Nurses, paramedics respond together
In Anaheim, other cities, pilot program saves trips to the ER
ANAHEIM, CALIF. A home-bound heart patient called 911. His leg hurt where a catheter was inserted, but he didn’t complain of chest pains.
To paramedic Scott Fox, it was the kind of call that might have meant rushing the man to an emergency room. “There was no talking him out of it,” Fox recalls. Now he has another option.
He arrived at the man’s home with a nurse practitioner, Victoria Morrison, who calmed him down, checked him out and contacted his cardiologist to set up a next-day appointment.
“We saved the ER visit for a patient, which wouldn’t have done anything for him anyways,” Fox says.
This city is one of several around the country that are looking to provide better patient care and cut costs by having nurse practitioners ride alongside paramedics on non-urgent calls. When it comes to a twisted ankle or minor stomach pain, the two work together to find a solution that avoids a trip to the ER.
“As far as the paramedic goes, you want to get on scene as quick as you can and you want to get them loaded up into an ambulance as quick as you can,” says Fox, also a fire captain. “Now you take a step back and say, ‘ What can we do for that patient here in their house to benefit them to keep them out of the ER when they really don’t have to go?’ ”
In Anaheim, the fire department receives 31,000 calls per year, of which 85% are for medical assistance, according to Fire Chief Randy Bruegman. Of those medical calls, 35% to 38% are deemed non-urgent and low in severity. They include animal bites, headaches and abdominal pain — the kind of calls that can quickly clog emergency rooms.
Anaheim created the one-year pilot program this year, working with local ambulance company Care Ambulance Service, medical provider Kaiser Permanente and local fire agencies. The project costs about $500,000.
Officials don’t yet have an estimate on expected savings, but they are tracking data throughout the program.
The pilot aims to help alleviate the stress of overcrowded waiting rooms, an issue that plagues Southern California, as well as cities across the nation, says Todd Newton, regional chief of emergency medicine at Kaiser Permanente. He says these programs could significantly improve emergency health care for patients.
“They don’t have to come in. They don’t have to wait. They are being treated in a comfortable setting. It opens up our beds for people who really need them,” Newton says. “Everybody wins.”
The program was modeled after a similar pilot being tested in Mesa, Ariz.
“Now you take a step back and say, ‘What can we do for that patient here in their house to benefit them to keep them out of the ER when they really don’t have to go?’ ”
Scott Fox, paramedic