Could paramedics provide a solution for rural patients at high risk to prevent emergency room return visits?
7 to 34%7 to 34% of Medicare patients transported by ambulance to an ER could have been treated in an outpatient setting.
Many rural emergency medical technicians spend half their time waiting for disaster to strike - time that DNP student and nurse practitioner Matt Payne (DNP `19) thinks could be used for reimbursable activities, like keeping just-released patients from returning to the ER unnessarily and better meeting their healthcare needs at home.
For his DNP capstone, Payne - a veteran firefighter and paramedic - tested the acceptability and efficacy of a novel paramedic-home visiting program for rural patients in Page and Rappahannock counties.
Payne followed up with five patients aged 65 to 85 within 24 hours after their release from the ER, spending an average of 20 minutes in their home to answer questions about medications, their diagnosis, and any physical symptoms from which they suffered. He used the "Optimizing Safe Transitions" (8 Ps) screening tool and offered his patients a post-screening survey to gauge their expereince and satisfaction.
The result? Patients better understood their discharge instructions, appreciated the convenience of the home visit, and were significantly less likely to return to the ER within 72 hours.
Now Payne - a Clinical Nurse Leader graduate and a nurse practitioner with Page Memorial Hospital in Luray, Va., and a former nurse in the ER - hopes to expand the program further and "bridge the silos in healthcare to keep people well."