News

Community Paramedic Program Delivers Continued Care in Iowa

Bailey Poolman

01/15/2017

Jan. 13--In early July, Greater Regional Medical Center implemented a new program to continue care beyond the hospital.

The community paramedic program allows paramedics and emergency medical technicians (EMTs) to work beyond the structure of responding to various calls throughout the day. The crews in Creston attend scheduled appointments with patients who are released and cover a variety of things.

"One of our main goals or focuses was to lower readmission rates because insurance won't pay for the hospital visit if they're readmitted within 30 days," said Jen Worisek, paramedic and EMS/ambulance manager. "Not that our numbers were high, by any means, because they weren't. They were actually pretty good. But, they just wanted to improve that, they wanted to make that number as close to zero as they could."

According to Community Paramedic's website, the program is organic and "exists for the sole purpose of serving the needs of a particular community." It goes on to say there are similar initiatives throughout the United States.

The program in Creston began about one year ago when Worisek and a coworker talked with a doctor at the hospital about beginning the program. Worisek then spoke with several others throughout the hospital to gather information and discuss the various patients they might cover.

Creston's specific goal is to reduce readmissions by meeting with patients after they are released from the hospital, but before their follow-up appointments.

"On the day of discharge, things can be hectic. You have the doc coming in there talking about, 'Okay, when you get home you need to be doing this,' and the nurse comes in and reiterates it, and then you have ... to schedule an appointment," Worisek said. "That's a long day for the patient going home."

The patient will get a call after being discharged to allow paramedics to stop by the home and visit. Paramedics and EMTs will cover discharge instructions with the patient, go over medication doses and make sure the patient goes off certain medications if requested by the physician. A set of vitals will also be taken, and EMS personnel will also make sure the patient has the follow-up appointment scheduled and has a way of getting to that appointment.

"It's also a sense of comfort for them (patients). They're not just leaving the hospital with an 'Alright, we're done with you, make sure you see your doc in a week from now,'" Worisek said. "I get a lot of good feedback from patients that we do see saying they're glad that someone else is continuing that care, in a sense, and looking out for them."

Worisek believes the program has been successful thus far, thanks to preventing at least five readmissions and several frequent emergency room visits, all the while providing comfort to the patients.

Criteria

In order for Greater Regional EMS personnel to contact patients, the patients have to meet certain criteria, including age and diagnosis. The patients also have to live within a certain distance of the hospital.

When the program began, personnel would stay in touch with patients living in Union County. Since then, the age criteria has decreased and now patients who live within a 15-mile radius of the hospital, including in a different county, can be seen.

If the patients don't meet the criteria but are borderline, a physician may contact EMS personnel to set up an appointment with the patient anyway to continue care and make sure the patient's health doesn't decline.

"It's as much of a prevention as it is anything," said Casey Larson, paramedic and EMS/ambulance manager. "Even though it's after the fact, you're really trying to prevent a readmit."

"We're a hospital-based service. We work hand-in-hand with the majority of the doctors. The doctors feel that they can come to us and say, 'Hey, this guy's going home. Will you do a follow-up visit and make sure they stop taking this medication?' They know they can trust us to go out there and know we are going to get done what needs to get done," Worisek said. "I thought we had a great opportunity being a hospital-based service that we would be able to do this."