Issue link: https://emsworld.epubxp.com/i/336320
TRANSITION OF CARE E MS is most commonly appreciated for its vital role in 9-1-1 emergency medical response. However, it's often underutilized to provide medical transport for patients who are unable to be transported by traditional means. This includes trans- porting vulnerable patients who have been discharged from a hospital or emergency depart- ment. A significant number of these patients transition directly from the hospital's acute-care environment to the patient's own home environment. It is well documented that the transition from the hospi- tal to the home is susceptible to lapses in quality and a loss of key information regarding a pa- tient's care. 1 Following an acute hospitalization, as many as 76% of elderly patients are con- fused about their follow-up care plan. 2 Forty percent of patients over age 60 will experience a fall in the next six months. 3 For too long, our fee-for-ser- vice healthcare system has re- warded an arrangement that paradoxically benefited orga- nizations when patients expe- rienced a poor-quality health- care transition, often result- ing in a hospital readmission. Meanwhile, the EMS reim- bursement model emphasizes transportation over the provi- sion of care. 4 In addition, vary- ing degrees of regulatory issues and organizational cultural is- sues have allowed an entire workforce to remain underuti- lized and disassociated from the rest of the healthcare sys- tem. As the population ages, there will be an increasing de- mand for the healthcare system to transform the current model of emergency care, including healthcare provided by EMS. 5 Thankfully recent trends in healthcare policy, accelerated by the Affordable Care Act, have begun realigning incentives to- ward a coordinated experience that crosses over individual medical disciplines, workforces and institutions with the goal of improving patient outcomes. In light of these changes, EMS 14 Integrated Healthcare Delivery July 2014 www.ihdelivery.com 14 By Kevin G. Munjal, MD, MPH, & Hugh Chapin, MD, EMT The Impact of EMTs on the Post-Discharge Transition of Care Collaborative efort seeks to reduce hospital readmissions and falls IHD_14-16_PostDischarge0714.indd 14 6/13/14 11:23 AM