It takes a system: Exploring new and disruptive systems of practice in paramedicine.
Presented by: Timothy Makrides, PhD Student, Monash University
Ethics: approval granted by the Monash University for each research project presented in this abstract.
General Disclosure Statement: Authors have nothing to disclose.
Note: this abstract presents several research papers completed within a wider research series undertaken as part of the lead authors PhD program.
Introduction: In the 60 years since its formation, the Anglo-American paramedic system, as a subset of paramedicine, has continued to grow and modernize and is now considered a well-established component of the healthcare, public health and public safety systems in English speaking western countries. While brief and fragmented accounts of the differences between systems have been noted in the literature, until recently there has been a lack of research that explores and identifies new sub-models of paramedicine within the Anglo-American paramedic system. In a realist sense, despite the lack of research into system modernization, paramedic practice has continued to grow and in some cases flourish, however, other systems have shown less growth and innovation. Until recently, we didn’t know why this was.
A recent scoping review conducted by our research team identified two conceptual sub-models of paramedicine within the Anglo-American paramedic system known as the Professionally Autonomous paramedic system, commonly found in Australia, New Zealand and the UK, and the Directive paramedic system commonly found in Canada and the US. With two new sub-models now identified, our research team has set out to explore them in more depth.
Background: This abstract presents the first four research papers completed as part of a wider research thesis exploring the modernization of the Anglo-American paramedic system with the aim of charting the history of the Anglo-American paramedic system and then subsequently exploring, identifying, defining, and comparing these novel systems of practice. These papers include a historical narrative review, scoping review, conceptual framework, and Delphi study.
Methods: Our papers used several different methodologies including a narrative review, scoping review, conceptual framework and Delphi questionnaire methodology.
Results: In our first paper, a historical narrative review, we charted the history of the Anglo-American paramedic system. An important step in understanding the origins and stimulus for change. In our second paper, a scoping review, we identified what is known about the characteristics of modern paramedic systems and identified two new systems of practice. In the third paper, a conceptual framework, we developed a roadmap for our research series, adapted to existing health quality frameworks. In our final paper, we conducted a Delphi study to define the two new system of practice using expert consensus.
Conclusion: This abstract is intended to present a series of research designed to immerse the audience in our journey to disrupt paramedic practice as we explore new newly identified models of paramedic system design aimed at modernizing the profession to meet the needs of our unique healthcare and public health systems.
No two paramedic systems are the same. But what makes them so different?
In an attempt to answer this question, our small but mighty research team is currently exploring the difference between two newly identified paramedic systems, known as the Directive and Professionally Autonomous paramedic systems and we need your help.
Our survey is currently live and we're hoping that you might be able to share it with your respective paramedic networks to help us better inform paramedic system design for decades to come.
The survey is open to paramedics practicing in Australia, UK, New Zealand, USA, Ireland and Canada.
Should you require any more information regarding the nature of they research survey please don't hesitate to contact me anytime. Thank you once again for taking the time to support our teams research.
About the author:
Tim Makrides, CCP, BClinPrac, PhD(c)
Tim started his career in the Australian Defence Force where he served as a medic for six years before transitioning to the Queensland Ambulance Service. After three years as an Advanced Care Paramedic working in some of Australia’s most remote communities Tim undertook his Critical Care training and transitioned to the Critical Care Paramedic role before eventually making the move across to Vancouver, Canada.
In his current role as the Manager, Clinical Services with the British Columbia Ambulance Service, Tim leads the organizations Paramedic Specialist, Secondary Triage and Integrated care programs. Tim holds both undergraduate and postgraduate degrees in paramedicine and is undertaking a PhD at Monash University focused on paramedic leadership, system design and modernization. He also holds several academic appointments, is the Managing Editor of the Journal of High Threat & Austere Medicine and is an avid Vancouver Canucks supporter.