Exploring the implementation of the Rural Advanced Care Community Paramedics (RACCP) in rural and remote British Columbia
Rural and remote communities in BC face challenges that urban areas do not experience and face significant challenges having their health care and emergency needs adequately, appropriately, and effectively met. The geographic remoteness, long distances to and between appropriate facilities, low population densities, weather, topography, and limited availability of providers make it more challenging for individuals to access health care and to deliver reliable and appropriate paramedic care. As a result, new roles are being implemented in rural settings as a means of addressing gaps in care and bolstering existing healthcare services.
In 2018, the BC Emergency Health Services (BCEHS) Community Paramedicine (CP) program was expanded to include the implementation of ACPs within rural and remote communities. The new Rural Advanced Care Community Paramedic (RACCP) role further expanded the traditional scope of practice of CPs. The RACCP was designed to build upon the existing CP foundation of scheduled patient visits, to include providing direct care to those with a higher acuity and using advanced skills to deliver patient care across a broad range of settings. This model was developed purposefully to allow the RACCPs to directly access local needs and develop their roles to address gaps and extend access to healthcare services. This can include community health assessments, patient monitoring, medication prescription, and providing direct support to frontline healthcare providers, including physicians, during complex emergency situations.
The purpose of this study is to examine the implementation and integration of the RACCP role in six rural and remote communities in BC. The objectives of this work are: 1) To examine the implementation of the RACCP role in six rural and remote communities of BC; and 2) To understand the barriers and facilitators impacting the integration of RACCPs in rural and remote communities in BC. We have undertaken stakeholder consultations and in-depth semi-structured interviews with key stakeholders at each of the six community sites, including Fort. St John, Valemount, Prince Rupert, Cranbrook, Campbell River, and Ganges/Salt Spring. This work is guided by the question: ‘Does the implementation of Rural Advanced Care Community Paramedics (RACCPs) enhance healthcare access and delivery in six rural and remote communities in BC?’ This work involved exploring the roles and contributions of RACCPs in each of the communities and will critically examining the barriers and facilitators that may impact the implementation and integration of this role.
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