Program aims at preventing hospital readmission

December 12, 2013

68-year-old Marie Foster took care of her husband until the day he died. While she focused on his health, her health got worse. She now has end stage COPD (Chronic Obstructive Pulmonary Disease).

Marie had been in and out of the hospital until she was enrolled in the EMS Transition Coach Program at Inspira Woodbury.

Paramedic Karl Milano let me tag along on his visit. The EMS director says they make home visits to patients like Ms. Foster who are at risk for re-admission.

Milano says, "Typically your heart failure patients, end stage COPD patients, COPD patients and anyone who is a frequent readmission who needs a little extra help at home."

Karl first met Ms. Foster on an emergency run. Now he helps prevent those emergencies by checking her vital signs, her safety and making sure she's doing everything she can to stay healthy.

"Taking her meds like she should, keeping her doctor's appointments," says Milano.

So far it's working. Out of 55 patients, 152 visits, only 5-percent have been readmitted. The national average readmission rate is 19-percent.

Marie says, "I think it's the greatest thing they ever could have started."

And while patients like it, Karl says for paramedics, it's also very rewarding.

"It's kind of like good therapy for us. We can see a patient getting better, sitting down and talking to them because we usually don't get time to in the back of the ambulance."

The program is free to patients who were treated at the hospital. Right now it's funded by a grant from the Robert Wood Johnson Foundation.

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