Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Sibbald, Shannon L.

Abstract

Lift assist refers to calls for emergency medical services indicating that an individual has fallen, is unable to mobilize, receives no treatment on scene, and refuses transport to the hospital following paramedic response. As the aging population grows, there is a national increase in the lift assist call type, impacting paramedic services, patient health outcomes, and primary care providers. This qualitative focused ethnography study utilized semi-structured interviews with community paramedics (CPs) to describe the role of CPs in providing lift assists in Southwestern Ontario. Interview transcripts were inductively coded and analyzed to generate themes and broader categories to examine paramedic perceptions of community paramedicine programming and the experience of responding to lift assists. This study revealed that having CPs provide lift assists could improve patient health outcomes through a more appropriate response, enhanced assessments, and care provider follow up while simultaneously reducing emergency department presentations and paramedic burden.

Summary for Lay Audience

Many older adults in Southwestern Ontario call 9-1-1 after falling within the home. In many cases, they may not be medical emergencies as these older adults simply need help returning to a seated or standing position. Older adults who fall within the home require trained health care professionals to respond, assess the patient and provide adequate follow up care; in many instances individuals simply require a lift assist. Community paramedics (CPs) are paramedics with additional training to provide care for older adults within the community through an expanded scope of practice and home visits. The goals of this study were to understand how paramedics view community paramedicine programming and describe paramedics’ experience of responding to lift assist calls in Middlesex-London. Through interviewing techniques, this study described the experience of providing lift assists and explored the role of community paramedicine programming in performing these lifts for patients in order to allow front-line medics to prioritize medical emergencies. This study found that while paramedics agree that these patients require a trained health care professional to do a full assessment of the patient, they generally feel that providing lift assists are not a good use of emergency medical services’ time and resources. CPs providing lift assists in Southwestern Ontario would be an opportunity to provide care to vulnerable patients, spend more time with the patient, assess their living environment and follow-up with their family physician and care team. Participants expressed that while CPs providing lift assists would improve patient quality of life and relieve paramedic burden, a lack of secure funding and poor communication with 9-1-1 dispatch operators are barriers to this change. This study suggests that if CPs provided lift assists in Southwestern Ontario, patient health outcomes would be improved while reducing paramedic burnout and unnecessary emergency department presentations.

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