911 Keeps Hospice Patients Out of the ER

Fort Worth area paramedics have partnered with VITAS Healthcare, the country’s largest hospice organization, to treat hospice patients to help avoid trips to the ER. These specially trained community paramedics spend time with the patient and family, most often reducing a costly hospital trip and unnecessary treatment.

An average of 18% of hospice patients go to the emergency room at least once before their death. The paramedic-hospice partnerships are promoting better patient care. The ACA creates financial penalties for hospitals with too many patient readmissions. Hospice also benefits financially since they are paid $200 a day, no matter where their patients are treated. The VITAS program targets patients who are moderately to highly likely to call 911 or end up in the hospital. Hospice patients who do call 911 are identified through various routes and a community paramedic is dispatched along with traditional ambulance.

Patients on hospice can develop scary symptoms during their final weeks or days. They might suffer a breathing crisis or a seizure. A hospice nurse is accessible around the clock, but may have to drive a longer distance to reach the patient than emergency response services can. The paramedics involved require both psychology and social work skills along with their medical training.

A similar pilot program studied the use of community paramedics in Ventura, California as well as in Long Island, New York. Ventura paramedics found that they did a lot of talking to upset people as well as reminding them about what hospice is about.

Patients can still insist on going to the emergency room. During the first five years of Fort Worth’s program, just 20% were transported. In Ventura, transports declined from 80% to 37% of hospice calls. A community paramedic may stay on the scene until the hospice nurse arrives to keep a sense of calm to a stressful situation.
Huff, Charlotte. “For Some Hospice Patients, A 911 Call Saves A Trip To The ER.” News. Kaiser Health News, 28 Feb 2017. Web. 28 Feb 2017.

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