Tom is a dedicated paramedic, passionate about ensuring equitable access to healthcare for all. As the Coordinator of Integrated Care at NSW Ambulance, he leads integrated care initiatives to improve healthcare access, delivery, and quality, with a particular focus on rural and remote communities.
Beyond Triple Zero (000): Supporting Rural and Remote Communities through Paramedic Connect
Tom Doyle Byrne,1 Matthew Simpson,1 Nick Rosser,1 Melik Ibrahim1, Kimberley J Davis1,2
1 Clinical Capability Safety and Quality, NSW Ambulance, Sydney Olympic Park
2 Graduate School of Medicine, Faculty of Science Medicine and Health, University of Wollongong
Abstract
Background
Rural and remote patients face significant healthcare access challenges and poorer outcomes compared to those in metropolitan areas. Contributing factors include social isolation, distance from healthcare facilities, and difficulties recruiting and retaining health care professionals. The NSW Ambulance Paramedic Connect program integrates paramedics into the broader health workforce in small rural communities, providing community and primary healthcare while maintaining emergency response capacity. We evaluated this program as part of a quality improvement project to better understand it’s utilisation, management and governance.
Methods
Electronic Medical Records (eMRs) from 2019-2023 were analysed. Relevance screening ensured accuracy. Quantitative analysis identified activity and patient volumes by year and station involvement. Thematic analysis categorised primary clinical activities, and rurality was assessed using the Modified Monash categorisation. Qualitative data was gained through focus groups and a clinician experience survey.
Results
Primary clinical activities included welfare checks, patient monitoring, and regular medication administration. The program operated in small rural towns, and remote and very remote communities. Focus groups identified program awareness, integration of care, collaboration, and vulnerable patients as common themes. Activity and patient numbers decreased throughout the period studied.
Conclusion
The Paramedic Connect program effectively integrates paramedics into rural and remote communities, providing primary care and emergency department assistance, benefiting patients, communities, and clinicians. However, utilisation and program management vary across communities. Recommendations include clearly defined guidelines, comprehensive education and global governance structures which enable flexibility for individual community needs. Further research is needed to understand patient and clinician experience and emergency ambulance utilisation.