Community paramedicine to support palliative care

Abstract

Objective This commentary describes community paramedicine (CP) and the potentiality of an expanded scope of practice to provide home-based palliative care. Background The prevalence of individuals desiring palliative care within their home is growing, requiring the provision of high-quality care. CP is a novel approach to delivering care, allowing paramedics to provide community-based, non-urgent care as well as crisis and symptom management within the home. The need for home-based palliative care at earlier stages of the disease trajectory will be essential for the growing older adult population. Community-based models of care are essential in alleviating health systems burden by reducing emergency department visits and over-reliance on primary care. Methods A rapid review was conducted to determine current scope of practice and geographical coverage of CP programming, as well as a broader literature search describing current roles. Discussion An expanded scope of CP practice that provides palliative care has immense potential in alleviating health system burden while simultaneously improving patient health outcomes. Pilot CP palliative care programs in Alberta, Nova Scotia and Prince Edward Island have demonstrated the benefits of community paramedics providing palliative care through reduced emergency department visits and improved patient satisfaction. Community paramedics are well equipped to provide high-quality palliative care earlier within the patient’s disease trajectory and support the patient and caregiver through remote patient monitoring.