Paramedics Assessing Elders at Risk for Independence Loss

blindsideflank

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Alberta has a program called CHAPS. (Community Health and Pre-hospital
Support)

"As first responders often granted access to private homes, EMS is uniquely positioned to identify older individuals living in the community who need a home care referral or other health and community supports to help them remain well and independent. Specifically, the initiative expands the scope of paramedics to include identifying seniors who may be at risk for adverse outcomes using the PERIL tool (Paramedics Assessing Elders at Risk for Independence Loss)."

Seniors are referred to Community Care Access – Home Care for assessment.



http://www.health.alberta.ca/initiatives/5-year-plan-progress.html

1.8b – Expand the role of emergency medical technicians and paramedics to identify older, at risk, individuals who may need screening for falls, home care, and other services (pilot in Calgary, Edmonton, and Parkland County).

Complete – The Community Health and Pre-Hospital Support program (CHAPS) has been rolled out across the province. Through CHAPS, individuals who may need home care or other services to lower their risk of falls and/or deteriorating health are identified by EMS practitioners using an assessment tool. Once at-risk individuals are identified, they are referred to home care. Pilot projects in Calgary, Edmonton and Parkland County showed the program reduced the number of repeat EMS calls and emergency department visits. In Calgary, for example, for all patients referred to CHAPS between October 2010 and October 2011, they had a total of 609 EMS events in the 90 days including, and prior to, the date of their CHAPS enrolment. In the 90 days following CHAPS enrolment, these same patients had a total of 369 EMS visits, for a decrease of 240 EMS events or a 60.5% reduction in EMS usage by these patients. The CHAPS program is part of the larger ‘Emergency to Home’ project.




I am interested in programs like this and the assessment criteria used. Does anyone else do something like this and what is the screening criteria? I have heard of the PERIL criteria ( http://imgpublic.mci-group.com/ie/ICEM2012/Wednesday/track8/Jacques_Lee.pdf page 18)
 
the above study shows that homecare will reduce the use on the ambulance system/emerg

and this further supports our ability to screen these patients. I wish i could find the criteria they used to screen though. This is the future of how we justify our wages (expand our scope to reduce healthcare costs)

http://www.ncbi.nlm.nih.gov/pubmed/1590608
MAIN RESULTS:
Paramedics identified 197 people with possible problems, 124 of whom received an assessment. The remainder could not be assessed due to death, moving, referral, or transfer to a long-term care facility. Assessors confirmed the presence of a problem in 121 of 124 assessed cases, a positive predictive value of 98%. The program was useful for 94 people, 48% of those identified and assessed.
CONCLUSION:
Paramedics can serve as case finders for at-risk elderly, and effective linkage to service agencies can occur.
 
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