Richmond Heights Fire Department has announced that after more than two years of planning and coordinating with University Hospitals, it will be launching a Community Paramedicine Program.
It will officially start July 1 and is aimed to provide direct and preventive healthcare to individuals who are frequent users of the 911 call system. Fire Chief Marc Neumann said that the program will be aimed at keeping people out of the hospital if they don’t need to be. He said that hospital systems in the area, due to the closure of individual hospitals, have increased the strain on a system that is often tied up with more acute emergencies.
“Over the last couple of years, what we’ve been experiencing in emergency medical services is that there is a lot of traffic in our emergency departments,” Neumann said. “The emergency departments in all hospitals have been becoming increasingly busy, which results in the ambulances who are there to have delayed offloads in their patients and reduced availability in their community.
“When you look at the patients and you really take a look at the different reasons why they are going, there is a trend that you will find high utilizers that go to the emergency room. Many times, the emergency room is not where they need to go, they need help, but they are not sure on the type of help that they need. That’s where the community paramedic comes into place.”
The program will, according to University Hospitals, provide education on chronic illness, assess and increase home safety, enhance independence for seniors living in their home, connect residents to medical and social services, identify and close gaps in clinical or social needs, and provide post-hospital release follow-up care, including coordinating needed physician and hospital appointments.
Neumann said the way his department will be identifying patients that could use the program is by looking at their database of previous calls over the past year. He said that people who called more than three times with issues that fall under the program’s guidelines will be reached out to by the new community paramedic in order to see if they need additional help.
“The community paramedic reaches out to patients that we find through our Patient Care Reporting System, to offer help, to determine if maybe they do need some assistance,” Neumann said. “Locally, we’ve had a few hospital closures, one was UH Richmond, another one was Bedford, which means that the other hospital emergency departments are absorbing that as well.”
He said reducing emergencies in the home will lead to a reduced need in going to the hospital. One way the community paramedic would help in that is by helping the community focus on risks before they get to the point of needing a higher level of intervention.
“The other priority of the program is to really help our senior population with safety in the home,” Neumann said. “A big challenge is safety in the home with seniors, which I’m proud to be a member of, is fall safety. We want to help reduce the fall risk by performing home safety assessments and fall prevention education.
“Also, people with chronic conditions sometimes have trouble managing their medications, or nutrition, or education, and that’s where a community paramedic can be a liaison between the provider and the patient to assist them in that,” he added. “All these different areas people do call 911 when they don’t know who to call, and this (program) can let them ultimately be safe at home.”
He said planning the program has been underway for two years, and that a community paramedic will be starting in July. From there the paramedic will go to University Hospitals for additional training in community medicine, and then they will start reaching out to patients in the community.
“You might ask why two years, well, it’s a public-private relationship with us and University Hospitals,” Neumann said. “We had to develop the backbone of the program which included the memorandum of understanding with University Hospitals, funding, and then go through the internal legislative process in the city.
“Paramedics can’t work alone. They work under the license of a physician. When emergency paramedics respond they have a very robust book of protocols that they use for emergency services, over 300 pages. The community paramedic although they are paramedics the same as emergency paramedics, they have a separate set of protocols that they use. So, part of those two years was protocol development as well.”
He said the trend of looking toward prevention before intervention is happening in other communities statewide and at a national level. He said that emergency services have to stay evolving to better fit the ever-changing dynamics that any community has, and that in his view, this type of change is equivalent to when emergency services became its own service, rather than an extension of the police, as it was during the 80’s and 90’s.
“We have fire prevention, and we go through great efforts to protect life and property with fire prevention,” Neumann said. “Just as we have a fire or safety inspector, or fire prevention officer, we now have an EMS prevention officer as well. I think it’s a logical step, it’s an emerging trend throughout the nation, it’s a new era in public safety and EMS.”
