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

社区辅助医疗项目旨在为服务不足的弱势群体提供快速和定制的护理，这些群体通常需要通过紧急9-1-1服务获得重复援助。虽然评估表明，这些方案在减少紧急服务的使用和节省城市资金方面是有效的，但关于这些方案在改善其服务对象的生活质量方面有多成功以及它们是否公平地为社区提供服务的知识有限。这个参与性行动研究项目探讨了旧金山消防局社区医疗辅助部门的弱势客户和医疗辅助人员的观点。第一阶段的目标是确定由客户和员工定义的成功指标，并开发一种有意义的方法来衡量成功结果的进展。该项目旨在整合来自几个不同社区医疗辅助项目的数据，以更好地了解客户群体。从这个项目中获得的见解将用于开发、试点和评估干预措施，以提高旧金山和美国其他社区的社区辅助医疗服务的有效性和公平提供。该项目的愿景是加强社区辅助医疗工作，以改善严重依赖急救服务的旧金山居民的生活质量和复原力。现有的评估社区辅助医疗项目的指标只关注成本节约和效率，而不是弱势客户和社区护理人员的经验。研究小组将衡量个人和社区层面的成功，跟踪这些项目的公平程度，并制定策略，以减少社区护理人员的倦怠和道德伤害。第一阶段的活动以三个核心问题为指导：1)社区辅助医疗人员、客户和市政利益相关者如何定义社区辅助医疗项目的成功？2)衡量社区辅助医疗项目公平提供的有用指标是什么？评估这些指标应常规收集哪些数据？3)哪些干预措施可以改善社区辅助医疗服务的协调、设计、公平提供和/或效率？第二阶段试点将测试最佳做法，这些做法可以被其他社区辅助医疗项目推广和采用，这些项目的目标是为弱势群体提供服务。该项目是对公民创新挑战项目（track b）的回应，旨在弥合基本资源与服务和社区需求之间的差距，是国家科学基金会、国土安全部和能源部之间的合作项目。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

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.