Canadian health officials are successfully taking an unusual approach to keeping seniors out of the costly emergency department with a program that, they say, could easily play in the U.S. too.
Often, nursing homes must phone paramedics when residents require a level of care too complex for the facility. With that in mind, officials at the Alberta Health Services have established a program that sends a “mobile urgent care clinic” to long-term care facilities. It treats residents on-site for lower-acuity ailments.
What started as a pilot in just Calgary has expanded to eight cities, Ryan Kozicky, director of the EMS Mobile Integrated Healthcare program told McKnight’s. Last year alone, the program helped to avoid some 12,000 trips to the ED. On average, each encounter cost about $8,400 (US) less than if the resident were transported. He believes such an offering would easily work in the States.
“Absolutely, I think it would work,” Kozicky said. “We’ve identified and demonstrated that low-acuity treatment can be done in nursing homes, and both the patients and the sites benefit from this work. I think that there is huge opportunity in the U.S. to expand such a service.”
So, how does it work? They start by visiting nursing homes to provide information and a phone number to call when complex situations arise. When called, a community paramedic does a quick triage and sends an emergency vehicle out to the facility
Upon arrival, the paramedic does a quick assessment and consultation via video chat with a physician, who helps come up with a treatment plan. The vehicle does not have sirens or the ability to transport. But the paramedic can perform many aspects of care, ranging from medication administration, blood transfusions, sutures or facilitating X-rays. They have treated all sorts of ailments thus far — pneumonia, COPD, nausea, wound care and urinary tract infections, to name just a few.
About 95% of the time, paramedics have been able to treat patients on site, Kozicky said. For the other 5%, when resident did require transport, there were no adverse outcomes experienced, he added.
What started out as a small pilot in Calgary has now spread out to eight cities. There are 30 such units, with services also planned for the towns of Lethbridge and Medicine Hat. All told, the specialty units touch 80% of the province of Alberta.
