Abstract
Session E presented Friday, September 28,10:00-11:00 am. Purpose:Statement of Relevance: As health care shifts away from hospital-centered, inpatient treatment, key providers of delivery emerge to provide a continuum of health care services outside of the hospital. Accelerating changes in how and where health care is being delivered have created the opportunity for nursing to play a significant role in the development of a cost-effective multidisciplinary care plan, filling gaps with educated providers, capable of independent clinical decision-making and ability to educate patients about treatment regimens for maintenance of good health. Design: Background: In an effort to address access to care, Minnesota in 2007, funded a pilot program to educate skilled paramedics to increase their role in providing primary care for needy community members. The training program consists of 144 didactic hours and 196 clinical hours which lead to the attainment of 14 credits toward a degree. Since its inception, Hennepin Technical College has trained over 170 Minnesota Paramedics to this certification and approximately 500 national/international candidates. Setting: A healthcare facility in Minneapolis, Minnesota. Participants/Subjects: This program served 455 patients with 4,500 total visits. The payer mix consisted of 85% public sources, of which 50% came from Medicaid. Diagnoses of patients seen included: stroke, behavioral health, congestive heart failure, and diabetes. Referrals came from multiple care team members and settings: emergency departments (ED), home care, and primary care. Methods: Methods: One of the programs was conducted by a healthcare facility in Minneapolis, Minnesota. The program started in 2012 and ten paramedics were certified to the level of Community Paramedics (CPs). The clinic is housed in a chemical dependency treatment center providing patient care 8 hours a day, 5 days a week. Patient numbers range from 12 - 16 per day. These CPs see "High Medical Risk Recall Patients" with 10 or more medications, at least 3 chronic diseases, medications with a tight therapeutic window (Coumadin, Digitalis, etc.), and mental health-related comorbidities. Results/Outcomes: Results: Analysis of data from October 2012-13 shows that CPs reduce utilization of hospital emergency care for patients selected for the program because of ED over-utilization. Comparison of utilization 8 and 12 weeks before and after initiation of CP intervention shows up to a 50% reduction in inpatient/ED utilization. Applying national average cost data for inpatient/ED allows a conservative cost savings of $8,500 per patient (based on fewer readmissions/ED visits) within specified time frame. Implications: Conclusion: Community paramedic education and targeted interventions can produce substantial cost savings while serving the needs of high-needs patient populations. Limitations of the study that constitute challenges for expansion to other locales include: identifying the "right" patients, determining the "right" level of resource, and defining the value of the program.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Nursing Innovation, Interprofessional Collaborations, Improved Care
Recommended Citation
Ahlers, Mary L.; Kershaw, Josephine; and Wilcox, Michael, "Community paramedic education drives evidence-based practice and health care cost savings" (2019). General Submissions: Presenations (Oral and Poster). 92.
https://www.sigmarepository.org/gen_sub_presentations/2018/posters/92
Conference Name
Emergency Nursing 2018
Conference Host
Emergency Nurses Association
Conference Location
Pittsburgh, Pennsylvania, USA
Conference Year
2018
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Community paramedic education drives evidence-based practice and health care cost savings
Pittsburgh, Pennsylvania, USA
Session E presented Friday, September 28,10:00-11:00 am. Purpose:Statement of Relevance: As health care shifts away from hospital-centered, inpatient treatment, key providers of delivery emerge to provide a continuum of health care services outside of the hospital. Accelerating changes in how and where health care is being delivered have created the opportunity for nursing to play a significant role in the development of a cost-effective multidisciplinary care plan, filling gaps with educated providers, capable of independent clinical decision-making and ability to educate patients about treatment regimens for maintenance of good health. Design: Background: In an effort to address access to care, Minnesota in 2007, funded a pilot program to educate skilled paramedics to increase their role in providing primary care for needy community members. The training program consists of 144 didactic hours and 196 clinical hours which lead to the attainment of 14 credits toward a degree. Since its inception, Hennepin Technical College has trained over 170 Minnesota Paramedics to this certification and approximately 500 national/international candidates. Setting: A healthcare facility in Minneapolis, Minnesota. Participants/Subjects: This program served 455 patients with 4,500 total visits. The payer mix consisted of 85% public sources, of which 50% came from Medicaid. Diagnoses of patients seen included: stroke, behavioral health, congestive heart failure, and diabetes. Referrals came from multiple care team members and settings: emergency departments (ED), home care, and primary care. Methods: Methods: One of the programs was conducted by a healthcare facility in Minneapolis, Minnesota. The program started in 2012 and ten paramedics were certified to the level of Community Paramedics (CPs). The clinic is housed in a chemical dependency treatment center providing patient care 8 hours a day, 5 days a week. Patient numbers range from 12 - 16 per day. These CPs see "High Medical Risk Recall Patients" with 10 or more medications, at least 3 chronic diseases, medications with a tight therapeutic window (Coumadin, Digitalis, etc.), and mental health-related comorbidities. Results/Outcomes: Results: Analysis of data from October 2012-13 shows that CPs reduce utilization of hospital emergency care for patients selected for the program because of ED over-utilization. Comparison of utilization 8 and 12 weeks before and after initiation of CP intervention shows up to a 50% reduction in inpatient/ED utilization. Applying national average cost data for inpatient/ED allows a conservative cost savings of $8,500 per patient (based on fewer readmissions/ED visits) within specified time frame. Implications: Conclusion: Community paramedic education and targeted interventions can produce substantial cost savings while serving the needs of high-needs patient populations. Limitations of the study that constitute challenges for expansion to other locales include: identifying the "right" patients, determining the "right" level of resource, and defining the value of the program.