Building a Community: Part 2

To recap the first article in this series, Ada County Paramedics decided to fund a community paramedic program for at least the first year. This was important for two reasons: first, it showed the community that our agency believed enough in community paramedicine to budget for it, and second, it allowed us to dive in and get going, rather than just sit around planning.

I should mention we (in partnership with Idaho State University) went all out and applied for the CMS Health Care Innovations grant, fully expecting to get funded—we weren’t even close. What’s important here, though, is our agency jumped in full-throttle. I wish I could say we did a community needs assessment prior to jumping in, but we didn’t. Since then, however, the community paramedics have been feverishly defining the needs of our community, and oh what an education it has been.

We decided early on to start small. There are many ways to do this. You can focus on one or two chronic conditions that are prevalent in your area, on frequent flyers in your system or on something else. The point is, don’t bite off more than you can chew. This is where the community paramedic needs assessment would have come in handy. You could say we put the cart before the horse, and you’d be right. It was difficult deciding what to focus on, because the reality was we couldn’t find much data in our area pointing to the prevalence of any one or two specific conditions. There was a lot of anecdotal evidence but the concrete information was difficult to find. Each individual hospital system keeps its own records but they were impossible to get, and there isn’t a central repository of data, although our state is working on that right now. What’s more, there hasn’t been much communication or sharing between agencies, leading to inaccurate demographic information, estimates, data and the like.

All of which leads to my next point on tracking and documentation. It’s all about the data. Nobody wants to fund us yet, preferring to wait and see if our community paramedic program is successful first. You need to be able to show that your program is attaining its goals, and that it actually benefits the stakeholders. Our team created many different types of forms and tracking mechanisms. They created specific markers to measure, assessment forms, follow-up forms and a load of other forms. These are based on the gaps they identified along the way. The measures and forms helped us define the direction we are going in.

One of the great things about our community paramedic program is it’s been a catalyst for the formation of local health care networks with many participating agencies. OK, I don’t know if we can take all the credit. Sometimes I just think we’re in a perfect storm caused by anxiety over what form our healthcare will take. No matter, though. Now we’re all invited to the same meetings and we’re getting a better idea of the real issues in our area. It’s also helped us realize how many resources we actually have in our area—and where we’re almost completely lacking. We’re also finding out that most people really want to do the right thing, they just don’t know how to go about it. We helped open the dialog and now the group just keeps growing.

Our community paramedics have also spent much of the past six months taking the online community paramedic course through Colorado Mountain College. This is the first time the course has been offered to the general population, and more than 100 providers representing many different agencies took the course. The course is the first step in standardizing what a community paramedic is and does. Of course, the class will evolve over time, but its beauty is it allows for customization depending on the situation in your area. The course includes units on public and community health, mental health, end of life issues and a lot of primary health. It also includes clinical rotations in each topic area, including non-urgent patient assessment and how to use various pieces of medical equipment, among other things. Again, the clinicals can be customized depending on the needs in your area.