RACINE — The Racine Fire Department and Ascension All Saints Hospital are collaborating to create a program to have paramedics check in on patients who have been recently discharged from the hospital.
Fire Chief Steve Hansen spoke to the City Council’s Committee of the Whole about the Mobile Integrated Health program during the committee’s Oct. 22 budget hearings. Hansen said the department will launch its trial period for the program in mid-November.
The goal is to make sure patients are well on the road to recovery and don’t have to make any return trips to the hospital within a month of being discharged.
“The City of Racine Fire Department and Ascension All Saints have a shared vision to improve the health of the community,” said Ascension All Saints President Kristin McManmon. “We have partnered in an innovative way to achieve this goal by providing primary care at home for at-risk people in the community. This approach is resulting in reducing unnecessary use of the Emergency Department as well as readmissions in to the hospital.“
For 2019, the Fire Department is adding a new position of division chief for professional standards, which will have two primary duties: review emergency notices and reports and manage the MIH program.
The 2019 budget shows it intends to promote a current firefighter and not add another employee to the department rolls.
Dotting I’s and crossing T’s
Hansen told the committee that in 2017, more than 543 emergency medical services reports out of the 700 turned in to the department’s billing company were returned due to errors and omissions.
The professional standards chief’s job will be to check reports before they’re submitted for billing. Hansen said the hope is that more reports will be accepted the first time they’re submitted.
“Which will increase revenue for Fire Department, and hence the city,” Hansen said.
Road to recovery
The Professional Standards Division chief also will schedule and manage the paramedics involved with the MIH program. So far, nine paramedics have been trained at the University of Wisconsin-Milwaukee on how to carry out home visits with discharged patients.
For the trial period, the focus will be on patients who have been treated for more serious conditions, such as congestive heart failure, obstructive pulmonary disorders and cardiovascular strokes.
They’re looking at having the first visitation within 96 hours after the patient was discharged, but the goal eventually would be to have it within the first 24 hours.
During the visit, the paramedic would go over the patient’s discharge instructions and medications, take vital signs and assess their physical, social and mental well-being. Any alarming findings would be reported to the patient’s medical provider while the paramedic is still on site.
“The care team at Ascension All Saints collaborates with the Racine Fire Department on the development of care protocols and serves as the primary referral source for community members in the program,” said McManmon. “The uniqueness of this program is that the coordination of care spans our two organizations.”
Paramedics also will conduct home safety inspections and make recommendations to prevent the patient from further injury or illness.
“Some folks, especially our elderly patients, are living in conditions where they are tripping or falling on the floor rugs or having problems getting up in the bathroom because they don’t have a grab rail,” said Hansen.
They’ll also discuss long-term health plans, such as diet, exercise, smoking cessation if the patient smokes, and any other recommended rehabilitation.
The paramedics would then report their findings to the patient’s medical provider. They would also schedule follow-up visits as needed.
McManmon said in addition to the hospital’s financial and human resources, the Ascension All Saints Foundation has committed $75,000 to support the program.
Hansen said there are still some details that need to be worked out with the firefighters’ union over compensation before they’ll know what the cost will be for the program, and what Ascension’s total financial contribution will be.
The overall goal of reducing emergency-room visits could also potentially reduce the Fire Department’s emergency medical call log, both of which Hansen said could cut costs for the department and the hospital.
McManmon said in the pilot program, which Ascension began working on with South Shore Fire Department and RFD in September, the 25 people enrolled after experiencing heart failure had only one readmission, and three who required emergency services unrelated to their heart condition.
“These initial results are very encouraging and demonstrate the value of combining our capabilities across our organizations to improve the health of our community,” said McManmon.
“This collaboration is a great example of where local trusted, relationships result in local solutions,” said McManmon. “We look forward to continuing and expanding this great relationship to positively impact the lives for more people in our community, including our sickest population with multiple health challenges.”
"The City of Racine Fire Department and Ascension All Saints have a shared vision to improve the health of the community."
Kristin McManmon, Ascension All Saints president
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