‘I Certainly Wasn't as Patient-Centred’

Abstract

This article explores how a group of paramedics were cross-trained as community health workers (CHWs) in Indiana. Cross-training paramedics as CHWs provided a foundation to better understand the social issues that occur outside of the hospital and clinic, thereby enabling further empathy among paramedics and seeking means to connect patients to other health and social services agencies. I detail how earning a certification as a CHW shifted the mindset of the paramedics and their approach toward caregiving. Ultimately, I argue how cross-training healthcare professionals can further expand the general awareness of CHWs and possible opportunities for employment. However, steps must be taken to ensure that reducing the CHW model to a cross-training opportunity will not minimise the impacts of hiring a full-time CHW.

Community Paramedicine Supporting Community Needs: A Scoping Review<strong></strong>

“…This requires paramedicine leaders to critically examine whose voices and perspectives are included at decision-making tables and whose are not. This reinforces the necessity to further study and incorporate equitable practices for community and stakeholder engagement and apply learnings from others when assessing community need [27,41,45].…”

“…Authors cautioned against a one-size-fits-all approach and highlighted the need for programs to better address the needs of communities by including relevant program indicators [3,27,34,71]. A key recommendation across the literature was the need to meaningfully engage broader partners and communities early in program planning to understand how best to co-design and implement an integrated service model that addresses the specific needs of each community [3,27,29,34,41,54]. There were also cautions that focusing on increasing access to health and social services provided by the state-only risks further embedding settler colonialism in health and social equity efforts [72].…”

“…Amidst limitations from low health literacy and the complexities of system navigation, community paramedicines' role in care coordination arose as a key aspect of support provided by various program models [32][33][34][35][36][37]. Capabilities for community paramedicine to address health needs was demonstrated in reports that paramedics are perceived as trusted health professionals engaged in health promotion and education during home-visits and outreach, and is evident where care coordination and system navigation is a program feature [28,35,[38][39][40][41][42][43][44][45]. Programs proved adaptive when ad hoc response was required in instances of crisis, and included supporting persons impacted by flooding disasters and the COVID-19 pandemic [28,46].…”

“…A total of 36 studies (84%) reported on models of service delivery. In addition to outlining the service models, studies discussed the need for programs to be designed around community needs [3,27,34,41,45]. There was alignment across studies recommending engaging caregivers, broader stakeholders, and community members early when designing needs-based programming.…”

“…Paramedics received additional education focused on SDH in 24 of the included studies (56%), while Logan identified the benefit of paramedics receiving cross-training as Community Health Workers (CHW) [41]. Community paramedics are described as collaborating with allied health professional, social and community groups, amplifying the necessity of integrated and collaborative approaches to bolster the supports required to address social needs in community care planning.…”