practice
literature review

Community paramedics: a scoping review of their emergence and potential impact

21 May 2014
Features
02 May 2014
Volume 4 · Issue 1

Abstract

Objectives: This paper reports on the extent of the peer-reviewed literature relating to community paramedics since the inaugural meeting of the International Roundtable on Community Paramedicine in 2005. A scoping review was undertaken to: examine the extent, range and nature of research activity; determine the value of undertaking a full systematic review; summarise and disseminate research findings; and identify research gaps in the existing literature.

Methods: This scoping study systematically searched and located literature on community paramedics from 2005 to 2012 irrespective of study design. It mapped the key concepts underpinning the emergence of community paramedics and the main sources and types of evidence available. In this review the concept of community paramedics as defined by the International Roundtable on Community Paramedicine was used as the key reference point.

Results: The community paramedicine literature fell into three broad categories: theoretical studies; empirical studies measuring outcomes; and reviews. While there are few peer-reviewed articles, a growing number of empirical studies are beginning to emerge as a result of programme evaluations in various regions of the world. At this time there are a handful of relevant reviews in the literature that are focused on innovations in paramedic practice. One Australian research team has published all of the peer-reviewed theoretical papers underpinning this innovation in paramedic practice.

Conclusions: There is growing evidence of community paramedicine research in the literature, including some links with related studies, such as that of the extended care paramedic programmes in the United Kingdom. There remains a strong focus on commentaries and opinion papers in both peer-reviewed and trade publications. Nonetheless, there is an emerging research literature that is contributing to the development of community paramedicine programme models and the evaluation tools that will contribute toward the future evolution of the model.

The emergence of more complex professional paramedic roles such as community paramedicine raises a host of questions related to expectations, roles, and the extent to which the outcomes justify the investment in these innovations. In Canada, the United States, the United Kingdom, Australia, and New Zealand, pilot programmes and trials of different community paramedic-type models are being undertaken to test the concept, and to determine the safety and impact of these innovations (Mason et al, 2008; Blacker et al, 2009; Martin-Misener et al, 2009; Swain et al, 2010; Montera and Robinson, 2011).

These innovations in paramedic practice have often emerged organically from existing structures and local needs. There has been limited reference to developments elsewhere and they have rarely been based on empirical evidence of positive outcomes. While it can be argued that this is the result of there being a dearth of evidence (Patterson and Skillman, 2013), there may be significant work published throughout the world that is published in refereed journals and conference proceedings that are not routinely accessed by service providers or paramedics.

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Community paramedicine
Empirical studies
Reviews
Theoretical studies