You probably thought no one makes house calls anymore. But a select group of paramedics in Arlington are making home visits to chronically-ill patients.
Texas Health Arlington Memorial Hospital and the Arlington Fire Department initially joined forces to help a large population of indigent patients in an area surrounding the hospital, "elderly patients who were really struggling with their health,” said Lori Dachroeden, director of the paramedicine program at Texas Health Arlington. “Especially those patients who had chronic diseases like diabetes and heart failure.”
Using paramedics interested in more training to help manage people in the community with chronic conditions, a core group of about eight came together to provide at-home visits to patients, assisting with whatever services are needed, 24/7.
Patients benefit from the Arlington Community Healthcare program, but so does the hospital. Texas Health Arlington Memorial has seen a 50 to 70 percent drop in emergency room visits or inpatient readmissions since the program began three years ago.
How the House Calls Program began: "We had a large population of indigent patients in one area of the community, kind of surrounding the hospital – elderly patients who were really struggling with their health. Especially with chronic diseases like diabetes and heart failure. So we got paramedics to go make home visits for them. And they were able to identify all kinds of things that we would never have known about if hadn’t had the person in the home to take care of that patient and try to help them."
More about the patients: "A lot of patients that are in this program are uninsured. They’re people who don’t have necessarily somebody they can go to. We’ll assist them with medications if we need to get their medications or medical equipment. We have patients who are diabetics that didn’t have a way to check their blood sugars because they couldn’t afford it. All of those things are huge in making a difference in having a patient be successful in managing their health and can keep them from developing complications down the road."
The participating paramedics: "We had a group of paramedics that were interested in getting some advanced training on really helping to manage people in the community and manage chronic health conditions, so we have about eight paramedics now who are dedicated to this program. They rotate through and they do emergency calls as well, but we’ve got one core group that really is available 24/7. And any time those patients have problems, they will call on that group of paramedics who will talk with them. They may go out to the house and just check on them. They’ll work with them to try and prevent them from having to go to the hospital."
Reducing readmissions: "It’s a huge problem for hospitals – and for our patients. Usually when patients come back into the hospital, they’re sicker and sicker each time they come in."
How many: "For some of those people with chronic disease, it’s around 18 to 20 percent of those people who are going to have readmissions on a regular basis. With this program, we’ve seen a significant decrease – on the average around a 68 percent reduction in visits to our hospital either as an in-patient, a readmission or an emergency department visit."
Who’s eligible for the program? “Our paramedics can’t go outside the city of Arlington, so they have to live in Arlington. But the only other thing they really need to have is a chronic medical condition that they’re struggling to manage. And we provide all of this to them at no cost.”