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Community paramedicine

Davis G Patterson, Cynthia Coulthard, Lisa A Garberson, Gary Wingrove, Eric H Larson
Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and document review. Common goals included managing chronic disease (90.3%); and reducing emergency department visits (83.9%), hospital admissions/readmissions (83.9%), and costs (83.9%). Target populations included the chronically ill (90...
2016: Journal of Health Care for the Poor and Underserved
Karen A Abrashkin, Jonathan Washko, Jenny Zhang, Asantewaa Poku, Hyun Kim, Kristofer L Smith
Models addressing urgent clinical needs for older adults with multiple advanced chronic conditions are lacking. This observational study describes a Community Paramedicine (CP) model for treatment of acute medical conditions within an Advanced Illness Management (AIM) program, and compares its effect on emergency department (ED) use and subsequent hospitalization with that of traditional emergency medical services (EMS). Community paramedics were trained to evaluate and, with telemedicine-enhanced physician guidance, treat acute illnesses in individuals' homes...
December 2016: Journal of the American Geriatrics Society
Madison Brydges, Margaret Denton, Gina Agarwal
BACKGROUND: Expanded roles for paramedics, commonly termed community paramedicine, are becoming increasingly common. Paramedics working in community paramedicine roles represent a distinct departure away from the traditional emergency paradigm of paramedic services. Despite this, little research has addressed how community paramedics are perceived by their clients. METHODS: This study took an interpretivist qualitative approach to examine participants' perceptions of paramedics providing a community paramedicine program, named the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS)...
2016: BMC Health Services Research
Lisa I Iezzoni, Stephen C Dorner, Toyin Ajayi
Growing increasingly short of breath late one night, Ms. E. called her health care provider’s urgent care line, anticipating that the on-call nurse practitioner would have her transported to the emergency department (ED). Over the past 6 months, Ms. E. had made many ED visits. She is 83 years old..
March 24, 2016: New England Journal of Medicine
Baely M Crockett, Karalea D Jasiak, Todd A Walroth, Kerri E Degenkolb, Andrew C Stevens, Carolyn M Jung
BACKGROUND: Hospital readmissions have recently gained scrutiny by health systems as a result of their high costs of care and potential for financial penalty in hospital reimbursement. Mobile-integrated health and community paramedicine (MIH-CP) programs have expanded to serve patients at high risk of hospital readmission. Pharmacists have also improved clinical outcomes for patients during in-home visits. However, pharmacists working with a MIH-CP program have not been previously described...
March 21, 2016: Journal of Pharmacy Practice
Wendy J Wilcoxson
No abstract text is available yet for this article.
March 2016: Southern Medical Journal
Michael R Wilcox
No abstract text is available yet for this article.
February 2016: EMS World
Peter O'Meara, Christine Stirling, Michel Ruest, Angela Martin
BACKGROUND: Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery. METHODS: Using an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations...
February 2, 2016: BMC Health Services Research
Mark H Wilson, Karel Habig, Christopher Wright, Amy Hughes, Gareth Davies, Chirstopher H E Imray
Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes...
December 19, 2015: Lancet
Angela Martin, Peter O'Meara, Jane Farmer
OBJECTIVE: To evaluate a community paramedicine program in rural Ontario, Canada, through the perceptions and experiences of consumers. DESIGN: An observational ethnographic approach was used to acquire qualitative data through informal discussions, semi-structured interviews and direct observation of interactions between consumers and community paramedics. SETTING: The study was conducted in rural Ontario where a community paramedicine program has been established consisting of four components: ad hoc home visiting, ageing at home, paramedic wellness clinics and community paramedic response unit...
August 2016: Australian Journal of Rural Health
Gary Wingrove, Peter O'Meara, Michael Nolan
No abstract text is available yet for this article.
November 2015: EMS World
(no author information available yet)
No abstract text is available yet for this article.
December 2015: Annals of Emergency Medicine
Mike Rubin
As community paramedicine and other nonemergent initiatives become commonplace in EMS, caregivers are going to need communication skills that go beyond SAMPLE checklists. A minimalist approach to dialogue with patients, considered preferred if not essential in what was once almost exclusively a light-and-sirens environment, isn't acceptable when prehospital interventions require a thorough understanding not only of chief complaints, but also how the physical part of illness and injury is framed by the patient's environment...
October 2015: EMS World
Brenda Staffan
No abstract text is available yet for this article.
May 2015: JEMS: a Journal of Emergency Medical Services
Morgan M Clark, Guy R Gleisberg, Andrew R Karrer, Mark E A Escott
No abstract text is available yet for this article.
April 2015: JEMS: a Journal of Emergency Medical Services
Bryan Y Choi, Charles Blumberg, Kenneth Williams
Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs...
March 2016: Annals of Emergency Medicine
Gina Agarwal, Beatrice McDonough, Ricardo Angeles, Melissa Pirrie, Francine Marzanek, Brent McLeod, Lisa Dolovich
INTRODUCTION: Chronic diseases and falls substantially contribute to morbidity/mortality among seniors, causing this population to frequently seek emergency medical care. Research suggests the paramedic role can be successfully expanded to include community-based health promotion and prevention. This study implements a community paramedicine programme targeting seniors in subsidised housing, a high-risk population and frequent users of emergency medical services (EMS). The aims are to reduce EMS calls, improve health outcomes and healthcare utilisation...
June 11, 2015: BMJ Open
(no author information available yet)
No abstract text is available yet for this article.
2015: EMS World
Brian Schwartz
The disciplines of paramedicine and emergency medicine have evolved synchronously over the past four decades, linked by emergency physicians with expertise in prehospital care. Ambulance offload delay (OD) is an inevitable consequence of emergency department overcrowding (EDOC) and compromises the care of the patient on the ambulance stretcher in the emergency department (ED), as well as paramedic emergency medical service response in the community. Efforts to define transfer of care from paramedics to ED staff with a view to reducing offload time have met with resistance from both sides with different agendas...
November 2015: CJEM
Martina Heinelt, Ian R Drennan, Jinbaek Kim, Steven Lucas, Kyle Grant, Chris Spearen, Walter Tavares, Lina Al-Imari, Jane Philpott, Paul Hoogeveen, Laurie J Morrison
There is a lack of definitive evidence that preventative, in-home medical care provided by highly trained community paramedics reduces acute health care utilization and improves the overall well-being of patients suffering from chronic diseases. The Expanding Paramedicine in the Community (EPIC) trial is a randomized controlled trial designed to investigate the use of community paramedics in chronic disease management ( ID: NCT02034045). This case of a patient randomized to the intervention arm of the EPIC study demonstrates how the added layer of frequent patient contact by community paramedics and real-time electronic medical record (EMR) correspondence between the paramedics, physicians and other involved practitioners prevented possible life-threatening complications...
2015: Prehospital Emergency Care
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