Policy Update: Community Paramedicine Initiative

In April of this year, the BC Emergency Health Services (BCEHS) launched the province’s first Community Paramedicine Initiative, a program that will help provide patients with better access to health care in rural and remote communities by expanding the role of qualified paramedics. This article provides a look at how this program is operating in BC.

A 2014 UBCM Resolution (B 130) called on the BC government and BCEHS to research the Community Paramedicine Model of health care for use in all of rural and remote BC communities. The resolution also requested that ambulance paramedics be employed full time to deliver this service.

BCEHS is working closely with the Ministry of Health, the province’s Health Authorities, the Ambulance Paramedics of British Columbia (Local 873), the First Nations Health Authority, UBCM and others to implement the initiative, which will see 80 new full-time equivalent  (FTE) community paramedics over the next four years.

The initiative was initiated in three “prototype” communities in Northern Health: Chetwynd, Fort St. James and Hazelton, followed in August by the Interior Health communities of Creston and Princeton. BCHES is expected to announce the remaining prototype communities (from Island Health) later this month. All of the prototype communities were identified by BCEHS and the relevant Health Authority based on a combination of community need and the availability of resources to ensure a successful start.

During this first exploratory stage, paramedic unit chiefs familiar with the communities are working with local health care providers to help define the scope of services required and participate in the development a service plan. One of those paramedic unit chiefs is Ms. Patti Thompson, who is based in Hazelton and brings 28 years of experience as a paramedic to her position. 

Over the past few months, Ms. Thompson has been spending her time on community outreach and building awareness of community paramedicine in Hazelton, New Hazelton, Smithers and the most of the eight neighbouring First Nations communities. She’s met with doctors and nurses, participated in hospital rounds, discussed safety issues with local RCMP, spoken with municipal officials, made presentations to municipal councils and others, visited a number of First Nations’ health centres in the area, participated in the Hazelton Kidney Walk, and set up CPR classes for health care providers.  

“Community paramedics need to have a solid understanding of the demographics in the communities we serve,” Thompson explains. “The time I’ve been spending talking to people about the program, and helping them understand our approach in the communities we serve, is so important. Every conversation gives us positive, productive information to help move this project forward.”

The paramedic unit chiefs serving the prototype communities are not yet seeing patients in their homes: that will come in 2016 when the program rolls out to additional rural and remote communities, the community paramedics are hired and trained, and the necessary regulatory changes are in place.

Patients, referred by their family physician or other health care provider, will primarily be those living with chronic diseases such as congestive heart failure, chronic obstructive pulmonary disease and diabetes. Regular visits from a community paramedic can help these patients live longer in their own home, reduce their reliance on medically unnecessary 911 calls, and help ensure they stay connected with their doctor.

Thompson emphasized the need for paramedics to collaborate with other health care professionals, community leaders, first responder agencies, and everyone else providing care to the more vulnerable members of our community. “The job may not appeal to all paramedics, but it’s ideal for those who want to be able to build relationships and serve in their local communities.”

She also notes that a key objective of the initiative is to help stabilize paramedic staffing in rural and remote communities. “Smaller communities tend to have fewer paramedics on staff, primarily because of the lower call volumes,” she explains. “With community paramedicine, BCEHS will be able to offer new full and regular part-time positions to qualified paramedics. The part-time paramedics will be able to sign up for additional shifts in pre-hospital emergency response. That means better service for the community and more stable employment for the paramedic.”

Communities selected for the provincial rollout of the Community Paramedicine Initiative are expected to be announced in early 2016.

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