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Paramedic recruitment and retention for rural and remote locations: a scoping review
Introduction:
Canadian aeromedical transport and land ambulance services are the primary point of access to advanced levels of healthcare for rural and remote (including Indigenous) communities yet maintaining consistent and appropriate staffing in these work locations poses a consistent challenge. Since 2014, Northern Ontario Ornge bases that service rural and remote locations have been understaffed on average 40% more often than bases situated in Southern Ontario. Rural and remote ambulance services must consistently maintain appropriate staffing to ensure equitable access to care and better outcomes for patients. It is unclear what is known about recruitment and retention of paramedics in rural and remote areas.
Objective:
The primary objective of this scoping review is to examine the literature related to recruitment and retention of paramedics for rural and remote work locations. Secondary objectives include developing a conceptual model to guide future research.
Methods:
This was a collaborative study between content experts from Ornge (Ontario’s Air Ambulance and Critical Care Service) and the NOSM University. A search strategy was created with assistance of an information specialist, exploring concepts of paramedics, recruitment, retention and rural and remote work locations. Ovid MEDLINE, CINAHL, Embase, PubMed, Google Scholar databases were searched. Articles were screened for inclusion and then full text review by two independent reviewers. Data related to retention and recruitment strategies were then extracted for analysis. Results will be presented according to PRISMA-ScR standards.
Results:
The search yielded 879 relevant studies, of which 94 were included for full text review. Our initial observations indicate that there are no studies that describe paramedic recruitment and retention strategies for rural and remote primary work within Canada and few studies directly addressing our study concepts globally. Next steps include a thematic analysis of relevant studies to guide the development of a conceptual model for future research.
Conclusions:
Our preliminary findings indicate a significant gap in the literature. Continued research is required to better understand if ambulance services in Canada are employing current best-practice recommendations, seen throughout healthcare, to their rural and remote work location recruitment and retention strategies.
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