Community Paramedicine in Australia and Aotearoa New Zealand: A multi-method landscape scan

Community Paramedicine in Australia and Aotearoa New Zealand: A multi-method landscape scan

Introduction

The pressurisation of the Australian and Aotearoa New Zealand health care systems is an ongoing challenge in the delivery of equitable, community-based care. Novel solutions have expanded to employ paramedics in what was once contrived as “non-traditional” roles. Community paramedicine is one such example of a paradigm shift to augment established community-based healthcare delivery.

Aims

The aim of this research was to describe the current and emerging landscape of community paramedicine programs across Australia and Aotearoa New Zealand. Additionally, the objectives of the research included an understanding of the experience and education of paramedics working in a community paramedicine setting along with the perceptions and attitudes of stakeholders associated with those roles.

Methods

Examined through the lens of critical realist theory, the research employed a sequential explanatory design. Participants involved in a community paramedicine program were recruited from Australasian jurisdictional or private paramedic services and were first asked to complete an online survey. Consenting participants were subsequently invited to attend a semi-structured interview. The data was analysed utilising a descriptive inductive thematic approach informed by Braun and Clarke’s thematic analysis framework.

Results

Thirty-six participants representing 32 organisations participated in the study. The results indicated a heterogenous blend of paramedic capabilities and roles, across two broadly defined service delivery models; Extended Care Paramedics tend to operate in a reactive metropolitan-based model whereas Community Paramedics operate more predominately in regional and remote locales with a focus on preventative and longitudinal care. Experience, educational requirements, and attitudes were similarly diverse across the community paramedicine landscape.

Conclusion

Community paramedicine is a paradigm of care designed to augment an existing healthcare ecology. This research has identified a rich, albeit heterogenous landscape of community paramedicine programs across Australasia. Importantly, the findings of this study are indicative of the maturation of the paramedicine profession.

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