The definition of a community paramedic: An international consensus

Abstract

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]

Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

“…This may involve specialist paramedics, more commonly being referred to under an umbrella term of ‘community paramedic’. 7,87–93 Shannon et al identified a lack of quality literature to guide formation of such programs; suggesting a need for evidence, that includes qualitative research, to develop education, scope and outcome measures into the impacts of such initiatives. 93 This research provides a conceptual framework of how patients make-sense of requiring and receiving unscheduled healthcare from paramedics in the community; it may be useful to inform curriculum design, clinical guidelines, and construction of outcome measures for such initiatives.…”

‘It breaks a narrative of paramedics, that we’re lifesavers’: A qualitative study of health professionals’, bereaved family members’ and carers’ perceptions and experiences of palliative paramedicine

“…1 However, global health trends are shifting as we live longer, with greater levels of chronic disease, and increasing preferences to live and die at home. 2,3 As a result, paramedic practice is diversifying to include community paramedicine models, [4][5][6][7] and growing expertise in palliative and end-of-life care. [8][9][10] Yet, as paramedics respond to increasing numbers of palliative and end-of-life care patients in the community, the traditionalist orthodoxy of treatment and compulsory transfer to hospital is being questioned 9,10,11 Palliative paramedicine clinical practice guidelines 12 and training programmes 4 are emerging, alongside interdisciplinary palliative care teams that include paramedics, 13 to broaden scopes of practice and facilitate more homebased deaths.…”

“…1 However, global health trends are shifting as we live longer, with greater levels of chronic disease, and increasing preferences to live and die at home. 2,3 As a result, paramedic practice is diversifying to include community paramedicine models, 4 –7 and growing expertise in palliative and end-of-life care. 8 –10…”

Addition of community paramedics to a physician home‐visit program: A prospective cohort study

“…Community paramedicine leverages emergency medical services clinicians, known as "community paramedics," to serve as an extension of physicians into the community by collaboratively evaluating and treating non-emergent conditions without automatically transporting patient to an acute care setting. 19,20 The community paramedicine approach offers several potential benefits to an outpatient physician caring for older adults with urgent health needs: paramedics are mobile by design, trained to evaluate urgent healthcare issues, routinely provide in-home care to patients, carry diagnostic equipment and pharmaceutical treatments, frequently collaborate with physicians in real-time to receive additional orders, and can manage the logistics of telemedicine visits for patients with physical, financial, and/or technological barriers to using directto-consumer video visits. 15,[21][22][23] Prior investigations of community paramedic programs in home-based primary care and long-term care facilities demonstrated successful evaluation and management in-place without transport.…”