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Extended Care Paramedics

Chief Investigator:

Professor Ian Jacobs

Principal Investigators:

Professor Judith Finn, Associate Professor Glenn Arendts, Professor Daniel Fatovich, Associate Professor David Mountain, Dr Teresa Williams, Professor Peter Sprivulis and Winthrop Professor Tony Celenza

Associate Investigators:

Mr Tony Ahern, Assistant Professor Alexandra Bremner, Mr Joe Cuthbertson and Professor Peter Cameron

Year Commenced: 2012

Year Completed: Trial in progress

Funding: $370,000

Ethics Approval: Application in progress

Duration: 2.5 years

Overview:

As demand for Emergency Department (ED) services continues to exceed any increase that can be explained by population growth, strategies to reduce demand and/or increase supply are being explored. The concept of ambulance paramedics providing an alternative model of care to the current ‘see and transport to ED’ has intuitive appeal and a small number of so-called ‘extended care paramedics’ (ECPs) have been introduced in New South Wales and South Australia.

The premise is that for certain non-critically ill patients, the ECP can either ‘see and treat’ or see and refer’ to another primary or community care practitioner. However, there has not been any rigorous investigation of which patients can be safely managed in their home, nor has there been any rigorous evaluation of the impact on ED demand and ED over-crowding.

Our project will develop and test empirically derived clinical protocols for an extended care paramedic role for the Perth metropolitan area. In addition, we will model the impact of the introduction of ECPs on ED demand and investigate the potential for ameliorating the problem of ED over-crowding in Perth.

As recently reported by the AIHW, between 2009-10 and 2010-11, ED presentations increased in all states and territories, but the greatest increase occurred in Western Australia (8.1%). Moreover St John Ambulance has reported a 23% increase in cases attended in metropolitan Perth over the last 5 years, which is recognized as a key driver for ED demand. Our goal is to develop and test (through simulation) an empirically validated protocol for the introduction of ECPs in Perth. The goal is to reduce the number of patients transported by ambulance to Perth EDs, without compromising patient safety. We recognise that the success of such a strategy depends on the building of collaborative working relationships between the ambulance paramedics, ED clinicians, GPs and other primary/community care providers.

Status: Commenced in 2012

Contact Person: Professor Judith Finn – email: judith.finn@curtin.edu.au