Transitioning The Mind From Paramedic to Community Healthcare Provider
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Transcript of Transitioning The Mind From Paramedic to Community Healthcare Provider
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SUMMIT 2014 Advancing Care through Data
Transitioning The Mind!
Paramedic To Mobile Integrated Health Paramedic
© MedStar Mobile Healthcare 2014
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John Farris
• Second Generation Paramedic • Born and raised in a town of 300 people. • 12 Years certified in EMS • 7 years at MedStar Mobile Healthcare
– Paramedic 7.5 Years – FTO 5 Years – MHP 1.5 Years
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Why Do I Do What I Do?
• Compassion • Advocacy • Family
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The Regular Paramedic
• MedStar 44 Respond Priority 1 for 50 YOF SOB • CAD Notes: “I’ve gained weight now I can’t
breathe” • Unit finds SOB 50 YOF 10+ Lbs in 3 Days
History of CHF. • “But I don’t put sodium on anything” “They
told me to stay away from Sodium!”
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The Regular Paramedic
• “Ma’am Did you know salt is basically sodium?”
• Patient “No well that all makes sense now!” • “They didn’t tell me that they only gave me 5
minutes and told me to stay away from Sodium so I didn’t go to the Chemistry Lab!”
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The Regular Paramedic
• “MedStar 44 inbound your facility with a 50 YOF CC of exertional SOB and a 10 lb. weight gain”
• Patient is stable at this time V/S 150/98 96 92%rm 98% 02 Cannula
• Report to ED nurse: “This is me the cool paramedic and this patient needs some CHF education. She thought Sodium was only the element and didn’t realize it was salt.”
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The Regular Paramedic
• Recognized the problem • Treated appropriately • Gave appropriate report • Ensured proper continuity of care to prevent
next 911 call
• Or did they……………………………….?
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The Mobile Health Paramedic
• “MHP 711. Your client at address ….. Is calling requesting a visit for SOB. She states she is having SOB and a weight gain but refusing an ambulance.”
• “MHP 711 responding did client sound in distress on the phone?
• “Negative just complaining of SOB when she walks and something about her weight?”
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The Mobile Health Paramedic • “Good afternoon Mrs. Jones I hear your not doing so
great” “Lets sit down and talk.” • 50 YOF exertional SOB with same V/S as before • All treatment in home applied in living area • “Good evening Doctor this is John and I’ve got Mrs.
Jones here with a 10lb weight gain and exertional dyspnea. Here is her Chem. 8+, EKG and V/S. I would like to perform in home diuresis and then take an extensive amount of time with education here in the home. What do you think?”
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The Mobile Health Paramedic
• “Sounds good John. Make sure to reevaluate her labs and should her potassium get too low make sure she takes an additional supplement or ensure that she is eating appropriately. We will schedule an appointment tomorrow with her.”
• “Thanks doc. I will do treatment according to protocol and I believe that this was all due to an education deficit. I will update you should any changes occur”
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What is the difference?
• Same Patient • Same Symptoms • Same Residence • Patient-Centered Outcome
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What does it take to be a MHP?
• Time/Information Gathering • Compassion/Understanding • Persistence/Motivation • Communication • Confidence/Humility • Ethics
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Time/Information Gathering
• Ultimate deciding factor for patient outcome is patient understanding
• Patient’s trust is built • Patient learns at their own pace • Builds not only knowledge but understanding
and how to apply that knowledge • Investigate what is causing readmission
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Compassion/Understanding
• Put yourself in their shoes • Help them help themselves • Let them know you care. • Let them know what they CAN do!
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Persistence/Motivation
• Same message • Get patient involved in their own care • Develop a relationship with the patient and
their physician • Become their “Medical Life Coach”
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Communication
• You are now the Medical Translator – Doctor – Patient – Social/Case Manager – Nurse – Family – Resources etc……
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Confidence/Humility
• Understand that you may not know what you don’t know and that’s ok.
• Critical thinking on your own • You are the resource to the resources • Ultimately it may be the right decision to send
the patient to the hospital • Experience is paramount
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Ethics
• Treat the patient just like you would treat YOUR family.
• Pick up the newspaper on the way in. • Yes ma’am/sir
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Presidential Nomination
John Farris for President 2016!
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Summary
• There is no change in the ideal traits of a Paramedic and a MHP
• There is a change in approach and treatment • Ideally your MHP is a good regular Paramedic
wanting to do the right thing for the patient at the right time.
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Questions?