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 peak hours • 2 Emergency Support Units for Mass Casualty Events • Developing community paramedic service program

So how did we get here?

What the report showed

Hamilton Paramedics open over 67,000 doors each year Never knowing what is behind Always caring whatever it is We see opportunity

Par aram amedi edic S c Ser ervice ce 2011 2011 Pot otent ential al C Chal hallenges enges Aging Population • Increased frequency & complexity • More health care out of hospital = More DEMANDS SO WHAT DO WE DO?

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

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

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 •

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

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%

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 once: 60%

The Results – Eileen

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

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

What hat are are we e doi doing ng in 2011 t n 2011 to 2012? o 2012? • LH LHINS and and Prov ovince nce W Wide de Appl pplicat ation • Ref efer erral al for orm and and dat data bas a base • Educ ducation del n deliver ery y and and pac package age

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