Paramedics funded for home visits

Left to right are health promotion community paramedic Rebecca Poulin, Jennifer Amyotte, commander, community paramedicine and  professional standards, and care transitions community paramedic  Garry Lauzon. Missing  from photo are care  transitions community  paramedics Annik Thibault and Trevor  Love.

Left to right are health promotion community paramedic Rebecca Poulin, Jennifer Amyotte, commander, community paramedicine and professional standards, and care transitions community paramedic Garry Lauzon. Missing from photo are care transitions community paramedics Annik Thibault and Trevor Love.

Programs target high-risk patients with chronic diseases

Paramedics have always been responsible for providing emergency medical services and transporting people to the nearest Emergency Department. Now, seven Emergency Medical Service (EMS) organizations across Northern Ontario will also be tasked with keeping the frail elderly and high-risk patients with chronic diseases from having to call 911.

EMS organizations in Rainy River, Thunder Bay, Sudbury, North Bay, Temiskaming, Manitoulin and Nipissing have been funded by the Ministry of Health and Long-Term Care to make home visits and conduct wellness clinics with the objective of reducing Emergency Department visits and hospital readmissions.

Specially trained paramedics will assist with medication compliance, educate clients on managing their chronic diseases, make referrals to community programs and dispense medications under medical directives.

High-risk patients

Sudbury EMS, for example, has been funded to introduce a Transitions Care program targeting high-risk patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes and dementia following hospital discharge. It’s also rolling out a Health Promotion Community Paramedic program that will serve older adults in seniors’ housing and the vulnerable population, including the homeless.

Three paramedics assigned to the Transitions Care program will work closely with Health Sciences North and the North East Community Care Access Centre (CCAC) to provide post-discharge follow-up.

Rapid response nurses with the CCAC are tasked with making an initial home visit with high-risk patients within 24 to 48 hours of discharge and checking up on them for a period of 30 days. Paramedics with the Transitions Care program “will expand that out to 90 days,” said Jennifer Amyotte, commander, community paramedicine and professional standards with Sudbury EMS.

The visits will be scheduled and could also include phone calls, depending on a patient’s needs.

If a patient with CHF, for example, is showing signs of edema, paramedics will be able to dispense lasix to help manage the chronic illness in the home.

Alternatively, they can make an appointment for a patient to attend the Health Sciences North CHF clinic on a priority basis.

Patients will also be provided with a number to call to arrange for community paramedic visit.

“Paramedics are in a unique situation,” said Amyotte. “We get to see people in their home environment… with clutter, disorder, disorganized medications, no food and insufficient heat.”

Physicians, on the other hand, only see patients after nurses have cleaned them up, taken off their soiled clothes and put them in a clean gown.

“Sometimes, the observations we make don’t always get to the physician, so the physician says ‘she’s fine, she can go home,’ but they don’t always realize what they’re sending them home to.”

Because of their knowledge of the home environment, paramedics can make referrals to the CCAC to address issues such as these, said Amyotte.

The Health Promotion Community Paramedic program will make wellness visits with seniors living in social assistance housing as part of the province-wide Community Health Assessment study measuring the effectiveness of EMS outreach.

Education

Two buildings in Sudbury have been selected for the study, said Amyotte. Paramedics will provide education and wellness checks in one, while the other will serve as a control site. Emergency Department visits and hospital admissions will be tracked for seniors in both to determine the effectiveness of the program. The Health Promotion program will also conduct wellness clinics at soup kitchens and emergency shelters.

Each of the seven community paramedicine programs in Northern Ontario takes a slightly different approach and has been designed to meet the unique needs of the communities served.

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