Partnering EMS and Mental Health Reduces Call Volume

Jun 21, 2016 by

 

Last month, Nathan Stanaway’s article, “Community Paramedic Program Cuts Mental Health Patient Call Volume,” featured the Grady EMS Upstream Crisis Intervention Group, a community paramedicine project based in Atlanta launched in 2013 aimed at improving the care of patients with complaints of psychiatric nature.

Of the many patients that utilize EMS care, patients suffering from psychiatric illness make up a large portion of what Michael Colman, the vice president of EMS operations and the founder of The Grady EMS Upstream Crisis Intervention Group, deems frequent users—patients that use EMS at least five times a month. Colman explains in his article, “Innovations: Upstream Crisis Intervention Unit,” that excessive use of emergency departments for medical screening and crisis intervention psychiatric services has lead to the “inefficient use of expensive, limited resources” and has contributed to greater problems relating to emergency department overcrowding. In fact, a financial analysis conducted with random samples of 156 Grady Health System and Grady EMS charts revealed that the emergency department lost an average of $401 per patient treated, while EMS averaged $109 lost per ambulance transport.

The Grady EMS Upstream Crisis Intervention Group combatted this unsustainable practice by replicating the process of emergency department medical clearance at the “community level.” By supporting patients with online medical direction through the Georgia Crisis Action Line while in the care of the transport crew, and then directly referring them from the field to “definitive psychiatric outpatient or inpatient care,” unnecessary emergency department visits are prevented. Altogether, in their three years of service the Grady EMS Upstream Crisis Intervention Group have responded to 10,696 psychiatric calls, saving EMS over $300,000.

In New York, there exists a crisis hotline called LifeNet, which operates 24/7 and provides free health assessments and interventions for New Yorkers seeking behavioral health resources. Similar to Grady’s Intervention Group, LifeNet also includes a mobile crisis team that visits patients in crisis, assesses them for risk, stabilizes them, and refers them to other helpful services. Using Grady’s partnership between EMS and mental health services as an example, a future partnership between NYC’s EMS and mental health services holds great potential in bringing the same benefits that Grady’s EMS has brought to Atlanta’s emergency care system in the past three years.

Grady’s community paramedicine project is one of many springing up around the nation, all with a common goal in mind: to improve the specificity of emergency care provided to patients while also paving the way to sustainability. With the expanding roles of EMS, projects like this one can lead the way for many others to follow.

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