Tip of health care spear
P.E.I.’s paramedics and Mobile Integrated Healthcare program builds collaboration
Paramedics working in Prince Edward Island are highly-trained healthcare professionals who have the knowledge and expertise to do more for Islanders - with high quality patient care and safety as our highest priority. Having an essential and unique responsibility within our healthcare system, we are often only seen as providers of emergency medical care.
However, the paramedic profession has evolved to encompass a more comprehensive role and is adapting to help fill gaps in services for the populations we serve. We can be thought of as the tip of the health care spear - witnessing the most intimate aspects of a patient’s life and living conditions. Sometimes it’s difficult for people to get the care they need but as patient advocates, mobile in the community, paramedics are uniquely positioned to connect patients to the support and services that they may require.
Paramedics in P.E.I. are excited to implement new models of care into our practice. One such project is the upcoming Mobile Integrated Healthcare program (MIH) which serves to identify patients requiring additional short-term support and builds collaboration with other health and wellness agencies.
The program is designed to provide a seamless transition between components of the healthcare continuum and represents a transition from reactive to proactive healthcare. Mobile Integrated Healthcare is a natural evolution of paramedicine and similar programs have been implemented across Canada and around the world.
This has resulted in measurable improvements in healthcare. Paramedic facilitated MIH programs have successfully reduced the transport of enrolled patients to emergency departments (ED) by 63 per cent in parts of Ontario (1). In Nova Scotia, MIH programs have reduced visits to a rural ED by 23 per cent (3) and reduced transport from enrolled patients in long-term care facilities to ED by 74 per cent (2).
All of these programs seek to relieve the pressure on Canadas’ already overburdened hospital-based healthcare systems. Paramedics can, and want to do more to help.
In P.E.I., the Paramedics Providing Palliative Care at Home program has been enormously successful, treating 31 per cent of patients at home, thereby avoiding transport to hospital and allowing patients to remain where they want to be. The program has received two prestigious awards since its launch in 2016 and Island paramedics have a proven track record of embracing change and working with other allied health practitioners.
The province has recently announced that Mobile Integrated Healthcare will initially take three forms. The new programs include: Rapid Bridging - Integrated Palliative Care Program; Rapid Bridging - Hospital and Emergency Department Patients; and the Paramedic Check-In Program.
These programs are in no way duplicating existing services and are designed to help patients either remain in their home or transition back to their homes sooner, subject to their healthcare needs and subjective desires of the patient. These innovative programs are expected to decrease ED visits for non-emergency complaints, shorten hospital length of stay (LOS) and readmission rates, reduce long-term care LOS, reduce the number of 911 calls and transport rates of frequent EMS users and improve patient outcomes and satisfaction.
Paramedic Check-in Program aims to serve those who live at home and pose a risk for poor health outcomes. Paramedics may check in with patients who called 911 and chose to stay home after paramedic assessment or to provide assistance to individuals with chronic disease and special needs. Paramedics can help to ensure that these patients live in safe environments and have adequate social and physical support. Paramedics can refer patients found to be in further need to allied
health and wellness agencies in this population.
Rapid Bridging - Hospital and Emergency Department Patients program aims to serve eligible patients who are discharged from hospital or emergency departments but still require short term support at home.
Paramedics will work in collaboration with Home Care nurses and allied healthcare professionals, or until Home Care can assume
responsibility for patient care to ensure the unique needs of the patient are met and that they can remain in the comfort of their own home.
Rapid Bridging - Integrated Palliative Care Program aims to aid the patients’ transition into the palliative care program and provide support to these patients in conjunction with the Provincial Integrated Palliative Care Program.