Residents in Sarnia-Lambton who have been identified as
utilizing both 911 and emergency department services are now able to access
proactive, non-emergency care through the Community Paramedicine Program.
A collaborative pilot program between Sarnia-Lambton
emergency medical services (EMS) and Bluewater Health was initiated in August
2017 to target patient populations that have frequent emergency visits and are
high risk for hospital admission. Specially trained Lambton EMS paramedics
respond in a non-emergency vehicle to provide care to identified frequent 911
callers. This effort is both reducing the number of 911 calls and improving
care for frequent 911 users. Patients
are identified by hospital, community and EMS staff.
Health Quality Ontario had the chance to catch up with
Carrie Gavigan, Resource, Utilization and Flow Coordinator and Laurie
Robichaud, Health Links and Patient Flow Coordinator, both from Bluewater
Health, to learn about this innovative program and how community paramedics are
working with stakeholders to support patients receiving care in the community
How did this program originate?
Bluewater Health reviewed emergency department data and
determined that there was a select high user patient population who could
benefit from increased community support, but did have access to additional
resources to provide care that they needed.
These results yielded an opportunity to think differently
about how to use community service providers to better support frequent health
system users in the community. The
collaboration with EMS was initially proposed at a leadership table in which
various stakeholders from numerous sectors attended. This was essential to get
buy-in and the right stakeholders on board. It contributed tremendously to the
success of the program.
How do paramedics support patients in the community?
Initially, the program received LHIN funding for four
paramedics. In partnership with Fanshawe College and community health service
providers, the paramedics underwent four weeks of classroom lessons and four
weeks of clinical placements.
Paramedics were trained to
respond to numerous health conditions including mental health, geriatric or
complex chronic disease care, all of which may not require a traditional
The paramedics work a combination of ambulance shifts and
shifts in the non-emergency program, which runs seven days a week, 12 hours a
day. Presently, a team of paramedics see up to 14 patients per day.
Paramedics check in on patients via home visits, phone calls
and remote telemetry monitoring. They complete assessments, develop coordinated
care plans that help with things such as medications, remote monitoring on
blood glucose levels, and routine blood work. The program operates with an
iPad® that uploads electronic medical records and assessments onto a secure
portal that can communicate with appropriate providers.
The Community Paramedic Program receives referrals
predominantly from the hospital and other community partners, triaged through
Bluewater Health. Individualized
coordinated care plans are created collaboratively by care coordinators and the
What has been the impact of the Community Paramedic Program?
Among our target population of frequent health system users,
early results saw a 62% drop in 911 calls, 58% fewer visits to the emergency
department, and 55% fewer hospital admissions.
The program recently saw its 100th patient and has begun
offering monthly wellness clinics in under-serviced areas of the county to
reach seniors and ‘at-risk’ residents without primary care physicians or
What are the key factors that contributed to your
Getting early buy-in from key stakeholders was fundamental
to the success of this program. Working with numerous community partners was
The community is also small and with only five paramedics
conducting home visits and providing community medical assistance, this allows
for a unique relationship between paramedics and patients.
The program will continue to grow and respond to the needs
within the Sarnia-Lambton community and maintain the strong collaboration and
relationship with Bluewater Health to provide this important service.