Southwestern District Health Unit
Report date
October 2017
What has been most instrumental to your progress?
Four paramedics were trained in classroom training, with 1 completing full community paramedic training.
A formalized process was developed for medical entities to request a paramedic. The process is coordinated through Southwestern District Health Unit. The grant also allowed a mechanism to chart services onsite.
The trained Community Paramedic recently took on a new position as a CP but in Minnesota. However, because the process was established for referral, follow-up and case management, the loss of the paramedic, did not stop the process of helping people. Nurses were utilized to help continue helping those needing services. Without this grant, that would have been more of a challenge.
Key lessons learned
Our biggest challenge is training individuals as Community paramedics. They had the desire to train, but the distance and agencies that could do the hands on training was too far away. I think this discouraged some from being able to continue. There is a shortage of paramedics in general, and this became even more of an issue having them specialize.
We lost our paramedic that was trained and moved to Minnesota, where she works full time as a community paramedic. The others that were is training, did not have time to finish. This created a challenge on using them for the grant. We did not however; stop the process that was continued, and utilized nurses so that the process and serving the community could continue. It was just not at the level we had hoped.
It has caused us to think outside the box, thinking of different ways to use perhaps EMT's to assist in different ways.
Reflections on the community innovation process
I believe it was a combination of several. We had to get buy in from others that we had a gap, but then had to come up with different ways to fill the gap, using models and processes put into place.The biggest thing is not to give up trying and testing different things to continue to help fill the gaps, and to be willing to change direction as opposed to just quitting because we lost the paramedics.
Progress toward an innovation
So with a shortage of paramedics, we have decided to think outside the box. Based on our community health improvement planning process, stress, behavioral health, and mental health continue to be a huge issue within our region. Stress has escalated now within our farming population as well, due to the drought. So these are ideas we have come up with and have started, but could be enhanced and escalated if we could have a grant continuance and shift of focus. One big shift will be to utilize EMT personnel to assist in various ways (based on their scope of practice). This will still be utilizing extra personnel for shortages, just not to the level as a paramedics. One example: 3. Do more community based screenings for high blood pressure, mental health etc utilizing the CP coordinator (RN) and EMT personnel. This would also utilize our referral system with other providers. This would allow more people to be identified that could potentially have cardiac, depression, High Blood Pressure etc issues. This is a huge need in the SW because of the drought affecting many, and the continued influx of people for oil.
What it will take to reach an innovation?
We will continue to work with partners to come up with ways to serve our communities. The biggest hurdle will always be staffing and funding, but we will continue the processes at what ever level we can.
What's next?
Continue to do the referral process—utilizing SWDHU staff nurses/Contract Staff for home based individual care
Do more community based screenings for high blood pressure, mental health etc utilizing the CP coordinator (RN) and EMT personnel. This would also utilize our referral system with other providers. This would allow more people to be identified that could potentially have cardiac, depression, High Blood Pressure etc issues. This is a huge need in the SW because of the drought affecting many, and the continued influx of people for oil.
SWDHU has hired an EMT as part of the staff (not under this grant) but this person could assist in the gaps. WE would like to train another staff person as an EMT, so we would have at least 2 actual SWDHU staff as EMT to assist. With this grant though, we would continue to utilize other outside EMT personnel, for additional help as needed. We will still try and use paramedics as they are available.
Because there is a huge shortage of Psychiatric services in the SW, but all over ND, SWDHU partners with Center for Psychiatric Health to bring in mental health services via telehealth and use EMT for checking them in, vitals etc.
Do more community based screenings for high blood pressure, mental health etc utilizing the CP coordinator (RN) and EMT personnel. This would also utilize our referral system with other providers. This would allow more people to be identified that could potentially have cardiac, depression, High Blood Pressure etc issues. This is a huge need in the SW because of the drought affecting many, and the continued influx of people for oil.
SWDHU has hired an EMT as part of the staff (not under this grant) but this person could assist in the gaps. WE would like to train another staff person as an EMT, so we would have at least 2 actual SWDHU staff as EMT to assist. With this grant though, we would continue to utilize other outside EMT personnel, for additional help as needed. We will still try and use paramedics as they are available.
Because there is a huge shortage of Psychiatric services in the SW, but all over ND, SWDHU partners with Center for Psychiatric Health to bring in mental health services via telehealth and use EMT for checking them in, vitals etc.
If you could do it all over again...
Be willing to be flexible, and not stop just because something doesn't go the direction you had hoped. Continue to work with partners, and continue to be willing to try different and innovative ways to help others.
One last thought
This grant certainly opened up doors that would not normally been opened. Thanks so much.