Article Text
Abstract
Background Paramedic Practitioner (PP) scope of practice is not comprehensively understood by Emergency Operations Centre (EOC) staff and tasking may be suboptimal. In one UK ambulance trust in November 2018, one PP team was enabled to remotely monitor live incidents and, alongside some continued EOC-dispatch, to self-task to incidents they judged would benefit from their additional knowledge and skills. Evidence on self-tasking benefit was found from helicopter emergency services only.
Methods A retrospective cross-sectional study was utilised to evaluate the impact on self-sufficiency - defined as incidents completed by a PP without the need for further ambulance resources - and conveyance rates of PPs utilising a ‘self-tasking’ dispatch model. PP-completed shift reports were collected over a 6-month period from ten PPs working in one trust locality. Excluded cases: Category-1 calls, healthcare professional calls, PP referrals and back-up requests originating from on-scene ambulance clinicians. Descriptive statistics were used to compare rates of self-sufficiency and conveyance between self-tasked and EOC-dispatched incidents.
Results Shift reports detailing 964 incidents were analysed; 705 were self-tasked and 259 were EOC-tasked. PPs showed a statistically significant increase in self-sufficiency when utilising the self-tasking method of dispatch compared to EOC initiated dispatch (88% self-tasked versus 72% EOC-tasked, χ2 40.4, df 1, p<0.01). There was also an increased non-conveyance rate self-tasking compared to EOC-led tasking (64% versus 56%, χ2 5.3, df 1, p<0.05).
Conclusions PPs appear to find it easier to identify incidents suited to their scope to be self-sufficient than EOC staff. This study is a small-scale evaluation in one site, does not adjust for confounders, and does not constitute a direct comparison of the two models. There remains a need for more rigorous research on this topic, though this evaluation suggests that there may be benefits to be gained from PPs self-tasking.