Gordy Vosberg, director of emergency medical services for CentraCare-Health Monticello, is excited about a new program the hospital has introduced to help patients, which involves his team of paramedics.
Monticello is the first to begin a pilot program called Healthy At Home. It is offered to patients in the hospital with certain diagnosis that put them at high risk of re-admission.
“It’s a collaboration,” said Vosberg. “Between the attending physician, the primary care provider and EMS services. We set up an appointment for an EMS staff member to visit the patient within 48 hours of their discharge to home.”
Early intervention is key, Vosberg says. Most re-admissions happen within a 30-day time period. Paramedics help the patient answer questions about their care and their follow-up plan and make sure a follow-up visit to the primary care provider is scheduled. They answer any questions the patient or their loved ones may be having about their medications or other aspects of their care.
“Statistics show up to 80% of patients may not fully understand their discharge instructions when released from the hospital. There is just so much information presented at the time,” Vosberg said. “As a final step, the paramedic leaves the patient with a daily tool they can use for self-monitoring their progress.”
For the time being, the program is only offered to patients with four diagnosis; chronic obstructive pulmonary disease (COPD), asthma, pneumonia or chronic heart failure (CHF), four chronic, complex leading causes of hospital re-admission. They hope to expand the list of diagnosis that qualify for the extra help, which is voluntary and free to the patient, Vosberg says.
“The program has been in place since January and has already proven helpful. One good example we had was a patient who is new to the area,” he said. “The paramedic was able to walk the person through the process of finding a primary care provider in the area.”
Paramedics are trained to focus quickly on the patient and their surroundings, and precisely evaluate the situation. Having them visit patients in their homes is a way of collaborating with the patient outside the building.
“Patients have an additional conduit for resources and we get to see them in their own surroundings where they are more relaxed,” Vosberg said.
“The program optimizes resources, keeps people healthy and in their homes, their communities, their jobs, and gives them social interactions. It has been successful. We have only done a few home visits so far but we have had no re-admissions on the patients we have visited and the visits have been very well received.”
While the program is small and the focus has been kept narrow, Vosberg expects to see it spread throughout the CentraCare system.
“This is a pilot project,” Vosberg said. “We want to make sure we do this correctly so the patient receives the greatest benefit. There will be more discussion soon.”
The program was a year in development before being put into place. The next step will be more training for EMS personnel.
“We want to promote high quality emergency medical services throughout the CentraCare system,” Vosberg said. “To allow patients the maximum opportunity for success.”
