Community Paramedicine EMERGENCY MEDICAL SERVICES OHIOHEALTHEMS.COM - - PowerPoint PPT Presentation

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Aug 28, 2022 110 likes •358 views

Mobile Integrated Healthcare Community Paramedicine EMERGENCY MEDICAL SERVICES OHIOHEALTHEMS.COM Joint Vision Statement In its simplest definition, Mobile Integrated Healthcare (MIH) is the provision of healthcare using patient-centered, mobile

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Mobile Integrated Healthcare

Community Paramedicine

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Joint Vision Statement

In its simplest definition, Mobile Integrated Healthcare (MIH) is the provision of healthcare using patient-centered, mobile resources in the out-of-hospital environment. It may include, but is not limited to, services such as providing telephone advice to 9-1-1 callers instead of resource dispatch; providing community paramedicine (CP) care, chronic disease management, preventive care or post-discharge follow-up visits;

r transport or referral to a broad spectrum of appropriate care,

not limited to hospital emergency departments.

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Joint Vision Statement

Authors

– The National Association of Emergency Medical Technicians – National Association of EMS Physicians – National Association of EMS Educators – National Association of State EMS Officials – American College of Emergency Physicians – Other partnering organizations

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Purpose

Provide Support and Referrals

– Recently Discharged – At Risk of ED Return or Hospital Readmission – Targeted Populations

Asthma/COPD, CHF, Diabetes, Substance Abuse, Etc.

– High System Utilizers

EMS, ED, Hospital, Social Services

– Underserved Populations

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Purpose

Provide Options

– Alternate Dispositions

Assess, Treat, Refer, and/or Release

– Alternate Transport Destinations

Physician Office, Clinic, Urgent Care, Etc.

– Others

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Background

Late 2012

– OhioHealth EMS Leads OhioHealth System Efforts

Exploring Mobile Integrated Healthcare
Identifying the role of Community Paramedics
Evaluating new and innovative care models

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Implementation

Successful Patient Pilot

– Columbus Division of Fire – Targeted Learning

Training and education with nurse specialists
CHF clinic practicum

– Expanded Role Paramedics

Functioned with and under the on-scene direction of the

Associate EMS Medical Director

Not an Expanded Scope

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Implementation

Successful Patient Pilot

– CHF Patients

Home-based visits

– Successes

Destination Diversion

– 1 patient from ED transport (i.e. potential hospital readmission) to CHF Clinic

Good catch

– 1 patient called 911 due to CP team education about possible weight gains

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

OhioHealth EMS to host the first comprehensive community paramedic course in Central Ohio.

Classroom

– Approximately 100 Hours

Practicum

– Approximately 125 Hours

Course Information

– Registration and Prerequisite Information TBA

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

Content Areas

– Advanced Medical Life Support – Behavioral Health – Case Management – Chronic Disease Management – Community and Public Health – Community Resources – Congestive Heart Failure and Coagulation Management

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

Content Areas

– Continuum of Care – COPD and Pulmonary Disease – Cultural Competence – Diabetes and Endocrine Disease – Geriatric Emergency Medical Services (GEMS) – Healthcare Disparities – Healthcare Documentation

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

Content Areas

– Healthy Lifestyles and Wellness – Home Healthcare – Hospice – Infusion Therapy

Port and Catheter Assessment

– Interdisciplinary Healthcare – Nutrition

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

Content Areas

– Palliative Care and Pain Management – Patient Advocacy – Patient Collaboration – Patient Capacitance and Transformational Change – Patient Resource Management – Primary Care

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Provider Education

Content Areas

– Readmission Reduction – Renal Disease and Dialysis – Short-term Acute Care – Social Determinants of Health – Social Needs and Assessment – Substance Abuse and Addiction – Transitions-of-Care – Wound Management

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Introductions

– Patient, Family, Paramedic

Confirm and Discuss Reason for Visit

– Discuss Background and Supporting Information

Obtain Consents

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Identify Complaints
Identify Acute vs Chronic Conditions?
Identify Changes in Conditions?
Determine Urgency?
Immediate Life Threat?
Immediate Corrective Action(s) Needed?
Objective Reason for Transport to ED?

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Review Past and Current History

– Prior Findings – Primary and Secondary Diagnoses – Pertinent Negatives

Identify Prior Hospitalizations and Visits
Review Prior Plans of Care
Review and Verify Medications and Compliance

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Verify Understanding of Prior Care Instructions
Determine Self-Efficacy and Compliance

– Prior Successes and Opportunities

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Identify Primary Care Physician
Identify Other Physician Relationships
Identify Hospital Relationships and Preferred

Facility

Identify Other Relationships

– Non-Physician Caregivers, Home Health, Hospice, Public Health and Community Care, Outpatient Centers and Clinics, and Social Services

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Complete Clinical Assessments

– Initial and Focused

Complete Secondary Interviews and

Assessments

– Socio-cultural, Environmental, Nutritional, and General Needs

Formulate Field Impression

– Integrate pathophysiological principles and assessment findings

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Provide Patient Care

– Protocol, Verbal Orders, Written Orders

Review and Communicate Findings

– Physicians, APPs, Nurses, Case Managers, Social Worker, or others

Implement Plan of Care

– New, Changed, or Continued

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Patient Visit Profile

Complete Patient and Caregiver Education
Verify Understanding and Agreement to Comply
Complete Documentation

Note: The unique circumstances of each patient episode will dictate the interaction, length of visit, etc.

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Thoughts and Questions?

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EMERGENCY MEDICAL SERVICES

OHIOHEALTHEMS.COM

Mobile Integrated Healthcare

Community Paramedicine

Joint Vision Statement

not limited to hospital emergency departments.

Joint Vision Statement

– The National Association of Emergency Medical Technicians – National Association of EMS Physicians – National Association of EMS Educators – National Association of State EMS Officials – American College of Emergency Physicians – Other partnering organizations

Purpose

– Recently Discharged – At Risk of ED Return or Hospital Readmission – Targeted Populations

– High System Utilizers

– Underserved Populations

Purpose

– Alternate Dispositions

– Alternate Transport Destinations

– Others

Background

– OhioHealth EMS Leads OhioHealth System Efforts

Implementation

– Columbus Division of Fire – Targeted Learning

– Expanded Role Paramedics

Associate EMS Medical Director

Implementation

– CHF Patients

– Successes

Provider Education

OhioHealth EMS to host the first comprehensive community paramedic course in Central Ohio.

– Approximately 100 Hours

– Approximately 125 Hours

– Registration and Prerequisite Information TBA

Provider Education

– Advanced Medical Life Support – Behavioral Health – Case Management – Chronic Disease Management – Community and Public Health – Community Resources – Congestive Heart Failure and Coagulation Management

Provider Education

– Continuum of Care – COPD and Pulmonary Disease – Cultural Competence – Diabetes and Endocrine Disease – Geriatric Emergency Medical Services (GEMS) – Healthcare Disparities – Healthcare Documentation

Provider Education

– Healthy Lifestyles and Wellness – Home Healthcare – Hospice – Infusion Therapy

– Interdisciplinary Healthcare – Nutrition

Provider Education

– Palliative Care and Pain Management – Patient Advocacy – Patient Collaboration – Patient Capacitance and Transformational Change – Patient Resource Management – Primary Care

Provider Education

– Readmission Reduction – Renal Disease and Dialysis – Short-term Acute Care – Social Determinants of Health – Social Needs and Assessment – Substance Abuse and Addiction – Transitions-of-Care – Wound Management

Patient Visit Profile

– Patient, Family, Paramedic

– Discuss Background and Supporting Information

Patient Visit Profile

Patient Visit Profile

– Prior Findings – Primary and Secondary Diagnoses – Pertinent Negatives

Patient Visit Profile

– Prior Successes and Opportunities

Patient Visit Profile

Facility

– Non-Physician Caregivers, Home Health, Hospice, Public Health and Community Care, Outpatient Centers and Clinics, and Social Services

Patient Visit Profile

– Initial and Focused

Assessments

– Socio-cultural, Environmental, Nutritional, and General Needs

– Integrate pathophysiological principles and assessment findings

Patient Visit Profile

– Protocol, Verbal Orders, Written Orders

– Physicians, APPs, Nurses, Case Managers, Social Worker, or others

– New, Changed, or Continued

Patient Visit Profile

Note: The unique circumstances of each patient episode will dictate the interaction, length of visit, etc.

Thoughts and Questions?

Thank You!

Mobile Integrated Healthcare Resources

OhioHealthEMS.com/communityparamedic

For Information, Contact

Mark A. Huckaby, NRP EMS Operations Coordinator mark.huckaby@ohiohealth.com