Extending the paramedic role in rural Australia: a story of flexibility and innovation

O’Meara, Peter; Tourle, Vianne; Stirling, CM; Walker, Judi; Pedler, Daryl

doi:10.22605/rrh1978

Cited by 38 publications

(54 citation statements)

References 20 publications

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“…Professional role substitution in allied health has been effective in improving patient access across a range of specialities while releasing medical specialists to see more complex patients. 7,[12][13][14][15][16] Whilst there is growing literature supporting extended scope roles, robust evaluations are lacking. 14 The proportion of healthcare resources allocated to these models of care also remains largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Measuring performance of professional role substitution models of care against traditional medical care in healthcare—A systematic review

Mutsekwa

Wright

Byrnes

et al. 2021

Evaluation Clinical Practice

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Objectives: To identify outcome measures used to evaluate performance of healthcare professional role substitution against usual medical doctor or specialist medical doctor care to facilitate our understanding of the adequacy of these measures in assessing quality of healthcare delivery. Methods: Using a systematic approach, we searched Medline, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and Web of Science from database inception until May 2020. Studies that presented original comparative data on at least one outcome measure were included following screening by two authors. Findings were synthesized, and outcome measures classified into six domains which included: effectiveness, safety, appropriateness, access, continuity of care, efficiency, and sustainability which were informed by the Institute of Medicine dimensions of healthcare quality, the Australian health performance framework, and Levesque and Sutherland's integrated performance measurement framework.Results: One thirty five articles met the inclusion criteria, describing 58 separate outcome measures. Safety of role substitution models of care was assessed in 80 studies, effectiveness (n = 60), appropriateness (n = 40), access (n = 36), continuity of care (n = 6), efficiency and productivity (n = 45). Two-thirds of the studies that assessed productivity and efficiency performed an economic analysis (n = 27). The quality and rigour of evaluations varied substantially across studies, with two-thirds of all studies measuring and reporting outcomes from only one or two of these domains.Conclusions: There are a growing number of studies measuring the performance of non-medical healthcare professional substitution roles. Few have been subject to robust evaluations, and there is limited evidence on the scientific rigour and

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Section: Introductionmentioning

confidence: 99%

Measuring performance of professional role substitution models of care against traditional medical care in healthcare—A systematic review

Mutsekwa

Wright

Byrnes

et al. 2021

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…(19,24,28) The need for increased access to education opportunities was the most frequently mentioned theme across the studies, with nine articles discussing how beneficial this is for paramedics, particularly in preventing skill erosion. (16,(18)(19)(20)(21)24,(26)(27)(28) Strategies designed to address these key organisational and environmental challenges inform discussions on the other two main themes identified in this review.…”

Section: Resultsmentioning

confidence: 97%

“…However, this change in the service delivery model impacted on the perspectives of paramedics working in those communities with eight articles focusing on the perspectives of paramedics, community first responders and community paramedics on their role. (16,18,19,21,23,(26)(27)(28) Overall, implementation of new roles was consistently highlighted as a positive step towards getting rural communities access to healthcare more promptly. (20,22,23,27) However a note of caution is that volunteering is dependent on the motivation and altruism of volunteers (21)(22)(23) who consistently reported feeling misunderstood and underappreciated by their paramedic colleagues.…”

Section: Resultsmentioning

confidence: 99%

“…(16,18,19,21,23,(26)(27)(28) Overall, implementation of new roles was consistently highlighted as a positive step towards getting rural communities access to healthcare more promptly. (20,22,23,27) However a note of caution is that volunteering is dependent on the motivation and altruism of volunteers (21)(22)(23) who consistently reported feeling misunderstood and underappreciated by their paramedic colleagues. (20,23) The need to overcome organisational and environmental factors impacting on out-of-hospital healthcare in rural environments is addressed by the third main theme, the expanding role of paramedicine.…”

Section: Resultsmentioning

confidence: 99%

“…While one research study based in Qatar disagreed and did not find an increased mortality rate, (17) the majority of the research papers covering this topic did. (21,22,(25)(26)(27) The suspected causative factors of this varied, however some factors were presented as being unique to rural paramedicine. These factors can be divided into environmental factors and organisational factors.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The Nature of Paramedic Practice in Rural and Remote Locations: A Scoping Review

Spencer-Goodsir

Anderson

Sutton

2022

Australasian Journal of Paramedicine

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Introduction: Access to emergency healthcare services and specialist care – particularly paramedic services – is more restricted in the rural and remote areas of Australia, and this disparity is amplified further as remoteness increases. This review aims to investigate the availability of current research regarding both the expanding nature of paramedicine roles in rural environments, and the impacts of rurality on the quality of out-of-hospital care provided to patients. Methods: Arksey and O’Malley’s six-step methodological approach was used to perform a scoping review to assess the availability of literature. Key words including paramedic*, regional, rural, remote and role were inputted into the search engines Scopus, CINAHL and PubMed. Titles and abstracts of the 864 results were screened by all authors and inclusion/exclusion criteria applied, resulting in 13 remaining articles. Results: The final 13 articles comprised differing data collection types and methodologies from nine separate studies conducted in either Canada, Australia, the United Kingdom, the United States, Saudi Arabia or Qatar. Approximately 2.5 million patients, 534 paramedics, 331 other healthcare professionals and 35 case studies were included in the total combined results of these studies. Conclusion: Rural communities demonstrated increased mortality rates in out-of-hospital patients due to several factors including rostering, specialist service locations and limited resource availability. Factors which were beneficial to the outcomes of patients in rural settings included enhanced paramedic scopes of practice, the implementation of community paramedicine programmes and wider roles within the community for paramedics. A lack of research on the exact nature of these changing roles in rural paramedicine is evident.

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The bargaining of professionalism in emergency care practice: NHS paramedics and higher education

Givati

Markham

Street

2017

Adv in Health Sci Educ

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Over the past 2 decades, as part of reforms to the National Health Service and with it organizational changes to ambulance work in the UK, paramedic education has undergone a process of academisation and a shift from in-house, apprenticeship weeks-long occupational training, to university-based undergraduate programs. While the professional regulation and standardization of Allied Health Professionals’ education in high-income countries has captured scholarly attention, the study of paramedic practice is still in its infancy and there is a need to explore its evolvement in relation to the fluid societal–political circumstances affecting its provision and demand. Based on interviews with front-line paramedics, paramedic educators and paramedic science students in the South of England, this article examines how the reforms to paramedic education have impacted the professionalization of paramedics and their discourse of professionalism. Framed within to the ‘new’ sociology of professions, the case of British paramedics demonstrates the complex nature of the relationship between the university and professional practice. It appears that universities, the providers of paramedic education, are caught between two opposing discourses of professionalism: on the one hand, that of providing a platform for students’ socialization and engagement with professionalism ‘from within’ practice which is based on students’ common goals and mutual experiences, and, on the other hand, serving as a conduit for managerial/organizational strategies of professionalism which appear to undermine the role of university socialization.

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Extending the paramedic role in rural Australia: a story of flexibility and innovation

Cited by 38 publications

References 20 publications

Measuring performance of professional role substitution models of care against traditional medical care in healthcare—A systematic review

Measuring performance of professional role substitution models of care against traditional medical care in healthcare—A systematic review

The Nature of Paramedic Practice in Rural and Remote Locations: A Scoping Review

The bargaining of professionalism in emergency care practice: NHS paramedics and higher education

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