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Table 2 Descriptions of new models of paramedic care in Ontario

From: Building integrated, adaptive and responsive healthcare systems – lessons from paramedicine in Ontario, Canada

Category or target population Program characteristics and typical activities
Chronic disease management and aging at home Paramedics supporting primary and home care teams – including physicians, nurses, social workers and personal support workers – to provide individualized preventative and emergent care to clients at home. Target populations include those with heart and lung disease, diabetes and dementia. Services include home wellness visits, blood and urine analysis, medication adjustment and symptom management.
Community outreach and harm reduction Paramedics supporting mobile clinics, outreach and harm reduction programs in community housing, shelters and street settings. Health prevention, promotion and safe consumption services for range of populations: seniors; people on social assistance; people who are homeless or undocumented; people with substance use disorders.
Low-acuity urgent care Response teams to assess and treat unscheduled, non-emergent needs such as general illness, minor wounds and injuries; mechanisms to initiate follow-up care in the community without involving the emergency department.
Mental health and situational crises Crisis response teams – which may include a combination of paramedics, nurses, social workers or police officers – for clients experiencing a mental health or situational crisis. Clinical guidelines and criteria to directly refer or transport clients to designated mental health facilities.
Palliative care 24-h pain and symptom management provided by paramedics for clients rostered to a palliative care team. Provision of comfort measures to support clients’ wishes to remain at home rather than go to the hospital at end-of-life.
Public health and vaccines Paramedics supporting public health initiatives by providing in-home and on-site vaccinations, distribution of naloxone kits and public education programs.
System navigation, case finding and needs assessment Based on data on increased service use or observations at the scene of an emergency, paramedics initiate home visits to discover unmet needs and referrals to follow-up services, including connecting clients with primary care teams, case management and services that address social determinants (e.g., nutrition, income, transport).
Transitions to home after hospital discharge Paramedics providing clients in-home assessments and wellness checks after discharge from hospital to identify unmet health and social needs. Paramedics serving as a ‘bridging’ service before home and community care supports are activated, and providing treatment for symptoms that can be managed in the home setting.