FLORENCE, Ky. — The Florence Fire Department will clock more than 11,000 fire and EMS runs by the end of the year. While most of those 911 calls are for urgent incidents, many are also avoidable.
Roughly 20% of patients riding in the back of an ambulance have chronic illnesses, including obstructive pulmonary disease (COPD), diabetes, heart failure and kidney disease — all conditions that require routine maintenance by patients and can become acute illnesses if not addressed properly.
Those patients are often familiar faces in the emergency room.
"Any ER across the Tri-State area anymore is seeing such a vast increase in patients right now," Florence EMS Battalion Chief Danielle Stiner said. "There is a great wait time. So you'll go there and sometimes have to wait several hours to be seen by a physician."
The repeat visits are bogging down emergency services, Stiner said. That's why her department is now one of the two in Northern Kentucky that will pilot a 12-month program to reduce avoidable trips to the emergency department and inpatient hospital stays for adults with conditions that can be managed at home with the proper care.
The paramedicine program, which has been piloted in other parts of Kentucky, will allow the Florence Fire Department to hire two part-time paramedicine associates. The new employees will partner with nurses from St. Elizabeth Hospital to identify patients with eligible chronic conditions.
"We're going to focus on those and see what we can do to collaborate, to navigate how to keep them from being readmitted to the hospital several times, and at the same, time reduce our call volume and going back to these patients repeatedly for the same kind of illnesses that they see," Stiner said.
It's no surprise that a recent study found that Florence and Covington have the highest fire and EMS call volumes in Northern Kentucky — the twp cities have the highest populations. That's why Covington is also joining in the program.
“This is really filling the gap between Emergency Services and the emergency room,” Covington Assistant Chief of EMS Gary Rucker said. “Often, when patients are discharged, they aren’t clear on what to do once they’re home, and they will call 911 and go back to the hospital. What we’re trying to do is reduce emergency room and hospital admissions by helping them access resources and educate them on their disease process.”
Around 300 patients are expected to be served in the program's first year. During each community paramedicine visit, the responding team will assess the patient’s mental health, food, safety and transportation needs, and link patients to community resources when necessary.
Community paramedicine associates and team members will work with primary care to reintegrate the patient back into a routine.
"There absolutely is a need," Florence Fire/EMS Chief Chris Miller said. "As medical care has really shifted, and people rely more on emergency rooms and ambulances for medical care, it places a burden on both systems. Trying to get out ahead of it and get people care at home where they need it instead of taking up an ambulance for something that wouldn't require an emergency transport or tying up an ER bed for something that can be fixed outside the ER."
The program is funded by a grant of almost $175,000 from the Copic Medical Foundation, a nonprofit that aims to reduce fragmentation in the health care system. Rucker said the foundation will reimburse both cities for the part-time paramedics.
To evaluate the program’s success, the paramedicine teams will measure data such as avoidable trips to the emergency department, improved rates of follow-up visits with primary care providers and the number of referrals to community partners.
"Based on what we've seen from other parts of the country and the programs just south of us in Lexington, they seem to have an effect, I mean Lexington's program has grown exponentially over the years," said Miller. "Maybe three months, maybe six months before we start getting enough data to determine the effectiveness."
