Patient–paramedic trust could reduce unnecessary ED presentations

The professionalism and compassion of paramedics attending emergency calls can reduce unnecessary presentations at hospital emergency departments (EDs), according to research by a veteran ambulance officer.

Dr Robbie King, a senior advanced care paramedic with 15 years of experience with Queensland Ambulance Service, has conducted a five-year PhD at the University of the Sunshine Coast (UniSC) analysing the characteristics of more than 1.5 million NSW Ambulance patients between 2020 and 2021. His research found that 12.6% were not conveyed to an ED.

King, who currently works as a single responder on the Sunshine Coast, also interviewed 21 people from that category to better understand their experiences with paramedic and ambulance service health care.

“When patient–paramedic interactions included validation, thorough assessment, and both compassionate and professional care, patients who did not need to attend ED were able to regain self-efficacy to manage their concerns independently,” King said.

“The study identified that paramedics are trusted by patients as healthcare professionals who are able to support them with decision-making regarding necessity of attendance at hospital ED,” King said.

King said paramedics in those cases could help direct patients to the best healthcare service options for their needs. “However, in cases where this did not occur adequately for the patient, trust did not develop and patients continued to seek emergency health care until they found resolution.”

“The study showed how the ‘patient experience’ of paramedic-led health care could result in the identification of patients’ true needs, which might suit healthcare services other than an ED,” he said.

“This outcome differs from the traditionally accepted concept that ambulance services mostly attend acute emergencies in the community and transport patients to an ED for further assessment and, if necessary, treatment.”

King, whose PhD was supervised by UniSC Associate Professor of Health Promotion Florin Oprescu and Associate Professor of Midwifery Terri Downer, said its findings could help inform paramedic practice and education.

“This knowledge could also provide a foundation to develop patient-reported experience measures of paramedic-led, and ambulance service, health care,” he said. “Currently, there are no specific measures for patients not conveyed by an ambulance service to ED.”

Oprescu said the PhD had created a new theoretical model that could help academics and professionals better understand how patients experienced non-conveyance.

King will officially graduate in April with his University of the Sunshine Coast PhD. His study received funding from the Australasian College of Paramedicine.

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