Perceived value and benefits of the Community Paramedicine at Clinic (CP@clinic) programme: a descriptive qualitative study

Timely access to health information and services

Residents described CP@clinic as a place that connected its participants to community resources based on their current needs and health goals. Participants were able to skip several navigation steps that were required to access some community resources as community paramedics provided a more direct route to these services. Paramedics also provided individualised resources specific to their needs (ie, related to chronic condition management) and wants (ie, reaching healthy lifestyle goals). Participants were thankful for paramedics’ efforts to help them more easily access resources as well their advocating for an in-building fresh food market and investigating programmes that offered free podiatry, dental and other services.

Residents were routinely referred to their family physician for follow-up if they presented with signs and symptoms of a condition, or to an emergency room if needed. For some, the CP@clinic was a turning point in their lives, as programme paramedics were able to quickly identify potential forthcoming adverse health events. Several participants expressed their relief and gratitude for their doctor or ER referral, as they were then diagnosed with conditions such as pneumonia, atrial fibrillation and hypertension.

Residents were also referred to resources to alleviate pain, improve their health status and help reach their healthy living goals. These included physiotherapy, diabetic foot clinics and resources offering support for patients with Chronic Obstructive Pulmonary Disease and those experiencing mental health issues (ie, depression, anxiety). Referrals to the local Home and Community Care Support Services allowed residents to receive high-quality patient care and services in their home. Residents were also guided to services that they were unaware of before the clinic, such as eye and ear clinics and fall detection services. Participants were thankful that the paramedics often went above and beyond by bringing needed medical equipment directly to them (eg, new walker, asthma chamber).

Support to achieve personal health goals

Many residents remarked on the support they received to initiate and follow through on personal health goals. Participants valued the active engagement of CPs with chronic disease prevention related to exercise, diet modification and smoking cessation. Weekly check-ins helped to keep goals at the forefront for each participant and they noted how the CP would celebrate both large and small steps with them. One resident mentioned that they eventually discontinued their prescription for blood pressure pills, and another reported having lost 25 lbs from eating healthier and weighing in every week. Another resident was proud to share they had reduced their daily cigarette consumption from 15 to only 2 a day. Reminders to eat more fruits and vegetables, reduce salt and sugar intake, and exercise made participants more accountable and motivated to make healthy changes.

Better understanding of healthcare system

One interesting finding was the shifts in understanding of the healthcare system and when and whom to access (eg, 9-1-1 calls). A participant shared how through their connection with the CP they were able to better recognise when an ambulance was needed.

Regular engagement with community paramedics fostered residents’ personal health awareness along with knowledge of the healthcare system. For other residents, having access to information about community resources allowed for greater ownership of their health and what was available to them.

Created sense of community

Participants appreciated how the structure of CP@clinic fostered community and a sense of comradery and togetherness. Although sessions were individual, participants enjoyed seeing other residents as they waited for their appointment time. Participants voiced feeling grateful that they were able to get to know residents who may typically spend their time in their units and not partake in building activities. One participant described a resident who was not attending the clinic because she felt that she did not belong to it. The other residents at the clinic regularly encouraged this person to attend a session and she has been attending the clinic ever since. Social support from other residents was a key contributor to the growth and reach of the programme.

CP@clinic brought together building residents, with similar interests, who were motivated to learn how to manage and improve their health. There was a sense of being connected to something larger as they took steps to improve their health. This feeling of community motivated some residents to organise additional functions and gatherings within the building, such as Trivia nights, colouring groups and potluck meals.

Comfortable and familiar environment to talk about health

Residents appreciated both the physical environment of the clinic as well as the approach of the paramedics. Weekly check-ups and monitoring gave many peace-of-mind and was an opportunity to discuss previously unconsidered health issues. Residents felt encouraged to put their health first and without judgement of any earlier healthcare decisions. Timing of the sessions were raised by some participants, who noted afternoon sessions were easier to attend.

Several programme participants emphasised that they felt very comfortable with the paramedics and the programme setting. The clinic was a positive environment and many enjoyed the pleasantries and conversation that naturally transpired during each session. The paramedics were approachable and attentive, which contributed to the clinic’s welcoming atmosphere. One participant reported feeling less anxious talking about their health at the clinic than at other settings. During their visit, participants felt more relaxed and at ease asking questions, and were more likely to share concerns about their health and other issues. Conversations sometimes sparked additional health questions and solutions that were never considered before, or not originally the focus of that particular session.

Residents liked that they could attend to their health by simply walking downstairs to the CP@clinic programme, rather than at a public clinic or their regular primary healthcare provider. Participants saved time and some mentioned having less anxiety than when they visited their doctor. The clinic complemented the care received from the primary care provider who they only saw every few months, and for others primary care visits were minimised due to improvements in health from weekly monitoring and behaviour change.

Participants appreciated that the same CP staff attended the clinic allowing for a trusting relationship to form. The regularity of a weekly clinic also conveyed a sense that healthcare providers cared about them and their health. Residents valued paramedics’ patience and attentiveness during each session, and felt they were being listened to, as they were always given their undivided attention. Residents also noted how CPs would monitor attendance and connect with those who had not come for a few weeks. This attentiveness displayed a care and concern that encouraged participation.

Facilitated communication between healthcare professionals

Many participants acknowledged the communication between CP@clinic and their primary care provider and recognised the importance of this continuity of care. A few healthcare providers shared positive sentiments about the programme with participants. One resident was able to show their CP@clinic personal record book to their doctor. This displayed normal blood pressure measurements across several weeks, which led to the discontinuation of their blood pressure medication. For another resident, faxing the CP@clinic assessment report to their physician helped to facilitate a timely appointment from the physician’s office versus the resident needing to remember to book an appointment themselves.