SPONSORED BY THE REGIONAL EMS AUTHORITY (REMSA) NORTH CENTRAL EMS INSTITUTE

SEPTEMBER 2 - 5, 2014

Reno, NV U.S.A.INTERNATIONAL ROUNDTABLE ON COMMUNITY PARAMEDICINE

10th Annual meeting

2

CONFERENCE BROCHURE AND SCHEDULE

3

CONTENTS................................................................................................................Accommodations 4

..........................................................................................................Schedule at a Glance 5.......................................................................................................Presentation Abstracts 8

............................................................................................................................Sponsors 18

4

Enjoy shows or the casino floor for after hours fun and relaxation.

DESCRIPTIONExperience Reno’s most luxurious

resort rooms. Designed to inspire, your guest room features distinctive décor, con tempora r y f u r n i sh i ngs and unparalleled amenities. Oversized windows fill the room with natural light, and showcase breathtaking views of the city or mountains. Seamless in-room technology allows you to easily connect your laptop directly to the 42” HD flat screen TV. Upgrade to Reno’s only Concierge Hotel Tower. Treat yourself to VIP check-in, butler service and an exclusive lounge, serving complimentary continental breakfast and afternoon hors d’oeuvres. Atlantis has rooms with amenities to suit anyone, from the vacationing family, high roller or business traveler.

http://bit.ly/1qUjEgZ

RESERVATIONSThe Atlantis Casino Resort Spa

3800 S. Virginia St.Reno, NV, USA 89502Phone: (800)723-6500

Please note: there is a $12.00 plus tax nightly resort fee, which provides the following services and amenities to hotel guests at no additional charge. Access to our Cardio Theater and Fitness Center, in-room wired or wireless high-speed Internet, unlimited local phone calls, unlimited toll-free phone calls, valet and self-parking, use of indoor and outdoor pools and whirlpool spa, concierge services, and boarding pass printing services.

PARKING & TRANSPORTATIONReno-Tahoe International Airport

(RNO) is an award-winning international airport. If you are traveling by car, please see driving directions, from the airport or any other location.

The Atlantis Casino Resort offers complementary shuttle service to and from the airport. Taxi service is available to and from the airport. Transportation

Accommodations

Atlantis is honored to be a recipient of the distinguished AAA Four Diamond award. This prestigious recognition signifies the beauty and attention to detail eminent throughout the entire resort. Less than five percent of the nearly 31,000 properties approved by AAA achieve this coveted designation.

CONFERENCE BROCHURE AND SCHEDULE

5

TIME TUESDAY HOST1600 Registration Open

1800Grand 1-3

Welcome Reception – Exhibit Hall Hosted by: Regional Emergency Medical Services Authorityand North Central EMS Institute

Gary WingroveSponsored by: Zoll Medical Corporation

TIME WEDNESDAY SPEAKER0700 - 0830 Registration Open

0730 - 0830Grand 1-3

Continental Breakfast - Exhibit Hall PROVIDED

0830 - 0930Grand 5 - 7

10.A.1 HGH EMS Honor GuardWelcome and Introductions

10.A.2Welcome From Dignitaries

10.A.3Passing of the IRCP Gavel

Jim Gubbels President & CEO, REMSASusan Long President, NCEMSIPat Songer Chief, HGH EMS

Steven Tafoya EMS Program ManagerDr. Tracey GreenChief Medical Officer, Nevada Division of Public & Behavioral HealthAssemblyman James Oscarson

Gary Wingrove Chair, IRCPMartin Flaherty Managing Director, AACEJim GubbelsPresident & CEO of REMSA

0930 - 1000 10.B.1Radical Transformation of the English Ambulance Sector

Martin Flaherty, OBE

1000 - 1100 10.B.2 Prehospital Emergency Care – Through the Lens of the Institute for Healthcare Improvement

David M. Williams, PhD

1100 - 1130 10.B.3Actuarial Computed Results of a Rural Community Paramedic Program

Chris Montera, ACP

1130 - 1200 10.B.4Community Paramedics at Mass Gathering Events

Justin Sempsrott, MD

Schedule at a Glance

6

TIME WEDNESDAY (CONTINUED) SPEAKER1200 - 1300Grand 1 - 3

Lunch - Exhibit Hall Sponsored by:Medtronic Philanthropy

1300 - 1345Grand 5 - 7

10.C.1Launch of a Community Paramedic Program within a Healthcare System

Susan Long, ACP

1345 - 1415 10.C.2Community Paramedicine – Paramedic Referral to Community Partners

Michael Nolan, ACP

1415 - 1500 10.C.3Onward and Upward – Moving from Initial Pilot to Established Program

Mark Babson, ACPJeremiah Wickham, ACP

1500 - 1530Grand 1 - 3

Afternoon Tea - Exhibit Hall PROVIDED

1530 - 1600Grand 5 - 7

10.D.1The Role of Community Paramedics in Disaster Relief Efforts

Ryan Kozicky

1600 - 1630 10.D.2Alberta Health Services Community Paramedic Program: Development, Implementation, Evolution and Evaluation

Ty Eggenberger

1630 - 1730 10.D.3Prove It! – Data Metrics that Demonstrate Value and Safety for MIH/CP Services

Matt Zavadsky, MS-HSA

Dinner on your own

TIME THURSDAY SPEAKER0600 - 0815

0815

Bus Departs for Rancho San Rafael Park - Hot Air Balloon Mass AscensionsBus Departs for Hotel

0830 - 0930Grand 5 - 7

Continental Breakfast PROVIDED

0930 - 1000Grand 5 - 7

10.E.1Community Integrated Paramedicine – A Paradigm Shift for the US Fire Service

Les Paul Caid, MS

1000 - 1030 10.E.2Case Studies – Achieving the Triple Aim

Jeff Millar, ACP

1030 - 1100 10.E.3Education in the New South Wales Ambulance Service

Craig Hutchens, ACP

1100 - 1200 10.E.4Achieving the Triple Aim: REMSA’s Health Care Innovation Award Preliminary Outcomes

Brenda Staffan

1200 - 1300 Lunch - Bistro Napa PROVIDED

7

TIME THURSDAY (CONTINUED) SPEAKER1300 - 1400Grand 5 - 7

10.F.1A Clinical Career Path for Paramedics – Examining the Constructs for a Curriculum in Community Paramedicine

Attila Hertelendy, PhD, ACP

1400 - 1430 10.F.2Telemedicine and Real-Time Data Movement from the Bedside Provide an Economic Justification for Community Paramedicine

Jonathon S. Feit, MBA, MA

1430 - 1530 10.F.3Great Partnership – Filling the Healthcare Gap

Matthew Goudreau, BAGreg Davis, ACP

1600 Bus Departs for Lake Tahoe (Zephyr Cove)

1800 MS Dixie Dinner Cruise Zephyr Cove *EXTRA FEE NOT INCLUDED*

2100 Bus Departs for Return to Conference Hotel

TIME FRIDAY SPEAKER0800 - 0830Grand 5 - 7

Continental Breakfast PROVIDED

0830 - 0900Grand 5 - 7

10.G.1Community Paramedicine Partners with Nursing to Reduce 30 Day Readmissions

Julie Smith, RN Shawn Baumgartner, ACP

0900 - 0930 10.G.2From Long and Brier to Deep River – A Canadian Voyage in Community Paramedicine

John (Jay) Walker Michael Nolan

0930 - 1000 10.G.3College & University Education of Community Paramedics

Anne Montera, RN Baxter Larmon, PhD

1000 - 1030 Refreshment Break PROVIDED

1030 - 1100 10.H.1Making Sense of the Community Paramedicine Model – A Conceptual Guide for Innovators

Peter O’Meara, PhD

1100 - 1115 10.H.2Rapid Fire Closing Session: Topics in 15 MinutesDecreasing Recidivism – Six Months to Develop, Implement and Evaluate a Model that Fulfills the IHI Triple Aim

Kacy AllgoodAndrew C. Stevens, MD

1115 - 1130 10.H.3Paramedic Identification of Patients to Falls Prevention Program

Tom Dobson

1130 - 1200 10.H.4 Conference Wrap Up & Forward Looking to 2015 Gary Wingrove

FRIDAY AFTERNOON FRIDAY AFTERNOON FRIDAY AFTERNOON

1300 - 1500 International Paramedic Meeting/Delegates - Room Location Treasurers AB1300 - 1500 International Paramedic Meeting/Delegates - Room Location Treasurers AB1300 - 1500 International Paramedic Meeting/Delegates - Room Location Treasurers AB

1315 - 1630 Tour of REMSA Facilities and CHP Programs1315 - 1630 Tour of REMSA Facilities and CHP Programs1315 - 1630 Tour of REMSA Facilities and CHP Programs

8

Presentation Abstracts WEDNESDAY10.B.1 Radical Transformation of the English Ambulance Sector Martin Flaherty, OBE: Managing Director, Association of Ambulance Chief Executives The Urgent and Emergency Care system in England is currently the subject of a major review led by Professor Sir Bruce Keogh Medical Director for NHS England. It has been prompted by the recognition that the current system is unsustainable financially, confusing for patients and does not deliver optimum patient outcomes.In reviewing the system it has been accepted that the UK ambulance service which is the most trusted brand in the National Health Service (NHS) has much more to offer and indeed needs to play a central role in the new system.In doing so ambulance services will be radically re-engineered to provide better educated clinicians trained to degree level with a skill set which is geared both to the management of acute life-threatening conditions and also to the management of lower acuity patients. The emphasis here will be for ambulance services to be a vital part of local Urgent and Emergency Care Networks designed to manage more patients at home or in the community avoiding unnecessary hospital admissions.This radical change will all need to be delivered by 2017 and as such represents the most significant transformation programme to have faced the English Ambulance Sector in many years. This presentation will describe the drivers behind this proposal, the challenges it presents and describes the way in which the ambulance sector will rise to those challenges and re-invent itself to become a radically different service going forward.

10.B.2 Prehospital Emergency Care – Through the Lens of the Institute for Healthcare Improvement David M. Williams, PhD: Improvement Advisor and Faculty Institute for Healthcare Improvement The IHI Triple Aim is reshaping healthcare improvement around the world by focusing attention on patient experience, care quality, and per capita cost. EMS systems around the world are starting to take note and are trying innovative ways to aspire to meet the intent. Join IHI faculty and improvement advisor David M. Williams, Ph.D. as he introduces the Triple Aim framework and describes the outcomes and key drivers for prehospital emergency care to achieve. Learn about how IHI's improvement science methods can help you make measurable results and hear examples from EMS systems around the world resulting from IHI's innovation team research.

10.B.3 Actuarial Computed Results of a Rural Community Paramedic Program Christopher A. Montera, ACP: Assistant CEO, Eagle County Paramedic Services The Eagle County Paramedic Service Community Paramedic program has been operating since 2009 and collecting data for all patients since the first patient in 2010. Patient data and the acquisition of the data has not been easy. Chris will walk through the struggles of current ePCR data systems and then look at the programatic outcomes from a health care savings lens. Armed with 3 years of data the measurable outcomes and payer savings will be discussed and shown in a step-by-step process.

9

Presentation Abstracts Wednesday, Cont...

10.B.4 Community Paramedics at Mass Gathering EventsJustin Sempsrott, MD: Medical Director, Humboldt General Hospital EMS This presentation will explore the planning processes for delivering paramedic services to a mass event. The Burning Man Festival has been held in the Northern Nevada Black Rock Desert for the past 17 years. Obstacles of providing medical services in this remote desert location along with lessons learned will be shared, as well as cost savings and expanded medical services offered at the clinic.Justin will describe the role of Community Paramedics at mass gatherings, how mass gatherings should be seen as planned disasters and demonstrate ways to integrate Community Paramedics into the disaster planning. This fast paced presentation will discuss the role, education, and policys/protocols that should be in place prior to allowing the practice to start. The role of RN’s and CP’s will be discussed and how these two practice models work cohesively together.

10.C.1 Launch of a Community Paramedic Program within a Healthcare SystemSusan Long, ACP: Director of Clinical and Support Services, Allina Health EMSAllina Health is an integrated health system with hospitals, pharmacies, specialty care centers and specialty medical services that provide hospice care, oxygen and home medical equipment, and emergency medical services. As not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life. With so many services within Allina Health, finding a niche for Community Paramedics within the non-emergency health care system created unique opportunities and challenges for implementation of the Allina Health Community Paramedic services. Susan will discuss their journey and current status of Allina Health’s Community Paramedic Program.

10.C.2 Community Paramedicine – Paramedic Referral to Community PartnersMichael Nolan, ACP: Chief, County of Renfrew Paramedic ServiceThe County of Renfrew Paramedic Service and Ottawa Paramedic Service derived and internally validated a clinical prediction rule in a cohort of 2184 frail older persons. The “PERIL” prediction rule - Paramedics Assessing Elders at Risk for Independence Loss uses three variables that are evaluated by paramedics in the homes of older clients to identify those at highest risk for recurrent Emergency Department use, hospitalization or death within 30 days. This study has demonstrated that if a patient has a score of PERIL 2/3, 70% will have an adverse outcome within 30 days.Concurrent to the PERIL prediction rule, The County of Renfrew Paramedic Service and Ottawa Paramedic Service partnered with the Champlain Community Care Access Center (CCAC) to develop the “Paramedics and Community Care Team” program (PACCT). In this program paramedics directly refer patients living in the community with unmet needs to CCAC based upon their PERIL score. The objective of the PACCT program is to increase the quality of life of vulnerable older patients while decreasing recurrent ED / Paramedic Service use by linking the client with available community services. A province wide paramedic to CCAC referral process has been completed as of May 2014. All aspects of the design and delivery of this referral process will be presented.

10

Presentation Abstracts wednesday, Cont...10.C.3 Onward and Upward – Moving from Initial Pilot to Established ProgramMark Babson, ACP; Jeremiah Wickham, ACP: Community Paramedics, Ada County Paramedics The Ada County Community Paramedics will discuss our progress from initial pilots to established programs. The presentation will highlight how we’ve moved forward without major grant funding, data analysis, or research assistance. It will review the Ada County Community Paramedic specific pilot program conception process, stakeholder communication, data collection and analysis, and review of findings. The path has been a learning experience, and one that has yielded many lessons on finding a way to move a program forward with limited resources.

10.D.1 The Role of Community Paramedics in Disaster Relief EffortsRyan Kozicky: Manager, EMS Community Health, Alberta Health Services In June, 2013, Alberta, Canada, experienced heavy rainfall that triggered catastrophic flooding described by the provincial government as the worst in Alberta's history. Four people were confirmed dead as a direct result of the flooding and over 100,000 people were displaced throughout the region. Total damage estimates exceeded C$5 billion and in terms of insurable damages, it is the costliest disaster in Canadian history at $1.7 billion.1Many of the residents evacuated were frail elderly and those living in lower socioecomic conditions with minimal social support networks in place and multiple co-morbidities. Various evacuation sites were set up to address the need for housing and food, but there was limited primary care support in place. Many of those evacuated began developing acute illnesses from a lack of accessible health care for things such as medication administration, chronic disease management, mental health and minor trauma. 911 began noticing an increase in medical events occurring at the evacuation sites and the Alberta Health Services (AHS) Calgary Zone Community Paramedic program was asked to support flood relief efforts. There was significant planning under short timelines in order to facilitate a Community Paramedic response; tasks included deployment of CP resources, supply/equipment acquisition and coordination of medical oversight for treatment. Over the next 17 days the CP program assessed and treated in place 233 people impacted by the 2013 flooding. This presentation demonstrates the effectiveness of Community Paramedic application in helping manage the diverse healthcare needs of people impacted by a natural disaster.

11

Presentation Abstracts wednesday, Cont...10.D.2 Alberta Health Services Community Paramedic Program: Development, Implementation, Evolution and EvaluationTy Eggenberger: Team Lead, Calgary EMS Community Paramedic Program The Alberta Health Services (AHS) Community Paramedic Program (CPP), operational since November 2012, increases access to primary and specialty care through multidisciplinary collaboration. Health studies in Alberta prior to program launch determined that 28% of acute care visits1 were for complaints that may be appropriately managed by a family physician while only 51% of Albertans rated access to that type of health service as easy2. Barriers to health care inappropriately redirect patients to EMS for transport to emergency departments (ED) or cause delays in care that increase patient acuity, leading to the same costly, preventable outcome.This presentation demonstrates where and how the AHS CPP intervenes in the clinical course of disease to positively impact patient experience, outcome and navigation. It also outlines the two patient referral pathways created by the AHS CPP to reach vulnerable populations before they are pressured to access 911. Included is the development of the program’s own non-emergent dispatch system necessitated by its targeted early intervention prior to when EMS typically encounters patients.Data presented from over 2000 AHS CPP patient events validates that this paramedic resource reduces preventable EMS and ED events with low patient relapse. A comparison of cost and knowledge transfers between traditional EMS transport and AHS CPP care in place also supports this model of care. Review of a current patient survey speaks to patient experience as does a video recounting successful care in place. Throughout, the challenges, both past and present, of integrating this initiative into EMS and the greater healthcare system are highlighted with proposed solutions.

10.D.3 Prove It! – Data Metrics that Demonstrate Value and Safety for MIH/CP ServicesMatt Zavadsky, MS-HSA: Public Affairs Director, MedStar Mobile Healthcare Anything worth doing is worth doing well, but all too often traditional EMS agencies have struggled with determining and reporting outcome metrics that prove value to key stakeholders. This session will introduce the work being done by REMSA, eMedHealth and MedStar to create outcome and process-based data sets for MIH/CP programs that can be used by agencies for proving value. The presenters will also discuss the efforts underway to identify appropriate accrediting agencies for certification and accreditation of MIH/CP programs.

12

10.E.1 Community Integrated Paramedicine – A Paradigm Shift for the US Fire ServiceLes Paul Caid, MS: Chief, Rio Rico Fire Department The U.S. Fire Service has provided Emergency Medical Services (EMS) to the communities they serve for over 50 years. As healthcare costs continue to balloon and with the advent of the Affordable Care Act, the fire service is uniquely positioned to help fill gaps in the healthcare system. Community Integrated Paramedicine is a rapidly evolving field for both rural areas and urban communities. Located just 7 miles north of the US/Mexico Border, Rio Rico is located along the beautiful Santa Cruz River Valley. The rolling hills surrounding this valley are home to almost 23,000 residents who have no public transportation and are very under-resourced in healthcare services. After almost three years of preparation and laying a solid foundation, in January 2014, Rio Rico Fire District (RRFD) became the first agency in Arizona to implement community integrated “healthcare” paramedicine program, making home visits, promoting education and hoping to produce better healthcare outcomes. Centering on a chronic disease model, while also conducting a home environmental/safety survey and medicine reconciliation, there have been many “lessons learned” which will be shared with the audience. Even more exciting, our effort has now moved this same model into a larger group of seven fire agencies in Southern Arizona to corroborate this effort by validating data using a much larger target group. This presentation will provide an overview of this exciting concept, share lessons learned and detail the logistics of working toward validation of this paradigm shift in the fire service.

10.E.2 Case Studies – Achieving the Triple AimJeff Millar, ACP: Community Paramedic, County of Renfrew Paramedic Service Working as Community Paramedics within the County of Renfrew Paramedic Service, the achievement of the Triple Aim can be identified through the utilization of case studies. The three individual case studies demonstrate improved patient experience, improved health of populations and improving health care capacity. We demonstrate improved patient experience through a case study of a client who was being seen regularly and was found with an infection in his leg. The community paramedic recognized and was able to arrange for treatment at the CHC within an hour. The CPRU program has been able to improve health of clients in our communities by completing blood draws in the homes of clients who are unable to ambulate. Research shows that increasing the amount of time a patient on anticoagulant therapy is within the therapeutic INR range reduces the risk of adverse events, which are extremely costly on the health care system. The CPRU Program has improved health care capacity. This is demonstrated through a client who, during her visits to the CHC, had a blood pressure consistently in the 200 range, which lead to a change in medication. The CPRU Program was able to see her 8 times in the following 6 weeks, after the medication change to ensure a decreased blood pressure. Our visits allowed essential continued care without the need to visit the clinic. With approximately 80 Home Visit clients and over 200 Wellness Clinic clients seen monthly the CPRU program has been able to reduce the overall number of visits to the CHC by CPRU clients and in turn led to increased access to primary care for other community members.

Presentation Abstracts THURSDAY

13

10.E.3 Education in the New South Wales Ambulance ServiceCraig Hutchens, ACP: Paramedic Educator, Ambulance Service New South Wales The purpose of this presentation is to review the progress of the NSW Ambulance (NSWA) from 1985 to the present day with a mostly pictorial overview. And to also review how it maintains the clinical education and competency of around 4000 paramedics?The NSW Ambulance began in 1895 with a dedicated group of volunteers. Volunteerism continued to be the general makeup of the service till the 1960’s when due to a lack of numbers and a need to respond to more calls the paid Ambulance Officer (Paramedics) came onto the scene.In 1961 the first training school for Paramedics was started in Sydney. The intention of this school was to offer induction and ongoing training for all NSWA members. The qualification issued was a St John First Aid Certificate. But keeping track of who was qualified was not centralised and there were no guarantees of who kept themselves up to date. It was not till around 1996 when the Service’s Education Section became a Registered Training Organisation that the qualifications issued were nationally recognised. The need to centralise and keep more accurate records was now required. In 2004 the Service began its Certificate to Practice (CTP) Program. This requires Paramedics to renew their CTP every three years. This created the problem of ensuring that the Paramedics maintain their CTP and this presentation will look at how this was achieved. Prior to 2004 knowing who was certified or not was difficult (if not impossible), but current records now show that 99% of our paramedics have a current CTP.

10.E.4 Achieving the Triple Aim: REMSA’s Health Care Innovation Award Preliminary Outcomes Brenda Staffan: Project Director, Community Health Programs, Regional EMS Authority REMSA of Reno, NV is the recipient of a national Health Care Innovation Award and has implemented a comprehensive Community Health Program designed to improve the quality and experience of care, improve population health and lower overall costs.  This session will provide an overview of REMSA's preliminary outcomes for all three program components:  Community Paramedicine, Nurse Health Line and Transport to Alternative Destinations.  In addition, attendees will learn the five measures domains and the steps to design, collect and validate the outcomes necessary for a successful program.

10.F.1 A Clinical Career Path for Paramedics – Examining the Constructs for a Curriculum in Community ParamedicineAttila Hertelendy, PhD, ACP: Director, Emergency Health Services Program, George Washington University This session examines the current literature that influences policy and practice. The top 10 articles of the year will be reviewed that have a potential impact on clinical decision making and policy with a focus on cost, access to care and quality.

Presentation Abstracts THURSDAY CONT...

14

10.F.2 Telemedicine and Real-Time Data Movement from the Bedside Provide an Economic Justification for Community ParamedicineJonathon S. Feit, MBA, MA: CEO, Beyond Lucid Technologies (1)  Discussions of Community Paramedicine have historically focused mostly on cost savings to the healthcare system.  But due to ambulance payment schemas, systemic cost savings often do not apply directly to EMS. However, non-transport does negatively impact revenues.  Therefore, we must find another economic justification for Community Paramedicine – not systemic cost savings.(2)  Economic justification – those non-systemic cost savings – can be found in the form of agency-specific cost savings: i.e., reduced paperwork (i.e., physical paper and ink cost); reduced time / overtime spent completing paperwork; reduced payroll weight (i.e., increased throughput due to reduced operational redundancy); and the “soft cost” of reduced liability exposure. (3)  Due to the diversity of CP/MIH patient populations – and with an increase in their volume as healthcare reform progresses and the population ages – it become unwieldy to manually aggregate sufficient data quickly enough to track patients across the Accountable Care continuum, and thereby to achieve the Triple Aim of better access to care, better quality of care, and lower cost of care.(4)  Technologies that facilitate the collection, aggregation, communication (i.e., sharing), and analysis of patient information and provider impressions in real-time across the care continuum are key to scaling CP/MIH efforts while sufficiently lowering costs toward self-sustaining levels on the EMS side the equation, while simultaneously reducing risk and waste on the receiving (care facility) side of the equation to justify a proactive subsidy of pre-hospital CP/MIH activities.  In other words: a win-win.  Such technology suites should include telemedicine (including device data import), notifications, data mining and investigational tools, and health information exchange (for data system interoperability), including longitudinal records (i.e., past patient history) and outcomes from each encounter.    

10.F.3 Great Partnership – Filling the Healthcare GapMatthew Goudreau, BA & Greg Davis, ACP: Director of Clinical Services, EasCare Ambulance This presentation will be a review of our program, with an emphasis on the collaboration needed to develop the necessary relationships. EasCare worked closely with our ACO partner, Commonwealth Care Alliance (CCA), to identify specific needs within their existing home care system. Utilizing the principles of the Community Paramedic concept, our team constructed an entire program from the ground up.

Presentation Abstracts THURSDAY CONT...

15

10.G.1 Community Paramedicine Partners with Nursing to Reduce 30 Day ReadmissionsJulie Smith, RN & Shawn Baumgartner, ACP: Network Director, Rural Nebraska Regional Ambulance Network The audience will gain knowledge of the pilot project and review of data in utilizing both RNs and Community Paramedics in reducing re-hospitalization. The audience will better understand challenges in rural Nebraska related to initiating a pilot project with EMS and Acute Hospital discharges. The audience will be able to identify differences/ similarities and collaboration in the approach to patient care by Nursing and Community Paramedics.

10.G.2 From Long and Brier to Deep River – A Canadian Voyage in Community ParamedicineJohn (Jay) Walker & Michael Nolan: Regional Chief, Medavie EMS This presentation will be a review of our program, with an emphasis on the collaboration needed to develop the necessary relationships. EasCare worked closely with our ACO partner, Commonwealth Care Alliance (CCA), to identify specific needs within their existing home care system. Utilizing the principles of the Community Paramedic concept, our team constructed an entire program from the ground up.

10.G.3 College & University Education of Community ParamedicsAnne Montera, RN and Baxter Larmon, PhD: California Community Paramedic Network, University of California Los AngelesIs it time for a standardized “universal” community paramedic curriculum? What elements should be included in a worldwide curriculum? Could a regional college course be one of the best models for the worldwide curriculum? How would changes be implemented and how would compliance monitored? These are just a few of the questions that have come of age. This presentation will discuss the best practice models proven through evaluation and research. Further discussion will discuss the most recent research project that will answer some of these questions and showcase a statewide initiative.

Presentation Abstracts Friday

16

10.H.1 Making Sense of the Community Paramedicine Model – A Conceptual Guide for InnovatorsPeter O’Meara, PhD: Professor of Rural and Regional Paramedicine, LaTrobe University A predominately Australian research team synethized the findings of three related ethnographic case studies of rural paramedicine projects in Australia, Canada and the United States where community paramedicine programs are emerging in response to demographic changes and broader health system reform. The aims of the process were to use the research findings to identify the benefits and challenges of community paramedicine programs and to develop a conceptual model to help guide others introducing similar programs. The conceptual model that has emerged brings together the rural paramedicine role domains and key enabling factors that may be associated with successful community paramedicine programs. The resulting community paramedicine model follows the pneumonic of RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration into health system; Governance; Higher education; Treatment and transport options. This highlights the unique characteristics of community paramedicine that distinguish it from other related models of service delivery, such as mobile integrated healthcare and extended care paramedics. These include the model’s adaptability to different settings, its use of engagement strategies to integrate with local communities and health systems, and the crucial role of paramedic leadership in the development of effective governance structures and processes.

10.H.2 Rapid Fire Closing Session: Topics in 15 Minutes Decreasing Recidivism – Six Months to Develop, Implement and Evaluate a Model that Fulfills the IHI Triple AimKacy Allgood, Program Coordinator and Andrew C. Stevens, MD, Medical Director, Indianapolis EMS In September 2013, Indianapolis EMS (IEMS) was awarded a 3-year grant from the Health Resources and Services Administration (HRSA) to develop a community paramedicine model to improve patient outcomes for the local pediatric asthma patient population. The grant, Treat the Streets: Pre-Hospital Pediatric Asthma intervention Model to Improve Child Health Outcomes aims to:•reduce recidivism rates

•improve healthcare access•provide professional development for our staff

•conduct and disseminate research •pursue sustainable fundingThis healthcare model can be replicated to benefit other disease-specific patient populations.

Presentation Abstracts Friday Cont...

17

10.H.3 Paramedic Identification of Patients to Falls Prevention ProgramTom Dobson: Community Paramedicine Coordinator, Emergency Health Services Nova Scotia In the province of Nova Scotia, one in three seniors suffer a fall each year and 50% of those never regain their full mobility. Often these falls result in an EMS response either to treat the patient or simply provide lift assistance. In many instances patients wish to stay at home and avoid transport to Hospital. This patient population frequently goes unnoticed by Falls Prevention personnel and therefore do not get the support and services they need to avoid another fall. Paramedics have been trained to recognize this patient population and enroll them into a Falls Prevention program. On scene paramedics offer the services of the program to senior patients (age > 65) who have fallen but do not require transport to Hospital. Paramedics complete a referral check list with the assistance of the Medical Communications Centre and document key findings on their care report that will assist the Falls Prevention team in their follow-up with the patient. In the first 3 months of operation, paramedics have approached 29 patients and successfully enrolled 24 in the program. This presentation will discuss the enrollment rate of patients in the program and time frames in which they receive their first home visit from the Falls Prevention team. It will also examine the rate of falls requiring an EMS response for patients both prior and after their enrollment into the program. This data will be compared to those patients who refused enrollment in the program.

10.H.4 Conference Wrap Up & Forward Looking to 2015Gary Wingrove: Chair, IRCP

Presentation Abstracts Friday Cont...

PAGE 18 18

SponsorsMAJOR SPONSORS AND PROGRAM SUPPORT

CO-SPONSORS

EXHIBITORS

CONTRIBUTORS

Nevada State Office of Rural Health

19

20

THANK YOU!

Monthly IRCP calls begin again in January 2015. Please join our Google Group at ircprhd.googlegroups.com for meeting announcements and updates. For archives of materials please visit www.ircp.info for more information.

http://www.ncemsi.org

http://www.ircp.info http://www.internationalparamedic.org

www.communityparamedic.org