Embedded Files
PAGE 3
The high demand for acute health care and shortage of health resources in rural and remote communities has forced a reduction in the range of services provided, and a focus of rural GPs on illness treatment rather than wellness promotion. Despite its’ importance for injury and chronic disease, the need for prevention activities is an component of health that cannot easily be addressed in a climate of significant health service deficiency. The role of paramedics Since the late 1990s, one approach to addressing health workforce shortages has been developing in the form of new arrangements between Emergency Medical Systems (EMS) and managed care organisations. Whilst internationally a variety of innovative partnership models have been explored, the most notable developments have been made in the United Kingdom and the United States. In the UK’s National Health Service (NHS), these systems are facilitated by integration of the financial and resource utilisation needs of the primary care/managed care sector and are predicated by challenges to maintaining a sustainable medical and nursing workforce. The goals of these arrangements include: • extending resources over increasing demand • matching safe and appropriate resources to clinical need. In some models, a desired effect has also been reduction in EMS costs.1 Cost reduction has been evidenced in models which utilise emergency contact and despatch functions to stream patients to a variety of care environments (eg: General Practitioners, telephone health advice services, community nursing services, emergency ambulance response) contingent upon their symptoms and acuity. These models are collectively known as Multiple Option Decision Point (MOPD) systems. In Queensland, examination of potential models to facilitate similar adjunct health services is ongoing. Models under examination include, but are not necessarily restricted to: • mechanisms to facilitate closer working arrangements between paramedics and primary care practitioners, outpatient services, community nursing providers—some components of which been the United Kingdom • models similar to the Physicians Assistant (PA) program established in the United States. Physicians Assistants are health care professionals licensed to practice medicine under Physician supervision. Overseas, many PA’s have prior qualifications as nurses and paramedics • training and implementation of new qualifications as Primary Care Paramedics • American Emergency Medical Technician (EMT) models. Emergency Medical Technicians in the United States provide immediate health care and transport patients to medical facilities in much the same context, though typically with less training and a reduced scope of practice, as do paramedics in Queensland. Queensland Paramedics are among the most highly trained prehospital emergency health providers in the world. The combined approach to vocational and tertiary based Advanced Care and Intensive Care Paramedic programs deliver prehospital emergency care providers with significant clinical skill sets. In this context, Queensland is well placed to expand the utility of paramedics to wider public health and primary care health delivery. The National Public Health Partnership defines public health as “… organised response to society to protect and promote health, and to prevent illness, injury and disability”.13 Primary care is generally understood to refer to the prehospital community environment and general practice settings, but may extend to outpatient services in acute facilities. Both the environment and the intent referred to by these definitions are consistent with the focus of paramedic practice. Paramedics in rural and remote communities experience considerable periods of time not engaged in the undertaking of emergency work, and thus present a valuable resource for further utilisation. Expansion of the roles of Paramedics in rural and remote health networks could represent a significant improvement in access to basic health care needs for these communities.
Google Sites
Report abuse