The UCLA Center for Prehospital Care is launching two pilot programs Tuesday in Los Angeles that aim to reduce overcrowding in emergency rooms and hospitals.
The programs will be launched at UCLA Medical Center, Santa Monica and four Glendale clinics, said Cathy Chidester, director of the Los Angeles County Emergency Medical Services. UCLA Emergency Medical Services, which covers Westwood, is not affected.
One of the Community Paramedic Pilot Programs will allow patients with minor injuries to authorize their ambulatory transportation to urgent care centers instead of emergency rooms. The second program will train paramedics to conduct follow-up home visits on heart failure patients after they leave hospitals to reduce the readmission of these patients to medical care.
Los Angeles Emergency Medical Services began to collaborate with UCLA on the project more than two years ago, after the Institute of Medicine‘s study in 2005 and the federal government urged communities to seek new ways of utilizing emergency services to deliver medicine.
Baxter Larmon, a principal investigator of the UCLA pilot projects and adjunct professor of emergency medicine, said the American College of Emergency Physicians rated California emergency rooms an ‘F’ for their poor accessibility.
Larmon said people with serious medical conditions, such as heart attacks and trauma, may not get the care they need quickly enough because emergency rooms are overcrowded. Fewer hospital beds force paramedics to keep their ambulatory patients on the gurney for longer periods of time, preventing them from taking emergency calls.
He also said the program could increase patient satisfaction and decrease health insurance costs in the long run, although patients utilizing these services still must cover the cost of transportation.
The second pilot program seeks to reduce hospital readmission for Glendale patients with congestive heart failure who relapse after their hospital stays. Congestive heart failure occurs when the heart loses its ability to pump enough blood to meet the body’s demands.
Most hospital readmissions of congestive heart failure patients occur within the first week of discharge, said Steven Rottman, the program’s principal investigator and an adjunct professor of emergency medicine. In the program, paramedics will conduct one visit to the participating patient’s home 48 to 72 hours after his or her discharge to ensure the patient maintains the recommended diet and medication regimen.
Training of the program’s community paramedics – paramedics who serve rural communities where hospital access is hard to reach – consists of a core curriculum with an additional 60 to 80 hours of training for congestive heart failure care. The number of future community paramedics will depend on the voluntary participation of local fire and emergency departments, Chidester said.
If the programs successfully reduce overcrowding after one year, collaborators said they hope to officially rewrite California paramedic legislation to mandate these programs.