Paramedic Services Community Referral by EMS (CREMS) Hamilton - - PowerPoint PPT Presentation

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Paramedic Services Community Referral by EMS (CREMS) Hamilton - - PowerPoint PPT Presentation

Paramedic Services Community Referral by EMS (CREMS) Hamilton Current population 505,000 Urban, Suburban, Rural mix Hamilton Paramedic Service Hamilton Paramedic Service employs 300 paramedics Deploy ~ 30 vehicles during


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SLIDE 1

Community Referral by EMS (CREMS) Paramedic Services

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SLIDE 2

Hamilton

  • Current population 505,000
  • Urban, Suburban, Rural mix
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SLIDE 3

Hamilton Paramedic Service

  • Hamilton Paramedic Service

employs 300 paramedics

  • Deploy ~ 30 vehicles during

peak hours

  • 2 Emergency Support Units

for Mass Casualty Events

  • Developing community

paramedic service program

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SLIDE 4

So how did we get here?

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SLIDE 5

What the report showed

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SLIDE 6

Hamilton Paramedics open

  • ver 67,000 doors each year

Never knowing what is behind Always caring whatever it is We see opportunity

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SLIDE 7

Par aram amedi edic S c Ser ervice ce 2011 2011 Pot

  • tent

ential al C Chal hallenges enges

Aging Population

  • Increased frequency & complexity
  • More health care out of hospital

= More DEMANDS SO WHAT DO WE DO?

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SLIDE 8

Hamilton CREMS

  • CREMS Objectives
  • The referral process
  • Who are the patients?
  • Data to date
  • Case scenario
  • The future/collaboration
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SLIDE 9

CREMS - Background

Community Referral by EMS Structured process for paramedics to refer patients to alternatives re root problems. Toronto, Peel, Halton, York, Renfrew, Thunder Bay, Edmonton and Nova Scotia some of the services involved for 5-6 years. Generous funding from HNHB LHIN supported creation of initial pilot program in Hamilton

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SLIDE 10

CREMS Objectives

  • Hospital emergency department diversion
  • Improve match of patients’ needs to services

delivered

  • Reduce repeat paramedic calls by the same low

acuity patients better suited to another agency

  • Reduce hospital offload pressures
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SLIDE 11

The Referral Process

  • Patient refuses transport to hospital
  • Paramedics transport patient to hospital
  • Electronic referral form: www.hamiltoncrems.com
  • < 5 minutes to complete +/- phone call to CCAC
  • CCAC Contact Centre assigns Case Manager
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The Results to Date

  • Total referrals received to date: 428
  • Average referral rate: 1.6 referral/day
  • Average time to CCAC follow-up: 3.3days
  • New services initiated: 78%
  • Referrals who are EMS “repeat” patients: 54%
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The Results to Date

  • Highest number of calls for referral who are “repeat”

patients: 53 responses (current year)

  • # of patients transported to ED and NOT referred by

hospital staff: 50%

  • Percentage of paramedics referring patients at least
  • nce:60%
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SLIDE 14

The Results – Eileen

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The Results – Eileen

  • Elderly Flamborough resident
  • Increasingly frail, multiple falls, injuries, ED

admissions

  • No prior referral to CCAC
  • EMS responds 3 times in 2 days for “lift assist”
  • EMS refers patient to CCAC via CREMS
  • OT, PT & fall clinic in place within <24 hours
  • No further EMS calls since referral
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The Future - Collaboration

  • Opportunities to collaborate with various Hamilton’s

human services divisions to leverage resources

  • Community Services – identify clusters of repeat

patients in City of Hamilton facilities

  • Introduction of PERIL – evidence based inclusion
  • On-site Community Paramedic services?
  • Multi-disciplinary case management
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SLIDE 17

What hat are are we e doi doing ng in 2011 t n 2011 to 2012?

  • 2012?
  • LH

LHINS and and Prov

  • vince

nce W Wide de Appl pplicat ation

  • Ref

efer erral al for

  • rm and

and dat data bas a base

  • Educ

ducation del n deliver ery y and and pac package age

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Thank You

For the opportunity to share passion & success

Justin Pyke – Community Initiatives EMS Manager/Acting Deputy Chief Justin.pyke@hamilton.ca (905)981-7439