Every year, thousands of older patients arrive in hospital by ambulance for serious, but non-urgent, matters. In response, an initiative was created by the CISSS de la Montérégie-Centre, the Centre de communication santé and 2 ambulance companies—Ambulance Demers and CETAM—that serve nearby hospitals to ensure patients receive the care they need at the right moment and from the right professional. The result: Much fewer trips to the ER.
When a 911 call comes in from an older person for a non-urgent problem, the call is redirected to the home support paramedicine service. It takes about 30 minutes for a paramedic to arrive at the patient’s home in a marked car. The paramedic makes sure the patient isn’t in distress and determines if an ambulance is needed. They examine the patient and contact a nurse.
Based on a clinical assessment, the nurse recommends an alternative solution to the patient, like an appointment at a clinic or consultation with a pharmacist, and schedules a visit with a home care nurse the next day. If there are any concerns about the patient’s health, the home care team can consult a doctor.
Since January 2020, 5,600 patients have benefited from this unique service, the only of its kind in Quebec. And in 63% of calls, patients didn’t need to go to the emergency room. Patients’ satisfaction rate reached 96%. More than half received the care they needed at home, without having to see a doctor.
Project submitted by:
Nancy Beaulieu, Director, Home Support Services
Contributors:
Dr Dave Ross, Regional Medical Director, Prehospital Emergency Service
Hélène Hallis-Springuel, Homecare Nurse
Sylvain Bernier, Director of Operations and Human Resources, Ambulances Demers
Anne-Julie Gagnon, Home Support Nurse
Mathieu Demers, Assistant Director of Operations, Ambulances Demers
Dr. Sophie Gosselin, Chief of Emergency Medicine, Hôpital Charles-Le Moyne
Jérémy Ménard, Assistant General Manager, CETAM
Vincent Cregheur, Regional Coordinator, Prehospital Emergency Services
Sabrina Couture, Home Support Service Manager, Haut-Richelieu-Rouville local service network
Marc-André Gravel, paramedic operations manager, Ambulances Demers
