Evaluation of an Emergency Medical Services–Based Social Services Referral Program for Elderly Patients

Kue, Ricky; Ramstrom, Edward; Weisberg, Stacy; Restuccia, Marc C.

doi:10.1080/10903120802706179

Cited by 31 publications

(48 citation statements)

References 17 publications

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“…We identified numerous direct and indirect references to limited knowledge and understanding regarding a number of elements believed to be vital for referral programs, and participants linked these deficiencies to inadequate education. Indeed, others have identified limited education in this area at the entry to practice and ongoing professional development levels, 11 and the need for further or better training to improve accuracy or appropriateness in referral programs 3 and screening. 5 Another salient theme emerging from the data was the strong desire by paramedics to receive meaningful feedback and improve communication regarding referrals made.…”

Section: Discussionmentioning

confidence: 99%

“…2 One such strategy to address this issue could involve engaging paramedics in community health care initiatives. 3 In many instances, individuals who initiate 911 calls often do not require urgent interventions or care in the ED, but rather some level of long-term care directed at addressing their unmet social or medical needs. 3 Paramedics have demonstrated capacity in identifying individuals at risk of deterioration in the home.…”

Section: Introductionmentioning

confidence: 99%

“…3 In many instances, individuals who initiate 911 calls often do not require urgent interventions or care in the ED, but rather some level of long-term care directed at addressing their unmet social or medical needs. 3 Paramedics have demonstrated capacity in identifying individuals at risk of deterioration in the home. 4,5 As such, the paramedic community has developed, implemented, and continues to expand programs involving paramedics initiating referrals to community services (referred to as "community referrals by EMS (Emergency Medical Services)" or "CREMS").…”

Section: Introductionmentioning

confidence: 99%

“…Referral programs aim to promote the health and quality-of-life of seniors, improve their access to resources, and reduce 911-system activations and hospital visits. 3 The purpose of this study was to explore all levels of paramedic interaction with referral programs. By asking paramedics to share their experiences with such programs, we aimed to increase our understanding of the ways in which paramedics experience and participate in community-based referral programs.…”

Section: Introductionmentioning

confidence: 99%

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A Culture in Transition: Paramedic Experiences with Community Referral Programs

Brydges

Spearen²,

Birze

et al. 2015

CJEM

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Objectives: As an aging population continues to place strain on the health care system, many older adults are living with unmet social and medical needs. In response, Emergency Medical Services (EMS) have initiated programs that encourage paramedics to refer patients in need to community based support services. This qualitative study explores frontline paramedic experiences with referral programs to identify opportunities and challenges in their practice. Methods: This study used an intepretivist qualitative study design involving interviews of frontline paramedics employed in a region where referral programs were in place. Interviews were semi-structured and one-on-one. Data were transcribed verbatim and analyzed using inductive open coding throughout, then grouped to identify themes. Data collection and analysis were conducted simultaneously and flexibly until saturation. Results: Twenty-three interviews were conducted representing 6 regions. When participating with referral programs the data revealed that frontline paramedics appear to experience (a) role confusion, (b) an inadequate knowledge base, (c) inadequate feedback, (d) undefined accountability, and (e) strong patient advocacy. Conclusions: In a strained health care system, EMS and paramedics have an opportunity to better serve patients by initiating referrals for patients they encounter with unmet social and medical needs. However, referral programs face a number of challenges that, if left poorly addressed, may threaten the success of such programs. Résultats : il y a eu 23 entrevues, concernant 6 régions. D'après les données recueillies sur les ambulanciers paramédicaux de première ligne, qui participaient aux programmes d'aiguillage des patients, il semblait y avoir : a) une confusion de rôle; b) une base insuffisante de connaissances; c) un manque de rétroaction; d) une obligation de répondre de ses actes non définie; (e) une forte empathie pour les patients. Conclusions : Dans un système de soins de santé soumis à de fortes pressions, les SMU et les ambulanciers paramédicaux ont la possibilité de mieux rendre service aux patients qu'ils rencontrent en dirigeant ceux qui ont des besoins médicaux et sociaux non satisfaits vers les ressources appropriées. Toutefois, ces programmes connaissent un certain nombre de problèmes qui, s'ils sont négligés, risquent de nuire à leur réussite.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Culture in Transition: Paramedic Experiences with Community Referral Programs

Brydges

Spearen²,

Birze

et al. 2015

CJEM

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“…The CP-FI-CGA also asks respondents to provide a baseline level of health two weeks prior to the health crisis, providing an estimate of change. 9 EMS has been recognized for its potential role in public health, with research focusing on EMS screening for immunization need, 30 falls, 31 and referral to social services 32 . Frailty screening could inform decisions regarding transport to emergency care, referral to specialized geriatric services, and other community-based support services such as home care.…”

Section: Frailty: Screening and Assessmentmentioning

confidence: 99%

The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

Goldstein

McVey

Ackroyd‐Stolarz

2015

CJEM

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Caring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step. RÉSUMÉLa prestation des soins aux personnes âgées occupe une place importante dans les services médicaux d'urgence (SMU). Les systèmes de SMU étaient conçus au départ pour traiter des affections aiguës isolées, ce qui est très différent des pratiques exemplaires en matière de soins aux personnes âgées fragiles. Le repérage précoce des personnes âgées fragiles, fortement prédisposées à des événements défavorables pourrait améliorer la prestation des soins. Les ambulanciers paramédicaux sont bien placés pour jouer un rôle important dans une évaluation approfondie du degré de fragilité (ou de vulnérabilité), et les résultats obtenus peuvent éclairer les décisions prises par les fournisseurs de services préhospitaliers et, par la suite, dans les services d'urgence (SU). Des programmes innovateurs de SMU, de soins dans les SU et de soins de base pourraient réduire la charge de travail dans les SU tout en améliorant l'accès aux soins et, en dernier ressort, les résultats cliniques. Certaines personnes âgées fragiles pourraient profiter des ressources disponibles dans les SU et du bagage cumulé de connaissances spécialisées, tandis que d'autres profiteraient davantage d'autres solutions, habituellement d'une meilleure coordination des soins de base. Toutefois, cela vaudrait la peine de faire davantage de recherche afin de distinguer les deux groupes. Dans un cas comme dans l'autre, il faudrait donner des soins au bon moment, en plus de déterminer la nécessité de fournir des soins d'urgence ou des soins de courte durée; d'évaluer le...

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Interventions for preventing abuse in the elderly

Baker

Francis

Hairi

et al. 2016

Cochrane Database of Systematic Reviews

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Background Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. Objectives The objective of this review was to assess the e ectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention e ects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people.

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Evaluation of an Emergency Medical Services–Based Social Services Referral Program for Elderly Patients

Cited by 31 publications

References 17 publications

A Culture in Transition: Paramedic Experiences with Community Referral Programs

A Culture in Transition: Paramedic Experiences with Community Referral Programs

The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

Interventions for preventing abuse in the elderly

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