Winnipeg Free Press - PRINT EDITION

Project takes pressure off ERs

-- Frequent users to get alternate service -- The goal: reduce low-priority visits

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Winnipeg will expand a community paramedic program to reduce the number of non-urgent patients in city emergency rooms.

On Tuesday, City of Winnipeg and Winnipeg Regional Health Authority officials announced they will launch a six-month pilot project to connect frequent emergency-room visitors with alternate health services.

The initiative will build on a program at the Main Street Project, where six community paramedics assess potential health problems 24/7 and have cut the number of patients sent to emergency rooms by half.

During the first nine months of the Main Street Project program, paramedics assessed 161 people who needed to go to an ER -- a significant drop from the 350 to 400 patients sent to an ER in the same period in previous years.

Winnipeg Fire Paramedic Service acting deputy chief Christian Schmidt said some of the paramedic staff from the Main Street Project will be reassigned to the greater community for the pilot project and focus on people who often call 911.

The city has identified 40 people who made a total of 1,200 calls to the emergency line in 2012. When these individuals call 911 again, Schmidt said a community paramedic will be assigned to the call, along with fire and ambulance.

Currently, many frequent 911 callers end up in the ER or sign a patient-refusal form after they are assessed by emergency responders. Schmidt said they are not connected with the other health services they may need, so they call 911.

Community paramedics will now be able to refer patients to other urgent-care or other community health programs, depending on their needs, he said.

"We're hopeful it's going to have a significant impact," WRHA CEO Arlene Wilgosh said.

Wilgosh said the project aims to provide better alternate care so patients don't need to seek treatment at an ER by default.

Winnipeg hospitals see a higher proportion of less-urgent patients than other jurisdictions, she said, as about 30 to 40 per cent of all ER visitors are triaged as a priority 4 or 5 on the triage scale, the least urgent of all cases. Wilgosh said less-urgent patients account for fewer than 10 per cent of total ER visitors in other jurisdictions.

She said the WRHA's goal is to get the number of less-urgent patients who visit ERs down to 20 per cent of the total.

The community-paramedic project is the latest attempt to make emergency rooms more efficient and, in turn, reduce wait times and ambulance drop-off delays.

In April 2011, the city started to charge hospitals for delays that left paramedics waiting to unload patients. Initially, the city billed $113 per hour for each time paramedics waited more than 90 minutes. The threshold then dropped to 60 minutes.

The city planned to eventually charge hospitals for delays longer than 30 minutes, but health officials said that goal is not realistic.

Winnipeg ambulances still wait more than an hour to unload patients at city emergency rooms.

Schmidt said there is no quick fix to the wait-time problem, but officials believe community paramedics are part of the solution.

City council's protection and community services chairman Coun. Scott Fielding said the pilot project will be financed under the budget for the Main Street Project program and will provide more efficient health-care services. The WRHA will spend $693,352 to fund the Winnipeg Fire Paramedic Service staff at the Main Street Project in 2013, according to city officials.


-- with file from Larry Kusch

Republished from the Winnipeg Free Press print edition April 3, 2013 B1

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