These programs scattered around the U.S. serve a range of goals, depending on the particular community, such as helping isolated older patients, helping patients navigate health bureaucracy to find services, or reducing non-emergency visits to the emergency room.
With the Dayton program, ER physicians, primary care providers and ambulance crews can all refer patients who need help with managing health needs. The community paramedicine program team not only helps with health management and connections to health services, but also helps patients with getting connected to whatever resources are needed for wellness, such as help with housing, utilities, and insurance coverage.
Or in Young’s case, also making sure the smoke detectors are ready.
Credit: JIM NOELKER
Credit: JIM NOELKER
In Dayton, the program was launched by the Dayton Fire Department and Premier Health and is staffed by a paramedicine team, Nathan Pulliam and Kendra Harris. The program has the capacity for about 18 to 20 people enrolled at a time and are refurbishing a fire station off Catalpa Drive.
During Young’s visits, the paramedicine team checked vitals and talked with her about keeping up with medication and appointments. She said the program helped with her health whether it was reminders or assistance researching options for a doctor when she needed care. She said she was not sure at first about whether she wanted to sign up but it has been beneficial, such as helping her keep her blood pressure under control.
“It’s been a helpful tool. I don’t just look at them as people in the community, I look at them as part of my family,” she said, after Harris and Pulliam stopped by earlier this month.
Recently, she had surgery and said it meant a lot that the paramedicine team stopped by to visit her while she was in the hospital.
“It was a good surprise because the only visitors I had were the doctors and nurses and the aides. It meant a lot to me,” Young said.
Initial visits are an hour and a half and follow ups are about 30 minutes typically.
People are discharged from the community paramedicine program once the health goals set with the care team during your initial visit have been met and patients have been connected to community resources they need.
One of the goals is for the program partners to put together a community steering committee so they can be aware of what resources are available and what resources are needed.
Candy Skidmore, Premier vice president, service line integration, emergency and trauma, said looking at patients who frequent the emergency department, they found a lot of patients had chronic health issues and factors in their life preventing them being able to manage their health.
“Consequently, they were in what I was referring to as crisis health care. They would go along, have a crisis, go to the ER, get a little better, have another crisis, and go to the ER again,” Skidmore said.
She said they started looking at the geography of where patients were impacted, which was primarily northwest Dayton and the Dayton Fire Department reported similar information, which led to the partnership.
Harris said they start by listening and learning about what is going on in a patient’s environment that could be impacting them. Sometimes the reason someone is calling frequently for emergency help is because they can’t read. Sometimes patients need help getting all their records in order like Social Security Cards and birth certificates so they can apply for needed services.
“When we go to a house we’ll ask ‘What are some things you want to accomplish or help with?’" Pulliam said. "They’ll tell us and we’ll go back directly to the partners and get the help that they need for their goals.”
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