New programs aim to reduce hospital wait times, readmissions

In California, two new pilot programs are being launched by the UCLA Center for Prehospital Care, in collaboration with Los Angeles County Emergency Medical Services, to hopefully reduce rates of hospital readmissions, better manage ER overcrowding, cut health care costs and improve patient satisfaction, according to a press release.

The first program, the Community Paramedic Pilot Programs, which will launch September 1, 2015, in Santa Monica, and then shortly in Glendale, are designed to expand the roles of paramedics and other emergency medical services agencies.

“Our primary goal is to reduce overburdened emergency departments receiving patients with minor illnesses or injuries. Research has shown that wait times in busy emergency rooms can be up to six hours. In our program, we hope patients will be seen considerably quicker than that, which will be better for emergency rooms and patients,” Baxter Larmon, PhD, professor of medicine at the David Geffen School of Medicine at the University of California, said in the release.

 The programs comes as a result of a decade-old Institute of Medicine report which encouraged communities to find different ways to deliver emergency medical care, according to the release.

The programs will be run out of the Office of Statewide Health Planning and Development, which will allow paramedics to have more interaction with patients. 

The Alternate Transport Program will also launch on September 1, 2015. Pending patient approval and medical complaints, this program would allow ambulances to transport patients to approved urgent care centers, which typically have significantly shorter wait times, compared with ERs, according to the release. This program would also allow ambulances to return to service much more quickly.

Through UCLA, paramedics partaking in the program would receive training to guide in determining which patients would be treated at each location. 

The second program, also set to launch on September 1, aims to reduce hospital readmissions among recently discharged patients with congestive heart failure (CHF). Patients in the program would receive a home-visit from a paramedic, within 48 to 72 hours after hospital release, to evaluate the patient’s symptoms, ensure medication adherence, assess eating habits and determine if the patient’s home environment will allow them to remain healthy.

According to Steven Rottman, MD, adjunct professor of emergency medicine at UCLA, the first 72 hours after patients with CHF get discharged is the most critical time frame. He noted that more than 60% of readmissions occur within the first 3 days of discharge.

In addition to patient care, many hospitals may not be receiving Medicare reimbursement for CHF patients who are readmitted within 30 days of discharge, and could potentially be fined for patient readmission.

“Going back to the hospital is a disruptive experience for the patient and may not improve their quality of life. Anything we can do to cut costs, save hospital beds and give patients a good quality of life would be a vast improvement,” Rottman said in the release.

A 1-year follow-up will be conducted on both programs to determine if they were successful at reducing hospital readmissions and ER overcrowding.