Paramedicine in Canada and throughout the developed world is currently undergoing unprecedented transformation to its service delivery model, largely driven by the need to relieve healthcare systems from overcrowding, and ensure its availability for all citizens. These changes are facilitated by the ability of paramedic services to adopt a number of innovative technologies, and their ability to respond by adopting new service delivery models, which may entail the deployment of paramedics in various non-emergency roles or integration with other healthcare services.
The purpose of this dissertation is to determine how paramedic services innovate, and how that innovation is influenced by technology in particular. To fulfill this purpose, a two-phase sequential explanatory mixed-methods study is conducted, with a quantitative phase followed by a qualitative phase.
In the first phase a multilevel theoretical model consisting of constructs that measure Service Innovation Performance, Dynamic Capabilities, Information Technology (IT) Capabilities and Group-Level Healthcare Informatics Competencies was evaluated with WarpPLS 5.0. A dataset with participation from paramedic leaders of Canadian land-based paramedic services (n=43) and paramedics employed at these services (n=502) was used for this purpose. Findings from this phase indicate that the information technology related knowledge and skills possessed by paramedics have an impact on various organization level dynamic capabilities, as do various IT Capabilities that focus on the relationship between the paramedic service leadership and the IT service provider.
In the second phase, a qualitative approach was taken to explore contextual and other factors that facilitate or inhibit the ability of a paramedic service to innovate. Results from this phase suggest that Canadian paramedic services primarily undertake innovative activities with a strong focus on assuring and improving patient care. The use of an electronic patient care record (ePCR) is an important resource, as it enables activities such as the improvement of the clinical skills of paramedics, as well as facilitates the generation of business cases for equipment investment. Further, the informatics competencies of paramedics greatly facilitate the adoption of technology and equipment by individual services, as paramedics with a high amount of these competencies assist other paramedics when adopting technology, communicate innovative ideas within a service, and identify areas in need of change. The results of this dissertation underline the value of technology-related knowledge and skills for paramedics, and the importance of technology in ensuring that paramedic services provide a high and continually improving standard of patient care. / Thesis / Doctor of Philosophy (PhD) / Paramedicine in Canada is currently undergoing unprecedented transformation. These changes are driven by the need to relieve emergency healthcare resources from overcrowding, the increase in number of innovative technologies adopted by paramedic services, deployment of paramedics in various non-emergency roles, and increased integration with other healthcare services. The purpose of this dissertation is to determine how paramedic services innovate, and how innovation is influenced by technology. To this end, a two-phase sequential explanatory mixed-methods study is conducted, producing a few key findings that underline the value of technology in paramedicine. First, paramedics with information technology related skillsets can better identify opportunities for improvement in service delivery, and facilitate the organizational adoption of technology. Second, electronic patient care records are a vital source for a variety of innovative activities in paramedic services, such as organization-wide improvement of clinical skills and identification of areas where patient care can be improved.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/21236 |
| Date | January 2017 |
| Creators | Dohan, Michael |
| Contributors | Tan, Joseph, Business Administration |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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