Abstract
Introduction
Community paramedics provide care in a diverse range of settings that address the needs of the communities they serve. Their practice may include the provision of primary health care, health promotion, chronic and episodic disease management, clinical assessment, and needs-based interventions. There is an ongoing need for national guidance on the competencies and education requirements of community paramedics at a national level in Canada. To inform the development of such guidance, the roles that community paramedics enact in this context must first be identified and described.
Objective
We sought to identify both the various roles that community paramedics in Canada enact, and those that align with or support the ongoing evolution of this specialist context of paramedic practice.
Methods
This was a three-phase study that combined 1) frameworks describing community paramedicine in Canada, 2) a review of community paramedicine literature focused within the Canadian setting, and 3) a review of data reported by a pan-Canadian working group. Elements identified at each phase were extracted and mapped to an existing role description for paramedics in Canada. Elements central or unique to community paramedic practice were iteratively identified and highlighted in the proposed community paramedic roles model.
Results
Community paramedics perform multiple roles that span a broad continuum of the healthcare system: clinician, professional, education, advocate, team member, system navigator, and reflective practitioner. Community paramedics provide emergency care, primary care, and support public health initiatives. They deliver and support direct person-centred care through expanded assessment, diagnostic and therapeutic interventions (Clinician). They are situated in and engage with communities in designing programs to meet community needs (Professional). Through their trusted relationships with people receiving care and care partners, they engage in health promotion, health literacy, and education activities (Educator). Community paramedics coordinate care and help patients navigate the health and social care system (Health and Social Advocate). As members of interprofessional care teams (Team Member), they both accept referrals and refer within these teams, as well as support a range of disposition options. They continually assess and maintain their professional competence and personal wellbeing (Reflective Practitioner).
Discussion and conclusion
Community paramedics share common roles with other paramedics in Canada, but their enactment of these roles is contextually specific and involves elements that are either unique or more prominent when compared to traditional paramedic practice. The description of these roles in the community paramedic context will guide future developments of community paramedic competencies and education requirements.