It takes a system: Exploring new and disruptive systems of practice within the Anglo-American paramedic system

This thesis explores the structure and characteristics of modern Anglo-American paramedic systems and examines the factors that influence their design and how they relate to system performance. The study included seven peer-reviewed publications, including a narrative review of the history of paramedicine, a scoping review providing insight into the structure and characteristics of the paramedic system, and a survey evaluating the performance of two newly identified systems of practice: the Professionally Autonomous and Directive paramedic systems. Our thesis is designed to help paramedic systems improve system design for patients and paramedics alike, and its hoped that the roadmap for change contained within, acts as a catalyst for system modernization well into the future.