CIVIC-PG Track B: Strengthening community paramedicine services through action research

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Community paramedicine programs are designed to provide expedited and customized care to underserved and often vulnerable populations seeking repeat assistance through emergency 9-1-1 services. While evaluations show that these programs are effective at reducing use of emergency services and saving cities money, knowledge of how successful these programs are at improving the quality of life for the clients they serve and whether they serve the community equitably is limited. This participatory action research project explores the perspectives of San Francisco Fire Department Community Paramedicine Division’s vulnerable clients and the paramedicine staff. The goals in Stage 1 are to identify indicators of success as defined by clients and staff and develop a method to meaningfully measure progress toward successful outcomes. The project aims to consolidate data from several distinct community paramedicine programs to better understand the client population. Insights from this project will be used to develop, pilot, and evaluate interventions to improve effectiveness and equitable delivery of community paramedicine services in San Francisco and other communities across the United States. The vision for this project is to strengthen community paramedicine’s work to improve the quality of life and resilience of residents of San Francisco who rely heavily on emergency services. Existing metrics to evaluate community paramedicine programs focus only on cost-savings and efficiencies and not on the experiences of vulnerable clients and community paramedics. The research team will be measuring success at the individual- and community-level, tracking how equitably these programs are being delivered, and developing strategies to reduce burnout and moral injury among community paramedics. The Stage 1 activities are guided by three core questions: 1) how do community paramedicine staff, clients, and municipal stakeholders define success for community paramedicine programs?; 2) what are useful metrics to measure equitable delivery of community paramedicine programs and what data should be routinely collected to assess these metrics?; and 3) what interventions could improve the coordination, design, equitable delivery, and/or efficiency of community paramedicine services? The Stage 2 pilot will test best practices that could be scaled and adopted by other community paramedicine programs that share the goal of serving vulnerable populations.This project is in response to the Civic Innovation Challenge program—Track B. Bridging the gap between essential resources and services & community needs—and is a collaboration between NSF, the Department of Homeland Security, and the Department of Energy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.