Community Paramedicine

Community Paramedicine

The primary goal of UnityPoint Health - Trinity Regional Medical Center Community Paramedicine program is to keep patients healthy and happy in their homes, while redirecting health care to appropriate entities. The program provides a continuum of care through various entities (i.e. Primary Care Providers, Home Health agencies, Public Health, etc.), thereby decreasing unnecessary emergency room visits, hospital readmissions and ambulance transports.

Overview

The purpose of the one-time visit by Trinity Paramedics is to ensure the patient is in a safe environment within their household; and refer or implement any other service to optimize the safety and health of the patient.

When a patient is designated as a potential candidate, a referral is placed with an Emergency Department (ED) Navigator for review. Once the patient's needs, difficulties and resources needed are identified, a crew of trained paramedics are briefed on the patient encounter, discharge disposition, expected roadblocks to health care and or follow-up care.

The medics then travel via ambulance to the patient's address. Upon patient's approval to enter their home, simultaneous items are accomplished.

  • General impression of patient and current health are visualized.

  • The home environment is scanned for health hazards, such as lack of amenities, social help, general safety of home to include throw rugs or obvious housing issues.

(If patient is not home, a flyer is left at residence for patient with instructions to call Paramedicine program.)

The paramedics will ask the patient questions pertaining to information from the briefing, such as how they feel post discharge, discharge instructions and medication management. They will also inquire with the patient on services they can assist in (i.e. prescription filling, home healthcare needs, financial assistance, and issues found in the home environment).

Visits typically do not last more than 20 to 25 minutes.

Criteria

  • ED visit, even if that same visit resulted in an admission

  • Medical event but did not meet the criteria for admission

  • Patient request for post discharge visit

  • Or the medical staff questions how the patient accepted, understood or received pertinent information and the patient's ability to follow through on post discharge plans

Global View

Every Community Paramedicine program is unique to meet the needs of its community. Unique to Fort Dodge's community is primary care access, which is why Community Paramedicine is used post discharged from the hospital knowing follow-up care with a primary care provider may be difficult.

In addition, with our aging population Community Paramedicine often refers patients to Palliative Care, Home Health Care agencies, as well as Public Health.

Validation

Our ACO waiver gives our Community Paramedics the ability to see patients in a home setting. It is noted that no medical procedures are performed in the home. However in the case of an emergency medical event, Community Paramedics can intervene with normal paramedic scope of practice with the patient's consent. In addition, if a patient is unconscious and no family member is present Community Paramedics can intervene.

Training

Training is designed specific for the Trinity Regional Medical Center Community Paramedic program. For our region medics need to be knowledgeable in community resources, Home Health Care abilities and limitations and Palliative Care involvement. Thus, clinical training is provided with: Webster County Public Health, UnityPoint at Home and UnityPoint Clinic - Palliative Medicine. To start, there are two hours of clinical  performed, as well as an informal overall program training. Since this process is new, this aspect of our Community Paramedicine is in constant review, updating and implementation.