ABSTRACT
Canada's rural shortage of health professionals can be offset by employing specially trained, locally-based paraprofessionals to implement professionally developed plans of care. Ontario's Integrated Services for Northern Children Program demonstrated the viability of this option. A review of 327 patient records and interviews with 100 parents, paraprofessionals, and professionals found that there was good continuity of care and satisfaction with care quality because the multidisciplinary professional team of consultants provided constant and consistent monitoring of the paraprofessionals. Ongoing treatment occurred in the community, eliminating the disruption to the children's lives that repeated trips to the city would cause. Rural residents place a premium on care at home. Liability issues for employers and for professionals who delegate caregiving tasks currently restrict the use of paraprofessionals; these can be addressed through certification based on practice standards and improved education programs.
