The rural and regional ambulance paramedic: moving beyond emergency response

Conclusions This research project has reviewed and analysed the emerging roles of paramedics in rural and regional areas. Its outcomes have the potential to set strategic directions for an ESP paramedic role for rural ambulance services in Australia. Expanding ambulance paramedics’ scope of practice offers the potential to improve patient care and the general health of the community. The industry partnership approach between ambulance authorities and universities has increased the research capacity of Australian pre-hospital services. The findings and recommendations are consistent with the general thrust of the recent Productivity Commission report on health workforce issues that emphasised the importance of designing and operating services that are both effective and efficient. Serious long-term recruitment and retention problems among rural health workers in Australia have contributed to inequitable health service access for rural Australians. In response new health care models with flexible workforce roles are emerging, including expanded-scope paramedic roles. Objective This research project addressed the need to develop more flexible and integrated services to improverural Australians’ health outcomes with a primary focus on the role of ambulance service personnel. The principal objective was to identify Australian and international trends in the evolving role of ambulance paramedics and to determine the key characteristics, roles and expected outcomes for an Expanded Scope of Practice (ESP) that are desirable, feasible and acceptable to key stakeholders. Research design Multiple case study methodology involving partner investigators and ambulance professionals as research associates. This study of ambulance practice was set in rural Tasmania, New South Wales, South Australia and Victoria innovative models of rural ambulance practice are evolving.Findings Paramedics are increasingly becoming first line primary health care providers in many small rural communities as the provision of other health care services contract. Within these emerging ESP models,paramedics are developing professional responsibilities throughout the cycle of care, through:• more active community involvement and support;• expansion of their capacity to work in partnership with other health providers in institutional settings or as part of the primary health system; and• the development of broader scopes of practice for paramedics in response to changes in technology,education and the ongoing shortage of other health professionals.