Community paramedicine as EMS’s CRR program

CP/MIH provides outreach, promotes wellness and navigates patients into and through the healthcare system as part of a greater objective – community risk reduction


If you take a look at some of the initiatives that our colleagues in the fire service have embraced, you’ll see a slight transition away from the concept of fire prevention and toward something a bit more encompassing, a bit more collaborative. That’s not to say that fire prevention initiatives have been abandoned (that’s hardly the case!). Rather, they’ve been combined with other initiatives and projects like public education, workplace safety and even a bit of EMS. They’ve rebranded their traditional approach of fire prevention to something more holistic: community risk reduction (CRR).

Community risk reduction, ladies and gentlemen, is not just a fire service thing. It’s also an EMS thing. CRR – as its name states – focuses on reducing the risk of injury, illness, chronic needs and system abuse. It focuses on promoting positive health, resource availability, and outreach and education. CRR, when you break it down, is what many EMS agencies have been doing, but they’ve been calling it something a little bit different, and have been focusing their efforts in a bit more narrowed context: community paramedicine (CP).

Community paramedicine is community risk reduction

EMS agencies can educate citizens on first aid and CPR skills, stop-the-bleed practices, medical alert devices, environmental/climate illness prevention, and in-home trip/fall hazard prevention. (Photo/American Ambulance Association)
EMS agencies can educate citizens on first aid and CPR skills, stop-the-bleed practices, medical alert devices, environmental/climate illness prevention, and in-home trip/fall hazard prevention. (Photo/American Ambulance Association)

Outreach, wellness and navigation ... we’ve discussed these concepts before in the context of CP and mobile integrated healthcare (MIH) programs. When you take a look at each of these components collectively – holistically – you’ll undoubtedly come to the same conclusion: that they’re the same components of a CRR program. Considering this, it’s fair to say that community paramedicine is a component of community risk reduction as a whole.

CP programs focus on individual-based population care, social and healthcare navigation, reducing 911 misuse and overall patient wellness. CP programs aren’t designed to be someone’s primary care. Rather, they’re designed to support someone’s primary care and to function as a resource between such appointments and other healthcare provider visits. They’re designed to reduce one’s risk of illness exacerbation and the need for emergency transport to a hospital. They’re designed as a component of community risk reduction.

What else fits into community risk reduction?

As CP fits into the context of CRR, it’s possible to structure and operate a CRR program without necessarily having to have a formal CP program. Fire departments educate citizens on fire safety, promote smoke detector installation, and educate citizens on the risk of wildfires and disasters. EMS agencies can educate citizens on first aid and CPR skills, stop-the-bleed practices, medical alert devices, environmental/climate illness prevention, and in-home trip/fall hazard prevention. These can all be presented through group/public training sessions, social platform posts, external marketing materials, and other community-wide information sharing initiatives. In fact, each of these components can be performed by any EMS provider level; EMR through paramedic. Nothing about this requires the development of a community paramedicine program, but it sure does correlate to one’s potential for added success!

Community paramedicine plus community risk reduction

In the ideal setting, community paramedicine can exist as a component of a community risk reduction program or division within an EMS agency. CP providers focus on many of the general CRR concepts outlined, but also focus on a more collaborative systems of care and direct patient relationship approach toward risk reduction.

Other EMS providers who may not require the same one-on-one patient relationship can focus on a bigger picture, such as educating larger populations (e.g., schools, workplaces, neighborhoods) on many of the same concepts. The CRR approach is more public-focused, while the CP approach is more patient-focused (with the patient still being a part of the general public).

Integrating the two together opens-up the possibility for internal promotion and career advancement opportunities, utilizing the unique talents and interests of more individuals (as opposed to solely specialty-trained paramedics), and allows for different job descriptions to be identified through delineated differences in one’s responsibilities.

After all, you may have a CP that is great in the one-on-one environment, but doesn’t thrive in a group environment. Affording the opportunity for individuals with the opposite skillset sets your agency up for greater success through embracing the holistic concept of community risk reduction.

Read next: How 4 community paramedicine programs are positively impacting healthcare

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