Wisconsin Paramedic Unit to Reach Out to Repeat Emergency Callers

April 29—About 30 paramedics from the Milwaukee Fire Department are receiving training for a new program officials hope will help reduce the number of repeat emergency calls from chronically ill people.

The goal of the Mobile Integrated Healthcare Program is to prevent chronic health issues from escalating to expensive trips to emergency rooms. Community paramedics, as they're called, make home visits to those identified as frequent callers for emergency medical services and work with them to better manage their chronic health conditions, such as asthma, congestive heart failure or diabetes.

Of the total 62,763 calls for emergency medical services last year, 7% (4,288 responses) were for the same 100 people, according to an analysis by the Milwaukee Fire Department.

The fire department will use dispatch records to identify residents for the new community paramedics program, according to Capt. Michael Wright, mobile integrated health care coordinator for the Milwaukee Fire Department. The paramedics will make a phone call to those targeted residents and ask if they want to participate; it's voluntary and is provided at no cost.

If a person agrees, the community paramedics will set up a home visit, assess their health and help connect them with medical services.

"We can teach them about their condition and how to manage it and how much better it is to go to a doctor at 11 a.m. rather than calling 911 at 11 p.m.," Wright said.

The home visits also can help paramedics identify and address other social obstacles to medical care, such as transportation to a doctor's office.

"It's reminiscent of a long time ago when we had home nursing," said Steven Riegg, battalion chief of the Milwaukee Fire Department EMS Division.

"Community paramedics are establishing that relationship and getting them (the patients) back on track health-wise," he said.

Paramedics are taking program coursework and doing clinicals through the University of Wisconsin-Milwaukee College of Nursing. They will complete online coursework on their own time and spend six paid days doing clinicals at Froedtert Hospital, working with nurses in chronic disease clinics and hospice.

They're scheduled to finish training in September and launch the project in October.

"Nowadays, the only way you can get a nurse in your home is hospice or if you are homebound," said Kim Litwack, associate dean for academic affairs at UWM. "Paramedics already are in patients' homes."

A national core curriculum for community paramedics will be used for the training, Litwack said. But because communities can tailor the curriculum for specific needs, Milwaukee's curriculum also will include addressing the city's unacceptably high rate of infant mortality, Litwack said.

Paramedics would talk with new parents about safe sleep practices, for example.

"Our paramedics are outstanding in emergency care or recognizing what I call the 'red light' patient," Litwack said. "We want to keep people from becoming lights-and-sirens patients."

The paramedics also will check smoke alarms, carbon monoxide detectors, promote firearms safety and look for other hazards, such as "slip and fall" areas in the home, Riegg said.

"They will do a whole health check to not only make sure the person is OK, but everybody in the house is living a safer life," Riegg said.

Paramedics would be scheduled to do community paramedic work on some days and would be scheduled to respond to 911 medical calls on other days. Paramedics on community paramedic duty still would be available in the event of a citywide emergency.

The Fire Department is using existing funds for training and has applied for a federal grant to cover costs of education, vehicles and equipment, but the award announcements have not yet been made. Regardless of the grant, the department will implement the three-month pilot program.

"This is a national movement," Litwack said. "There is a nursing shortage throughout the country... One of UWM's missions is community engagement, and this is the ultimate community engagement. There are very few organizations that cover the entire city like the fire department."

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