Community Paramedicine Program expands to offer new tactic to battle COVID-19
As the COVID-19 pandemic grew to record high cases in Merrill, local healthcare professionals came up with a plan to fight it by expanding a Community Paramedicine Program (CPP) that has been in place since 2018.
The CPP program, from Ascension Good Samaritan Hospital and the Merrill Fire Department, featured paramedics conducting patient home visits focused on those who were discharged from Ascension Good Samaritan with Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, or Pneumonia.
Patients that enrolled in the free CPP were contacted by the Fire Department, and an initial appointment was scheduled at their home within one week of leaving the hospital. The first two years of the program were very successful, with not one patient being readmitted to the hospital within a month.
As the COVID-19 pandemic swept across the country early in 2020, the CPP referrals dwindled until October, when things drastically changed. Around that time, Ascension Good Samaritan and other hospitals in the region and across the state were nearing capacity.
“Knowing that there were patients who typically would be admitted for observation for progression of COVID-19, we began discussing possible alternatives as cases continued to rise in the community,” said Jonathon Matuszewski, Chief Administrative Officer at Ascension Good Samaritan.
As the result of this discussion, it was determined that many of the patients who presented in the Emergency Department with COVID-19 symptoms required oxygen and additional monitoring, but could remain in the comfort of their own home.
The Ascension Good Samaritan team decided to reach out to the Merrill Fire Department to see if the CPP program could be expanded to include these COVID-19 patients. To accomplish this, an ad hoc committee was formed to connect the necessary hospital departments and Fire Department personnel.
“The committee collaborated weekly and quickly developed protocols to address the need for lower acuity COVID-19 patients to remain safely at home with the help of the CPP program,” said Michael Clark, M.D., Emergency Department Physician and Medical Director of Emergency Medical Services (EMS) at Ascension Good Samaritan. “This would in turn reduce admissions to the hospital and ensure available beds were being utilized by higher acuity patients who really needed hospitalization.”
The committee was able to address the issue through a combination of expanded home health options and the CPP program. Qualifying patients are referred to the appropriate home health service to assist with additional care support. For those non-qualifying home health patients requiring additional alternative care, the CPP program is recommended.
“For the Fire Department to expand their program, it was important to engage the membership in the decision making process,” said Merrill Fire Chief Josh Klug. “Safety and protection of the emergency personnel was of utmost concern.”
The Fire Department had already engaged in the use of Personal Protective Equipment (PPE) and limiting public access at the fire station; now they were being asked to expand their service on the frontlines of the pandemic.
“Not surprisingly, Merrill firefighters embraced the additional responsibilities and became an integral part of the solution, addressing the unique situation caused by the pandemic,” added Klug. “I am very proud that our staff answered the call for help and are fulfilling the first part of our mission by preventing harm in the community.”
Expanding the CPP program to care for COVID-19 patients required training on patient discharge instructions, equipment, and additional decontamination procedures. The Department trained on the use of Powered Air Purifying Respirators or PAPRs for use during COVID-19 visits, in order to conserve N95 respirators.
“PAPRs are quite common PPE for hospital staff, but less common for EMS personnel,” said Merrill Battalion Chief Phil Skoug. “Additionally, Fire Department personnel would need a decontamination procedure that would provide safety during and after the visit.”
Merrill paramedics saw their first COVID CPP patient on December 9, and there have been 11 referrals since then, that resulted in 9 initial CPP visits.
“So far we have met our intended goal of reducing COVID-19 related hospital admissions and improving patient outcomes,” said Dr. Clark. “The CPP program represents the first steps in expanding the role of EMS professionals from primarily response and treatment to more complete medical support to the community, to help prevent medical emergency conditions from occurring.”
Committee members are pleased with the results so far, knowing how important it has been to the Merrill community.
The CPP is funded through an annual grant of $20,000 from the Ascension Good Samaritan Community Outreach Department and is committed to additional funding as the need arises. “The addition of this collaborative program between Ascension Good Samaritan and the Merrill Fire Department exemplifies the ongoing commitment of providing compassionate personalized care, in the community we are so privileged to serve”. said Jane Bentz, Foundation and Community Outreach Director, Ascension Good Samaritan.
Ascension Good Samaritan Hospital (AGSH) Foundation and Community Outreach Director Jane Bentz formed an ad hoc committee that included herself; Chief Josh Klug, Merrill Fire Department; AGSH Emergency Department Supervisor Audrey Evans; AGSH Chief Administrative Officer Jonathon Matuszewski; ASGH ED Medical Director Dr. Heong P’ng; ASGH EMS Medical Director Dr. Michael Clark; Ascension Hospice & Home Health Director Janette Marien; and Ascension Regional Care Management Director Jennifer Falkowski.