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Community paramedic

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By Joel D'Eath Canadian Advance Care Paramedic. Interests include advanced airway, sim training, and pre-hospital emergency care.
D Wayne Taylor
Canadian healthcare is not universal. Nowhere is this lack of universality more evident than in the payment for drugs in Canada. Canadians without the financial wherewithal cannot access orphan drugs for rare diseases and take-at-home oral cancer drugs and many other pharmaceuticals. In addition to the physical and emotional tolls experienced, patients and survivors and their families and caregivers bear the brunt of an ever-growing financial burden. This article outlines how this happened and what to do about it...
March 2015: Healthcare Management Forum
Jamie R Daw, Steven G Morgan
OBJECTIVES: To describe recent changes and identify emergent trends in public drug benefit policies in Canada from 2000 to 2010. METHODS: For each province, we tracked pharmacare design (namely eligibility, premiums, and patient cost-sharing) over time for three beneficiary groups: social assistance recipients, seniors, and the general non-senior population. We assess which plan designs are emerging as a national standard, where the gaps in public coverage remain, and implications for progress towards national pharmacare...
January 2012: Health Policy
Blair L Bigham, Sioban M Kennedy, Ian Drennan, Laurie J Morrison
BACKGROUND: Paramedics are an important health human resource and are uniquely mobile in most communities across Canada. In the last dozen years, challenges in the delivery of health care have prompted governments from around the globe to consider expanding the role paramedics play in health systems. Utilizing paramedics for the management of urgent, low-acuity illnesses and injuries has been coined "community paramedicine," but the role, safety, and effectiveness of this concept are poorly understood...
July 2013: Prehospital Emergency Care
Ian R Drennan, Katie N Dainty, Paul Hoogeveen, Clare L Atzema, Norm Barrette, Gillian Hawker, Jeffrey S Hoch, Wanrudee Isaranuwatchai, Jane Philpott, Chris Spearen, Walter Tavares, Linda Turner, Melissa Farrell, Tom Filosa, Jennifer Kane, Alex Kiss, Laurie J Morrison
BACKGROUND: The incidence of chronic diseases, including diabetes mellitus (DM), heart failure (HF) and chronic obstructive pulmonary disease (COPD) is on the rise. The existing health care system must evolve to meet the growing needs of patients with these chronic diseases and reduce the strain on both acute care and hospital-based health care resources. Paramedics are an allied health care resource consisting of highly-trained practitioners who are comfortable working independently and in collaboration with other resources in the out-of-hospital setting...
2014: Trials
Gina Agarwal, Ricardo N Angeles, Beatrice McDonough, Brent McLeod, Francine Marzanek, Melissa Pirrie, Lisa Dolovich
BACKGROUND: Older adults have higher risk of developing cardiovascular disease, diabetes and falls, leading to costly emergency medical service (EMS) calls and emergency room visits. We developed the Community Health Assessment Program through EMS (CHAP-EMS) that focuses on health promotion/prevention of hypertension and diabetes, links with primary care practitioners, targets seniors living in subsidized housing, and aims to reduce morbidity from these conditions, thereby reducing EMS calls...
2015: BMC Research Notes
Madison Brydges, Chris Spearen, Arija Birze, Walter Tavares
OBJECTIVES: As an aging population continues to place strain on the health care system, many older adults are living with unmet social and medical needs. In response, Emergency Medical Services (EMS) have initiated programs that encourage paramedics to refer patients in need to community based support services. This qualitative study explores frontline paramedic experiences with referral programs to identify opportunities and challenges in their practice. METHODS: This study used an intepretivist qualitative study design involving interviews of frontline paramedics employed in a region where referral programs were in place...
November 2015: CJEM
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
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
Judah Goldstein, Jennifer McVey, Stacy Ackroyd-Stolarz
Caring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions...
January 2016: CJEM
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...
2015: BMJ Open
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
Pierre-Nicolas Carron, Fabrice Dami, Bertrand Yersin, Valérie Toppet, Bernard Burnand, Valérie Pittet
QUESTION: In the ageing European population, the proportion of interventions by the emergency medical services (EMS) for elderly patients is increasing, but little is known about the recent trend of EMS interventions in nursing homes. The aim of this analysis was to describe the evolution of the incidence of requests for prehospital EMS interventions for nursing home residents aged 65 years and over between 2004 and 2013. METHODS: A prospective population-based register of routinely collected data for each EMS intervention in the Canton of Vaud...
2015: Swiss Medical Weekly
Jan L Jensen, Andrew H Travers, Emily G Marshall, Ed Cain, Stephen Leadlay, Alix J E Carter
OBJECTIVE: An extended-care paramedic (ECP) program was implemented to provide emergency assessment and care on site to long-term care (LTC) residents suffering acute illness or injury. A single paramedic works collaboratively with physicians, LTC staff, patient, and family to develop care plans to address acute situations, often avoiding the need to transport the resident to hospital. We sought to identify insights gained and lessons learned during implementation and operation of this novel program...
January 2014: Prehospital Emergency Care
Judith C Finn, Daniel M Fatovich, Glenn Arendts, David Mountain, Hideo Tohira, Teresa A Williams, Peter Sprivulis, Antonio Celenza, Tony Ahern, Alexandra P Bremner, Peter Cameron, Meredith L Borland, Ian R Rogers, Ian G Jacobs
BACKGROUND: As demand for Emergency Department (ED) services continues to exceed increases explained by population growth, strategies to reduce ED presentations are being explored. The concept of ambulance paramedics providing an alternative model of care to the current default 'see and transport to ED' has intuitive appeal and has been implemented in several locations around the world. The premise is that for certain non-critically ill patients, the Extended Care Paramedic (ECP) can either 'see and treat' or 'see and refer' to another primary or community care practitioner, rather than transport to hospital...
2013: BMC Emergency Medicine
David C Cone, John Ahern, Christopher H Lee, Dorothy Baker, Terrence Murphy, Sandy Bogucki
INTRODUCTION: Responses for "lift assists" (LAs) are common in many emergency medical services (EMS) systems, and result when a person dials 9-1-1 because of an inability to get up, is subsequently determined to be uninjured, and is not transported for further medical attention. Although LAs often involve recurrent calls and are generally not reimbursable, little is known of their operational effects on EMS systems. We hypothesized that LAs present an opportunity for earlier treatment of subtle-onset medical conditions and injury prevention interventions in a population at high risk for falls...
January 2013: Prehospital Emergency Care
Michael K Howlett
Nova Scotia is building a system of prehospital care based on four principles: "Fail Safe" government ownership; "Full Service" advanced life support capable; "High Performance" resource efficiency; and "Fiscally Responsible" performance goals, incentives and penalties. Emergency Health Services Nova Scotia exercises funding and regulatory control through service provided by a private contractor. Benefits include improved fleet and equipment management, information systems, 911 dispatch and performance tracking, medical control and paramedic care, and public accountability...
2003: Healthcare Management Forum
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