Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.
BMC Emerg Med. 2024 Apr 1;24(1):50. doi: 10.1186/s12873-024-00972-5.
Community paramedicine (CP) is an extension of the traditional paramedic role, where paramedics provide non-acute care to patients in non-emergent conditions. Due to its success in reducing burden on hospital systems and improving patient outcomes, this type of paramedic role is being increasingly implemented within communities and health systems across Ontario. Previous literature has focused on the patient experience with CP programs, but there is lack of research on the paramedic perspective in this role. This paper aims to understand the perspectives and experiences, both positive and negative, of paramedics working in a CP program towards the community paramedic role.
An online survey was distributed through multiple communication channels (e.g. professional organizations, paramedic services, social media) and convenience sampling was used. Five open-ended questions asked paramedics about their perceptions and experiences with the CP role; the survey also collected demographic data. While the full survey was open to all paramedics, only those who had experience in a CP role were included in the current study. The data was qualitatively analyzed using a comparative thematic analysis.
Data was collected from 79 respondents who had worked in a CP program. Three overarching themes, with multiple sub-themes, were identified. The first theme was that CP programs fill important gaps in the healthcare system. The second was that they provide paramedics with an opportunity for lateral career movement in a role where they can have deeper patient connections. The third was that CP has created a paradigm shift within paramedicine, extending the traditional scope of the practice. While paramedics largely reported positive experiences, there were some negative perceptions regarding the slower pace of work and the "soft skills" required in the role that vary from the traditional paramedic identity.
CP programs utilize paramedic skills to fill a gap in the healthcare system, can improve paramedic mental health, and also provide a new pathway for paramedic careers. As a new role, there are some challenges that CP program planners should take into consideration, such as additional training needs and the varying perceptions of CP.
社区急救医学(CP)是传统急救医学角色的延伸,急救人员在非紧急情况下为患者提供非急性护理。由于其在减轻医院系统负担和改善患者预后方面的成功,这种类型的急救人员角色在安大略省的社区和卫生系统中越来越多地得到实施。先前的文献侧重于 CP 项目的患者体验,但在这种角色中缺乏对急救人员观点的研究。本文旨在了解从事 CP 项目的急救人员对社区急救医学角色的看法和体验,包括积极和消极的方面。
通过多种沟通渠道(例如专业组织、急救服务、社交媒体)分发在线调查,并采用方便抽样法。五个开放式问题要求急救人员谈谈他们对 CP 角色的看法和体验;该调查还收集了人口统计学数据。虽然完整的调查对所有急救人员开放,但只有那些有 CP 经验的人才被纳入本研究。使用比较主题分析对数据进行定性分析。
从 79 名曾在 CP 项目中工作的受访者那里收集了数据。确定了三个总体主题,其中包含多个子主题。第一个主题是 CP 项目填补了医疗保健系统中的重要空白。第二个主题是,它们为急救人员提供了在一个可以与患者建立更深入联系的角色中进行横向职业发展的机会。第三个主题是 CP 在急救医学领域引发了范式转变,扩展了传统的实践范围。虽然急救人员大多报告了积极的体验,但也有一些负面看法,认为工作节奏较慢,以及该角色所需的“软技能”与传统急救人员身份不同。
CP 项目利用急救人员的技能填补医疗保健系统中的空白,可以改善急救人员的心理健康,也为急救人员的职业发展提供了新途径。作为一个新角色,CP 项目规划者应该考虑到一些挑战,例如额外的培训需求和 CP 的不同看法。