According to an article published by HealthLeaders Media , New Hanover Regional Medical Center in Wilmington, N.C. is one of the only hospitals in North Carolina not to be fined for excessive readmissions over the last two years, and the organization’s leaders believe continued implementation of a unique paramedic-driven readmission reduction project will ensure that statistic remains solid.
In anticipation of the Centers for Medicare & Medicaid Services’ intended hike in reimbursement penalties for excessive 30-day readmissions and a growing list of conditions to be included in CMS’s formula, NHRMC launched a community paramedicine program in 2014. The concept for the program developed out of the realization that 29 percent of the community’s 9-1-1 calls were not for true emergencies but instead involved situations that could have been dealt with effectively in an environment besides the hospital Emergency Department — possibly, without ever leaving the home. Paired with the understanding that paramedics are capable of doing and authorized (in North Carolina) to do much more than what they are typically called upon to do, a new program was born in which paramedics provide patients in-home care and management of complications associated with certain chronic illnesses.
The hospital launched a pilot program in 2013 using just a few paramedics and a handful of heart failure patients identified as frequent visitors to the hospital and/or its ED. Within the sample group, ED visits dropped 93 percent, and the hospital saw a 54 percent drop in readmissions for these patients. Education coordinator David Glendenning, NREMT-P explained that despite the fact that the data set was so small, the financial impact of the pilot was huge. According to Glendenning, it was clear that a program like this could reduce ED visits, admissions and readmissions significantly.
NHRMC has since received grants, including a $281,000 grant from the Duke Endowment, to hire and train paramedics who work diligently to coordinate proper care for patients across the continuum. The paramedics work closely with primary care physicians, discharge nurses, home healthcare workers, case managers and pharmacists to provide the best care for these fragile patients. Advanced training for the paramedics includes coursework in nutrition, mental health, social services, cardiovascular medicine and rehabilitation as well as on-the-job shadowing of home healthcare workers and nurses. Program coordinators have found that these care providers can be especially helpful when it comes to proving counsel regarding nutrition and medication reconciliation.
To read more about New Hanover’s paramedicine initiative, click here.
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