and expectations. For paramedic services to expand service delivery models in rural Australia community participation and engagement with stakeholders is essential. They and paramedics must be willing to embrace meaningful and collaborative partnerships with patients, broader health networks, social services, politicians and researchers, and be prepared to step away from their traditional ‘command and control’ culture to co-design innovative paramedic models. SSM was a worthwhile approach to stakeholder engagement that has the potential to improve implementation of community paramedic programs through improved inclusion and the valuing of stakeholder perspectives.

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What’s in a name? The confusion in nomenclature of low-acuity specialist roles in paramedicine.

Cited by 7 publications

References 6 publications

The definition of a community paramedic: An international consensus

The definition of a community paramedic: An international consensus

Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review

Community Paramedicine through Multiple Stakeholder Lenses Using a Modified Soft Systems Methodology

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