Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization

This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean ag...

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Autores principales:	Oluwakemi Adio, Laura Ikuma, Sonja Wiley
Formato:	article
Lenguaje:	EN
Publicado:	The Beryl Institute 2020
Materias:	community paramedicine mih-cp patient experience interventions ems cost benefit cg-cahps follow-up patient-centered care Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/829fc4d485174b17934453c5e9beb12b
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spelling	oai:doaj.org-article:829fc4d485174b17934453c5e9beb12b2021-11-15T04:31:27ZManagement of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization2372-0247https://doaj.org/article/829fc4d485174b17934453c5e9beb12b2020-11-01T00:00:00Zhttps://pxjournal.org/journal/vol7/iss3/21https://doaj.org/toc/2372-0247This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean age of 59.8±17.6 years and have multiple chronic conditions. Of these, 36 completed a modified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey at 3- and 6-months following program enrollment. The main outcome measures were adherence to intake goals; types, modes, and frequencies of CP interventions; CG-CAHPS patient experience scores; and cost savings. Cost savings compared EMS transports, ED visits, and hospital admissions during CP enrollment versus the previous year. Analysis also correlated participant demographics with the type and frequency of interventions. Adherence to enrollee intake protocols range from 5.3% for medication reconciliation to 78.9% for assessments of daily living (ADL) and home safety. The most popular interventions were follow-up and wellness checks occurring primarily in patients’ homes, and 97% of participants would recommend the program to friends/relatives. Females and African-Americans had increased CP interventions (<em>p <.</em>0001). Mean post-program 911 calls decreased significantly from pre-program levels, from 14.1 to 7.8 (p = .0012), as did ED transports (10.1 to 5.6, p = .002), and non-ED transports (4 to 2.2, p = .0380). The estimated annual return on investment (ROI) is >51%. This study objectively illustrates program success, showing that carefully designed and managed CP programs can deliver Triple Aim objectives. <strong>Experience Framework</strong> This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (<a href="http://bit.ly/ExperienceFramework">http://bit.ly/ExperienceFramework</a>) <ul> <li><a href="https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Innovation%20%26%20Technology%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D">Access other PXJ articles</a> related to this lens.</li> <li><a href="https://www.theberylinstitute.org/page/Ecosystem-InnovationTechnology">Access other resources</a> related to this lens</li> </ul>Oluwakemi AdioLaura IkumaSonja WileyThe Beryl Institutearticlecommunity paramedicinemih-cppatient experienceinterventionsemscost benefitcg-cahpsfollow-uppatient-centered careMedicine (General)R5-920Public aspects of medicineRA1-1270ENPatient Experience Journal (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	community paramedicine mih-cp patient experience interventions ems cost benefit cg-cahps follow-up patient-centered care Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	community paramedicine mih-cp patient experience interventions ems cost benefit cg-cahps follow-up patient-centered care Medicine (General) R5-920 Public aspects of medicine RA1-1270 Oluwakemi Adio Laura Ikuma Sonja Wiley Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
description	This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean age of 59.8±17.6 years and have multiple chronic conditions. Of these, 36 completed a modified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey at 3- and 6-months following program enrollment. The main outcome measures were adherence to intake goals; types, modes, and frequencies of CP interventions; CG-CAHPS patient experience scores; and cost savings. Cost savings compared EMS transports, ED visits, and hospital admissions during CP enrollment versus the previous year. Analysis also correlated participant demographics with the type and frequency of interventions. Adherence to enrollee intake protocols range from 5.3% for medication reconciliation to 78.9% for assessments of daily living (ADL) and home safety. The most popular interventions were follow-up and wellness checks occurring primarily in patients’ homes, and 97% of participants would recommend the program to friends/relatives. Females and African-Americans had increased CP interventions (<em>p <.</em>0001). Mean post-program 911 calls decreased significantly from pre-program levels, from 14.1 to 7.8 (p = .0012), as did ED transports (10.1 to 5.6, p = .002), and non-ED transports (4 to 2.2, p = .0380). The estimated annual return on investment (ROI) is >51%. This study objectively illustrates program success, showing that carefully designed and managed CP programs can deliver Triple Aim objectives. <strong>Experience Framework</strong> This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (<a href="http://bit.ly/ExperienceFramework">http://bit.ly/ExperienceFramework</a>) <ul> <li><a href="https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Innovation%20%26%20Technology%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D">Access other PXJ articles</a> related to this lens.</li> <li><a href="https://www.theberylinstitute.org/page/Ecosystem-InnovationTechnology">Access other resources</a> related to this lens</li> </ul>
format	article
author	Oluwakemi Adio Laura Ikuma Sonja Wiley
author_facet	Oluwakemi Adio Laura Ikuma Sonja Wiley
author_sort	Oluwakemi Adio
title	Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
title_short	Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
title_full	Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
title_fullStr	Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
title_full_unstemmed	Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization
title_sort	management of frequent ed users by community paramedics improves patient experiences and reduces ems utilization
publisher	The Beryl Institute
publishDate	2020
url	https://doaj.org/article/829fc4d485174b17934453c5e9beb12b
work_keys_str_mv	AT oluwakemiadio managementoffrequentedusersbycommunityparamedicsimprovespatientexperiencesandreducesemsutilization AT lauraikuma managementoffrequentedusersbycommunityparamedicsimprovespatientexperiencesandreducesemsutilization AT sonjawiley managementoffrequentedusersbycommunityparamedicsimprovespatientexperiencesandreducesemsutilization
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Management of frequent ED users by community paramedics improves patient experiences and reduces EMS utilization

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