SASKATOON – Fewer patients are ending up in overcapacity and waiting less in emergency departments for an inpatient bed. Effective change that may not have reached the Saskatoon Health Region’s targets as part of its “90 Days of Innovation” but successes within the system are still undeniable.

One example of gains made over the last three months is a community paramedicine model, the future of medicine according to those on the front line of health care.

“I think once we can expand this program to include more long-term care facilities, more assisted living, more of the private care facilities we’re going to see a big impact,” said Gerry Schriemer, chief operating officer with M.D. Ambulance.

Between March 12 and June 9, the Saskatoon Health Region (SHR) launched the community paramedicine model at these five sites: Brightwater Senior Living, Luther Special Care Home, Porteous Lodge, Central Haven Special Care Home and Sherbrooke Community Centre.

Five advance care paramedics, trained by a geriatric evaluation management team at Saskatoon City Hospital, now treat elderly patients on-site in consultation with a physician familiar with their medical history.

“We may treat and keep them at home and come back and re-assess them either later that day or the next day or the next day and avoid that ER admission,” added Schriemer.

Patients can now be treated for things like dehydration in the comfort of their own care home, where they’re more likely to thrive especially among patients suffering from dementia.

When we have some of our elderly patients you don’t want to get them out their environment that’s a challenge for them and then it’s a challenge for staff when they get back home because their own routine has been disrupted.

Over the next 10 years Schriemer sees community paramedicine being as big for M.D. Ambulance as its emergency response and says the model saves the health care system money, time and discomfort to a patient.

“I think one of the big things is when we have these patients that can be treated in their residence and not transported they’re the lower acuity, so when you go into an already crowded ER or overcrowded ER you know who’s waiting for a bed, it’s those in the lower acuity.”

As a result of the pilot, 15 patients were able to avoid being admitted to hospital since the start of 90 Days of Innovation. In conjunction with other initiatives, the number of patients in overcapacity beds has also declined by 58 per cent.

“We have now gotten to a point where on some of the mornings that we come in we actually have empty ER beds, sometimes just two or three are enough to make that difference,” said Ryan Baliski, manager of emergency for St. Paul’s Hospital.

Health officials believe this pilot project’s potential is huge if applied to all 30 long-term cares homes in the region.

“We know that 1,240 of the transports happen from our long-term care facilities to our hospitals every year and 57 per cent of those turn into admissions, many times those admissions can be avoided altogether by just sending that clinical support to the home to support the team and that resident in the home,” said Corey Miller, the lead for community strategies for the 90 Days of Innovation with SHR.

Even more promising say officials is if this method of medicine was used at more than 70 plus personal care homes in the area.

“We’ve proven proof of concept through that experiment that we’ve got a winner here, now our job is to spread it and sustain it across,” remarked Dan Florizone, president and CEO of SHR.

Other successful examples of community paramedicine being practiced in Saskatoon include a primary care paramedic introduced to the Saskatoon Police Service detention unit in 2013 following three deaths in eight months.

In 2014, paramedics were called to the Saskatoon Lighthouse more than 400 times and in February it was announced a rotation of four paramedics would be available to clients 12 hours a day, seven days a week.

According to Schriemer, there were one to one point five transports a day from the Lighthouse to hospitals.  Those numbers have since declined to one to two a week after this six-month pilot project was introduced.