title: Community paramedicine model of care: an observational, ethnographic case study.
abstract: BACKGROUND
  Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery.
  
  
  METHODS
  Using an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations. We then applied a combination of thematic analysis techniques and boundary theory to develop a community paramedicine model of care.
  
  
  RESULTS
  A model of care that distinguishes community paramedicine from other paramedic service innovations emerged that follows the mnemonic RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration with health, aged care and social services; Governance and leadership; Higher education; Treatment and transport options.
  
  
  CONCLUSIONS
  Community engagement and situated practice distinguish community paramedicine models of care from other paramedicine and out-of-hospital health care models. Successful community paramedicine programs are integrated with health, aged care and social services and benefit from strong governance and paramedic leadership.
authors: La Trobe University, PO Box 199, Flora Hill, Victoria, 3552, Australia. p.omeara@latrobe.edu.au.|La Trobe Rural Health School, PO Box 199, Flora Hill, Victoria, 3552, Australia. p.omeara@latrobe.edu.au.
authors: Peter
authors: P
authors: O'Meara
authors: University of Tasmania, Private Bag 135, Hobart, Tasmania, 7001, Australia.
authors: Christine
authors: C
authors: Stirling
authors: County of Renfrew Paramedic Services, 9 International Drive, Pembroke, Ontario, K8A 6W5, Canada.
authors: Michel
authors: M
authors: Ruest
authors: La Trobe University, PO Box 199, Flora Hill, Victoria, 3550, Australia.
authors: Angela
authors: A
authors: Martin
mesh_terms: D000488:Allied Health Personnel / Q000193:education / Q000458:organization & administration*; D000884:Anthropology, Cultural; D054976:Clinical Governance; D003153:Community Health Services / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration; D004634:Emergency Medical Technicians / Q000592:standards; D006801:Humans; D007857:Leadership; D008962:Models, Theoretical; D009864:Ontario; D011320:Primary Health Care / Q000458:organization & administration; D011369:Professional-Patient Relations; D019035:Rural Health Services / Q000458:organization & administration; D014187:Transportation of Patients