Tualatin Valley Fire & Rescue: Making house calls

Mobile integrated health care enhances patient care and cuts down hospital readmission rates22 TVFR MIH Article

By TVFR Staff

Mobile integrated health care continues to be a priority and focus for Tualatin Valley Fire & Rescue’s Emergency Medical Services Division.

The district has a contract with Legacy Meridian Park Medical Center for mobile health care visits, as a result of a successful pilot project with the hospital. As part of the contract, firefighter paramedics visit patients after they are discharged from the hospital, with a goal of decreasing hospital readmissions.

According to recent data, the average hospital stay for patients transported after a 911 emergency call is 3.5 days. At discharge, high-risk patients are identified by the hospital staff and asked to voluntarily participate in the mobile integrated health care program.

A recent review of patient data conducted by TVF&R’s EMS Division showed that patients who opted not to participate in the project have a 23.5 percent readmission rate, while patients who choose to participate in the project have a readmission rate of only 6.3 percent.

With the average cost in the United States for a hospital readmission ranging anywhere from $10,000 to $40,000, and hospitals subject to losing Medicare reimbursement for patients readmitted within 30 days of discharge, this project benefits all involved, says EMS Division Chief Mark Stevens. Ultimately, patients receive better care, they stay out of the hospital, and the 911 emergency dispatch system receives fewer calls.

During home visits, paramedics perform a patient assessment that includes vital signs, blood glucose monitoring, 12-lead EKG (as requested), and ensure medication compliance. They also review daily weight, blood sugar, and activity logs the patient keeps for primary care physicians. Fluid and sodium intake education as well as nutrition recommendations and restrictions and physical activity recommendations are reinforced and monitored every visit.

The initial visit also includes an environmental assessment designed to decrease fall risks and create on overall safe living environment. Paramedics record the findings of their visits, and this information is shared with the hospital and patients’ health care providers.

“Our Meridian Park team values its partnership with both Tualatin Valley Fire & Rescue and Metro West Ambulance around the provision of mobile health care,” says Allyson Anderson, chief administrative officer of Meridian Park Medical Center at Legacy Health. “Keeping the patients’ needs in the center of our discussions, we have been able to put together a novel approach to outpatient care, which meets the patients’ needs to remain as independent and healthy as possible.”

TVF&R continues to work on forming new relationships throughout the medical community. These partnerships will advance an effort to decrease 911 usage, emergency room and hospital admissions, and readmissions. TVF&R’s Medical Services Officer Charmaine Kaptur says, “This program has been created to meet the philosophy, shared vision, mission, and organizational values of the TVF&R Strategic Plan and is in line with the Institute for Healthcare Improvement’s Triple Aim Philosophy ─ better care, better health, and lower costs.”

For more information, call 503-846-8685 or visit wcemergencycommunications.blogspot.com.