community paramedic there exist limitless opportunities in every industry. where there is an open...
TRANSCRIPT
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Community Paramedic
There exist limitless opportunities in every industry. Where there is an open mind, there will always be a frontier.
Charles F. Kettering
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The Rural and Remote Dilemma
• ¼ of Americans live in rural and remote areas
• Only 10% of America’s doctors practice there
• 4 times as many rural and remote residents traveled >30 miles for health care, compared to urban residents
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The Rural and Remote Dilemma
POPULATION OF RURAL AMERICANS 25%
PRACTICING DOCTORS 10%
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Rural and Remote Demographics
• More elderly • More immigrants • More poverty • Poorer health
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HEALTHY PEOPLE 2010
Goals:• Have a source of ongoing care• Have a usual primary care provider (PCP)• Increase the number of under-represented
ethnic and racial groups with degrees in health professions
• Reduce avoidable hospitalizations
www.healthypeople.gov
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Filling an Unmet Need with Untapped Resources
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Filling an Unmet Need with Untapped Resources
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Volunteer and Paid Paramedics
• EMTs/Paramedics already know how to deliver care locally
• Know how to assess resources and make decisions
• They could fill gaps in care with enhanced skills through targeted training
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Seizing the Opportunity • Built on the Rural and Frontier EMS Agenda
of the Future• Community Healthcare and Emergency
Cooperative (CHEC) developed the curriculum
• The curriculum supports the work of the International Roundtable on Community Paramedicine supports (IRCP)
• Spearheading a movement
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The Community Healthcare and Emergency Collaborative
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The Community Paramedic Program
• Expand role, not scope • Assess and identify gaps between
community needs and services• Improve quality of life/health
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The Community Paramedic Program
• Level 1 – Non-paramedic filling some roles of the Community Paramedic
• Level 2 -- Certificate or Associate degree• Level 3 – Bachelor’s degree• Level 4 – Master’s degree
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Expanded Services
• Primary care• Emergency care • Public health • Disease management • Prevention• Wellness • Mental health• Dental care
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Building on Experience
• Not entirely new • Similar successes around the world
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Building on Experience
QUEENSLAND,AUSTRALIA
NOVA SCOTIA
ALASKA
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Serves Long and Brier Island • Population: 1,240• >50% age 65+ • 2 hours + to nearest hospital • No local health care provider
Nova Scotia Community Paramedic Model
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Nova Scotia Community Paramedic Model
Program Development
1. Hired project manager
2. Assigned medical oversight physician
3. Expanded paramedics’ skill set
4. Explained program to community
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Reaching the Community • Health clinics• Home health assessments • Adopt-a-patient
Nova Scotia Community Paramedic Model
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Nova Scotia Community Paramedic Model Impressive Results
REDUCTION IN EMERGENCY ROOM VISITS
REDUCTION IN CLINIC VISITS
OVER 5 YEARS
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Queensland, AustraliaRural and Remote
Paramedic Program
• Australia’s second largest state • Rapidly increasing/aging population• Needed sustainable health care model
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• Expanded duties • Wound dressing with local anesthetics• Suturing/minor surgical procedures• Chronic pain management• X-rays• Mental health assessment/treatment
Queensland, AustraliaRural and Remote
Paramedic Program
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• Expanded activities• CPR/indigenous
first aid• Road accident
prevention• Community
presentations
Queensland, AustraliaRural and Remote
Paramedic Program
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Alaska Community Health Aide/Practitioner (CHA/P)
• > 550 CHA/Ps • 180 villages • > 300,000 patient encounters
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• 24-hour emergency care• Acute, non-emergent and urgent care• Prenatal, emergency childbirth and
newborn care• Preventive care• Chronic care
Alaska Community Health Aide/Practitioner (CHA/P)
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The List Goes On
• Red River Project, New Mexico • Independent Practice Medic, military • Guanajuato, Mexico
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Community Paramedic Training Program
• Where is the pilot based?• Which communities will be served?• Who is involved? Colleges? County?
Town? Hospitals?• When will it start?
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Community Paramedic Program
BRINGING THE BEST TOGETHER
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Keys to Community Paramedic Program
Flexible
Rural and Remote Centric
Resourceful
Gap-filling
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• Identify specific needs in community health care
• Standardized curriculum, modified for communities
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(but not exclusive)
• Target sparsely populated areas • Address special population issues
– Rising immigrant demographic – Aging in place– Decreasing availability of medical
professionals
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• Identifies what is available
• And what is missing
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• Creates “health home” for citizens• Eyes, ears, and voice of community
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Community Paramedic Guidelines
• Essential oversight by community care providers
• Practice where designated underserved • Approved and welcomed • Funding specific to each locale
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Major Benefits of Community Paramedic Program
• Keeps rural and remote health issues on the radar of policymakers and community leaders
• Measures and addresses health issues specific to rural and remote populations
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Making the Program a Reality
• Community/citizen support • Driven by local
needs and resources
• Current EMS/paramedics
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Making the Program a Reality
• University/community college participation • Establish international registry of student
graduates
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Curriculum Ready to Go
• Standardized multi-module delivery model
• Applicable across America and internationally
• Certificate, associate, bachelor’s, master’s programs
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Curriculum—Phase I
Foundational Skills @100 hours
• Role, advocacy, outreach and public health
• Community assessments
• Developing community strategies for care and prevention
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Curriculum—Phase II
Clinical Skills @15-146 hours
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Filling the Gaps Together
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Filling the Gaps Together
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Community Paramedic Program
Not many sounds in life, and I include all urban and rural sounds, exceed in
interest a knock at the door.
Charles Lamb
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