Our neighbors to the north have typically been a bit more transformative in EMS delivery than we in the states!
We know this because a couple of the AIMHI member agencies are high performance / high value members of AIMHI.
This model makes a lot of clinical, operational, and financial sense, and allows skilled EMS clinicians to not only respond to the low-acuity 911 calls, but also allows EMS crews in the field to triage patients who do not meet clinical criteria for a transport to the ED, to be treated in place, with a CP follow-up visit.
Very innovative, and patient-centric approach to system redesign!
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P.E.I.'s new paramedic units aimed at reducing demands on ambulances, ERs
Units could help free up ambulances in rural parts like Souris, West Prince
Stu Neatby · Journalist
5/8/24
https://www.saltwire.com/atlantic-canada/news/peis-new-paramedic-units-aimed-at-reducing-demands-on-ambulances-ers-100963025/
Health decision-makers say a new non-ambulatory unit could help keep more ambulances in rural areas like West Prince and Eastern Kings.
On May 7, Health Minister Mark McLane announced the province’s ambulatory provider, Island EMS, has officially launched new community paramedic response units (CPRU) – paramedic units intended to help 911 calls for patients with lower acuity needs.
McLane said as many as 35 per cent of 911 calls are from patients who don’t need to go to hospitals. He said the new CPRU units will be staffed by advanced care paramedics who can provide in-home treatments or referrals.
"This could save the patient a ride to the emergency department if they don't need to go there. Paramedics will connect the patient with appropriate care within the community," McLane said at a news conference the Island EMS office in Charlottetown.
The new units have been operating in an unofficial capacity since the fall, but Tuesday’s announcement signalled that the appropriate policy protocols for these CPRU teams are in place.
In lieu of ambulances, the CPRU paramedics will be transported via a Chevy Traverse or Subaru Outback stamped with the word "paramedic" on the hood.
Wait times
The province’s ambulance response times have grown longer across the board in both urban and rural community over the last year.
The wait times are longest in Souris, O’Leary and Alberton, which have median response times longer than 20 minutes. This compares to just over 15 minutes in Charlottetown, 12 minutes in Summerside and just over 12 and a half minutes in Stratford.
James Orchard, general manager of P.E.I. operations for Island EMS, said the new units will help free up ambulances, particularly those based in areas around Souris, Montague, O’Leary and Alberton, to get to emergencies faster.
Orchard said around half of 911 calls are based in Charlottetown.
"A lot of times the rural ambulances are being drawn into the centres because that's where the call volumes are. But, of course, all it takes is one call out in a very rural area and now we're behind the eight-ball to get to that call,” Orchard said.
"These units can handle that volume so that our rural ambulances are not pulled into it.”
Across P.E.I., the median ambulance response time was 14 minutes and 41 seconds for the period between Jan. 1 and March 31 of 2024. That’s 3 minutes and 24 seconds longer than the same time period in 2023.
Two of the community paramedic response units will be based in Charlottetown while one will be located in Summerside.
Helping patients
Orchard said patients often do not know how to navigate the health system. He said paramedics are well situated to be “advocates and navigators” for patients.
“People don't know what resources are really, in some cases, just down the street for them. In a lot of those cases, those resources are available, we just don't know about them," he said.
Dr. Scott Cameron, the provincial medical director for emergency health services, said these units could also help alleviate some of the stresses in emergency rooms.
“When 911 is called and paramedics arrive on the scene, patients will be triaged. Patients must meet the clinical indicators to be transported to the emergency department,” Cameron said at the May 7 news conference.
“If they do not meet clinical indicators for transport, Island EMS paramedics will leverage the CPRU team as necessary."
Tyler Graves, the president of the Paramedic Association of P.E.I. and a member of the new units, says the new units will allow more advanced care paramedics like himself to work to their full scope of practice.
"It's a huge opportunity for paramedics to just kind of prove that we can practise at a higher level,” Graves said. "But then also for the communities, it helps get people out of the hospital and keeps them out of the hospital if there's things that we can be doing at home."
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