Every year, more people are calling 911. As a result, EMS agencies and hospitals are scrambling to meet the growing need. Amid the chaos, community paramedicine has risen to the challenge, offering direct models to reduce emergency calls.
This article explores three ways community paramedicine is reducing 911 calls and offering patients a more integrated and whole-person approach.
Can Community Paramedicine Reduce Unnecessary 911 Calls?
A well-run community paramedic program can have tremendous results. The goal is to help repeat patients receive the definitive care they need.
Here are just a few examples of areas that have seen success with a community paramedic program:
- McDowell County, North Carolina
- Colorado Springs, Colorado
- Bedford County, Virginia
These are three examples of community paramedic models that have led to a measurable decrease in 911 calls.
How do these areas implement an effective community paramedic program?
Below, we discuss three ways these systems guide their patients in the right direction and lower 911 calls.
Community paramedic programs reduce 911 calls in the following ways:
- Programs for super-utilizers
- Hospice care coordination with EMS
- Transport to alternative destinations
Let us explore these solutions in more depth.
Reducing 911 Calls with Programs for Super-Utilizers
The super-utilizer programs try to reach out to those members of the community who call 911 the most. However, several studies have found that a small number of patients make up a large number of 911 calls and ER visits.
One study found that 5-8% of patients resulted in 21-28% of ER visits.
Sometimes, these people feel that 911 is their only resource. As a result, ambulance response times lag, ER visits are extended, and costs go through the roof.
Healthcare providers’ responsibility is to work with these patients, showing them practical alternatives to dialing 911 and meeting their needs before they are forced to call.
Here are three important ways community paramedics reach out to super-utilizers:
- Medication instruction and organization
- Managing symptoms
- Lifestyle education
Let us explore these further.
Medication Education and Organization
“I have got so many pills; I do not even know what I am taking.” Unfortunately, in healthcare, this phrase is common.
While patients need to take their medications, it is also critical that the patients understand their medication. Many meds have known side effects. Suppose the patient is unaware of how a medication will make them feel. In that case, they are more likely to activate the ambulance when alarming side effects occur.
For instance, if a patient is taking Morphine but does not realize that Morphine can cause constipation. The patient is then highly likely to call 911 or seek care at the ER when they start having stomach pain.
However, if the patient is aware of this potential side effect and given tools and knowledge to cope, they are less likely to end up in the ER.
Helping Patients with Symptom Management
Like managing medications’ side effects, many patients deal with pain and discomfort related to chronic illness.
Community paramedics are in a great position to help patients who have undergone recent procedures or who are dealing with a new diagnosis.
Often, when a patient experiences a new health event, their anxiety is high. As a result, when something negative happens, whether in an emergency or not, they reach out to their physicians.
Frequently, if the patient has problems after business hours, they have no choice but to call 911.
What is the answer?
Community paramedics can go directly into these patient’s homes. With proper training, community paramedics can administer medications and perform procedures and diagnostic tests to help treat the patient’s complaint.
By treating a patient’s symptoms before the patient’s symptoms spin out of control, community paramedics effectively reduce 911 calls.
Helping Patients – Lifestyle Education
Finally, community paramedics assist patients with lifestyle changes that
have positive effects.
Community paramedics are in a unique position. Unlike physicians, who now see patients almost exclusively in a clinical setting, paramedics go into the patient’s home. Evaluating a patient’s home makes it much easier to treat the environment, not just the patient.
If the community paramedic recognizes a problem, they can either help the patient directly or connect them with the appropriate resources.
Here are several ways community paramedics help with lifestyle education:
- Suggesting rails and ramps for frequent fall victims
- Removing rugs that could be a trip hazard
- Identifying health hazards in the home, like mold or gas leaks
- Educating the patient on hazardous activities and triggers
There are numerous ways community paramedics help super-utilizers, effectively reducing 911 calls and unnecessary ER visits.
Organized patient care requires good communication across agencies. For example, suppose the hospital knows something that can help the ambulance. In that case, it is in the patient’s best interest to share this information.
Colorado Springs CARES program has been using Julota to organize and track patient information. Julota provides a framework that allows these organizations to review patient records and allocate resources effortlessly.
Hospice Care Integration with Community Paramedics
Hospice care can quickly change from calm to stressful. If a patient becomes distressed, family members are often unsure how to proceed. As a result, hospice patients and family members have a high propensity for calling 911.
Unfortunately, when responding to hospice-related 911 calls, paramedics often face confusing treatment decisions.
Community paramedicine offers a bridge for hospice patients and healthcare providers to connect. If hospice can coordinate with the community paramedics and emergency departments, patients can receive the care they need.
Here are three significant ways community paramedicine benefits hospice patients and reduces unnecessary 911 calls:
- Beginning comfort measures
- Contacting the hospice RN
- Coordinating care with the emergency room physician
Let us explore these further.
Begin Comfort Measures
Often, a hospice patient has a specific care plan. For instance, if the patient appears in pain, a dose of medication is administered in specific intervals.
Unfortunately, hospice patients do not always follow the book. As a result, people are forced to call 911.
When community paramedic programs coordinate with hospice, those paramedics can approach the patient from an informed perspective.
Here are several ways community paramedics can comfort hospice patients:
- Administering medication
- Changing bandaging
- Repositioning the patient
Instead of immediately transporting these patients to the ED, the community paramedics may successfully treat the problem on-site.
Contact the Hospice RN
Typically, hospice patients are assigned a lead caretaker, often a nurse who oversees the patient’s care plan.
This nurse is typically the most knowledgeable in how the patient’s care should proceed. If the patient has a problem, community paramedics can contact the lead RN for guidance.
Instead of simply transporting the patient to the ER, the community paramedics can appropriately respond to the patient’s problem.
Coordinate with the Emergency Room Physician
If a patient must go to the ER, the most qualified person to make this decision is the ER physician themselves. Depending on the time of day (or extenuating circumstances), the hospice RN may not be in immediate contact.
Sometimes, especially in the case of trauma, the hospice patient should be seen in the ED. Community paramedics can talk directly with the ER physician to ensure the patient is transported to the proper facility.
Open communication between the patient, physician, family, and community paramedic is essential to properly treating the patient and reducing hospice-related 911 calls.
Julota offers a network for clear communication. Whether the physician, the paramedic, or the nurse, everyone can read the same map, ensuring they get the patient what they need.
The third way community paramedicine is reducing 911 calls by coordinating alternative patient destinations. As a result, numbers show that a large portion of 911 calls emergency visits are not true emergencies.
Community paramedics give patients a shoulder to lean on and can offer many alternatives to an ER stay.
Here are several possibilities for alternative destinations:
- Mental Health Facility
- Drug Detoxification Center
- Urgent Care and Primary Care Physician
Below, we look at these options closer.
Mental Health Facility
Statistics indicate that increased mental health problems plague the world. Nevertheless, many of these patients are not receiving the care they need.
The bigger tragedy? There are often resources available – the patients do not know about them or do not feel they can reach out.
Calling 911 is easy. Coordinating a long-term mental health plan is more complicated.
That is where community paramedics come in. They can respond to these patients and do the heavy lifting – making phone calls, scheduling appointments, and even providing transport to the treatment facility.
In a unified health system, community paramedics can ensure that patients have access to definitive care.
Drug Detoxification Center
In hand with mental health ailments, substance abuse has become a widespread threat. Today, it appears no one is safe from the devastating effects of drug addiction.
Community paramedicine helps patients who struggle with drug addiction by starting the process of enrolling these patients in definitive care.
Instead of simply transporting these patients to the ER, community paramedics can work with mental health and drug treatment centers to develop a cohesive care plan.
In Palm Beach, Florida, community paramedics are playing a role in recovering heroin addicts. Community paramedics will follow up with recovering heroin addicts, offering daily support as they recover.
Transport to Urgent Care Clinics and Primary Care Providers
Finally, many patients who deal with chronic health conditions are served best going directly to their primary care physician’s office. Primary care physicians are in an excellent position to treat a non-emergency, so the patient does not return to the ER.
Urgent cares are also an excellent option for many patients with urgent but non-emergency conditions. By transporting patients to an out-patient clinic, community paramedics reduce bottlenecks in the ER, ensuring all patients receive the care they need.
To allocate resources properly, communities need to communicate.
When community paramedics decide to transport to an alternative destination, it is vital to evaluate a patient’s medical history. Julota provides a platform where health providers can connect, regardless of their existing system.
The ET3 program through Medicare offers ambulance services the opportunity for reimbursement even without transporting to an emergency room. Julota helps EMS agencies collect the data they need to participate in programs like ET3 effectively.
Final Word on Reducing 911 Calls with Community Paramedicine
An efficient community paramedicine program will reduce unnecessary 911 calls. Models for super-utilizers, coordination with hospice care, and implementing transport to alternative destinations are three ways community paramedics raise the bar for patient care.