Community paramedicine model of care: an observational, ethnographic case study

BMC Health Serv Res. 2016 Feb 2;16:39. doi: 10.1186/s12913-016-1282-0.

Abstract

Background: Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery.

Methods: Using an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations. We then applied a combination of thematic analysis techniques and boundary theory to develop a community paramedicine model of care.

Results: A model of care that distinguishes community paramedicine from other paramedic service innovations emerged that follows the mnemonic RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration with health, aged care and social services; Governance and leadership; Higher education; Treatment and transport options.

Conclusions: Community engagement and situated practice distinguish community paramedicine models of care from other paramedicine and out-of-hospital health care models. Successful community paramedicine programs are integrated with health, aged care and social services and benefit from strong governance and paramedic leadership.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allied Health Personnel / education
  • Allied Health Personnel / organization & administration*
  • Anthropology, Cultural
  • Clinical Governance
  • Community Health Services / organization & administration*
  • Emergency Medical Services / organization & administration
  • Emergency Medical Technicians / standards
  • Humans
  • Leadership
  • Models, Theoretical
  • Ontario
  • Primary Health Care / organization & administration
  • Professional-Patient Relations
  • Rural Health Services / organization & administration
  • Transportation of Patients