Two Johnston County EMS paramedics will soon take on a new role – trying to prevent medical emergencies from happening.
A $350,000 Duke Endowment grant will pay the first responders to visit and help frequent 9-1-1 callers and sick people who are at risk of being readmitted to the hospital.
In coming weeks, the two paramedics will receive training in in-home care, a task that goes beyond the normal scope of a paramedic’s job duties, said Josh Holloman, the county’s EMS director. That training will include reviewing and monitoring doctor-prescribed care plans. The paramedics will also learn how to simply talk people through their problems.
“Ultimately, it’s about providing whatever that patient needs,” Holloman said.
The paramedics will focus on three groups of people, including the 25 most-frequent 9-1-1 callers and those most often admitted to Johnston Health’s emergency departments in Clayton and Smithfield.
Johnston County defines a frequent 9-1-1 caller as someone who dials more than four times in a month. Holloman said the top 25 callers dialed the 9-1-1 center between five and 37 times in 30 days.
“Clearly there is a need there that is not being met,” Holloman said.
The paramedics will also visit recently discharged hospital patients who are likely to be readmitted within 30 days.
“That includes heart-failure patients, chronic pulmonary disease patients and those with diabetes,” Holloman said.
Comparing the community paramedic program to community policing initiatives, Holloman said the goal is to reduce EMS transports and the readmission of hospital patients by 20 percent.
In addition to meeting a patient’s needs at home, Johnston County EMS will benefit from the preventive program by keeping its ambulances reserved for acute emergencies. Also, reducing repeat trips could also save the county money on fuel and other costs.
For Johnston Health, which partnered with county EMS leaders to apply for the Duke Endowment grant, the in-home care could help the hospital meet a growing responsibility after patients leave its doors. Changes driven by the Affordable Care Act and Centers for Medicare and Medicaid Services (CMS) are holding hospitals accountable for a longer period of time after patients go home.
The community paramedic program can help mitigate “avoidable readmissions,” meaning those that could most likely be prevented through proper treatment at home, said Beverly Legath, Johnston Health’s director of case management.
Legath said some discharged patients who are home-bound qualify for home health care, and a CMS grant is helping Johnston Health pay for transition coaches. The community paramedic program will add another way for patients to get help at home, she said.
“These patients have medically and socially complex needs and live at home,” Legath said. “They feel they have no health-care options other than emergency services.
“The community paramedic program can begin to address their medical and social needs in a cost-effective way that promotes better use of health-care resources.”
The Johnston County Board of Commissioners agreed to use the grant to move two paramedics to the new community roles. Holloman said the county will fill those paramedic vacancies with part-time staff.
When the grant funding runs out, or if the county wants to end the program, the two paramedics in the community positions would return to their prior roles.
Johnston Health Chief Executive Chuck Elliott said a committee of EMS staff, hospital leaders and other officials will administer the grant, meeting quarterly to make sure the program is meeting its objectives.
Holloman said he hopes to have the paramedics trained and on the road by early June.