The Ambulance Service of New South Wales plays an integral role in the Australian health system, however the demand for these health systems continues to grow. As the workload for Paramedics continues to escalate, so does the need to provide low acuity patients with an alternative pathway, it is here that the role of the Extended Care Paramedic has been introduced.
The Ambulance Service of New South Wales has piloted a program for this particular role in the community. This allows qualified paramedics to undertake a course that will enable them to assess, identify and treat patients of a lower acuity that may or may not necessarily need hospital. This expanding role allows the paramedic to provide primary health care needs, improve emergency response times and enhance the collaboration between health groups. This role allows a more tailored approach to direct care for the patient and their carers and may reduce the demand for resources on the associated emergency departments. As the Ambulance service further evolves this particular role in the community, it will see a shift of focus towards a “treat and leave” initiative. That is, it will oversee additional services to ensure the patients individual needs are met, rather than transporting them to the emergency department. This is vital when considering the long-term effects it will have on improving the health system and prompted me to reflect on this particular issue.
In my experience as both a Nurse and now a Paramedic student, I had come from a belief that the Ambulance service was only to provide pre-hospital emergency care only. Upon starting this degree, my views have changed significantly. In my first on-road practical, we were presented with many cases of patients that had called triple zero for minor injuries or illnesses that in my eyes could have been better treated at the doctor or local health clinic, rather than utilizing an emergency service. Although in the patients eyes it may be seen as an emergency I found myself thinking many a time how much better the health system could be if we could determine whether the patient should be provided with treatment or not. As a paramedic I know it is our duty of care to provide services to patients if they call, however the introduction of an ECP (which I had never heard of before going on road) was an obvious improvement to this dilemma. As one of my lecturers is an ECP, we were provided with the services and treatments that they attend to and it made sense to me that these programs were being introduced. Not only does it allow the emergency paramedics to attend to ‘real’ emergencies, but it also allows a more smooth and efficient transition for the patient being treated by the ECP in regards to referrals and treatment in their own home, which, lets face it, is a much nicer experience than sitting in the hospital waiting room for hours on end.
The Ambulance services in Australia play a vital role in the Australian health care system, however, according to COAT many of the national health policy initiatives that have been suggested previously have not been considered in regards to service delivery. He goes on to say that the reasons for this are unclear, but suggestively notes that it may be because the service is seen as an emergency system, rather than under the ‘health’ system. Alongside this, Gaston adds that by integrating the ambulance services under the health system umbrella rather than segregating, the outcomes of the “health initiatives’ will be greatly influenced positively. Because the Ambulance service has not been regarded as part of the health care team in the past, in recent years they have strategized to aim for a more relevant and expanded role Evans
Metropolitan areas are expanding these roles to increase efficiency and to allow paramedics to treat within a broader scope of practice, which means being able to safely treat the patient at home or within the community...
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