Accidental Falls, Cardiovascular Disease, Diabetes Mellitus, Food Insecurity, Social Isolation
Conditions
Keywords
Community Paramedicine, Paramedic, Emergency Medical Services, High Frequency Callers, Lift Assists
Brief summary
Community Paramedicine @Home (CP@Home) is a novel community paramedicine health assessment program for high users of Emergency Medical Services (EMS). Individuals who have been identified as active callers to EMS, individuals who have called EMS for lift-assists, and direct paramedic referrals are referred into the community paramedicine home visit program. The program will focus on in-home chronic disease management, community health service connections, and EMS usage education. Aside from chronic disease management, aspects of the program include health-related quality of life, social isolation and other social determinants of health. Participants in the program will have up to 3 one-on-one home visits from a community paramedic to ultimately reduce repeat EMS calls and improve their overall health.
Interventions
OTHERCP@Home
Community paramedics (CPs) will be assigned to visiting the participants for a first time the week following the initial EMS call. Participants will complete the informed consent process with a CP on their first visit. This visit will also include a full assessment and risk analysis that will take approximately 90 minutes and will be located in the participant's home. As a result of the initial visit, the CP will make all relevant clinical referrals and decisions based on predetermined @Home algorithms. A second visit will be made to the participant 2-4 weeks following the initial call for a streamlined follow-up and reassessment during a 30 minute period. A final visit will be made 6-8 weeks following the initial call for a final evaluation of their situation. It is anticipated the patient will be discharged from the CP@Home program at this point. If the patient calls EMS following the third visit, if they meet the inclusion criteria, they will be re-entered into the CP@Home program.
Sponsors
McMaster University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 3 or more EMS calls in the last 6 months from intervention start date AND active caller in the last 30 days OR * Any call for a lift assist to EMS in the past 30 days OR * Paramedic referral into program (identified by paramedic through usual practice)
Exclusion criteria
* Individuals living in long term care facilities * Individuals currently involved in a home visit or social navigator program
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in number of repeat EMS calls | Baseline and 1 year | Individual-level change in EMS call rate resulting in ambulance dispatch (pre-post intervention) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in number of ED presentations | Baseline and 1 year | Individual-level change in number of ED presentations (pre-post) |
| Change in number of hospital admissions | Baseline and 1 year | Individual-level change in number of hospital admissions (pre-post) |
Countries
Canada
Outcome results
None listed