Making Triage Decisions for the Acute Community Care Program: Paramedics Caring for Urgent Health Problems in Patients' Homes. (July 2019)

• Record Type: Journal Article
• Authors: Iezzoni, Lisa I.; Kothari, Dhruva; Camargo, Carlos A.; Wint, Amy J.; Cluett, W. Scott; Tripodis, Yorghos; Palmisano, Joseph
• Is Part Of: American journal of medical quality. Volume 34:Number 4(2019)
• Page Start: 331
• Page End: 338
• Publication Date: 2019-07
• Subjects: paramedics -- urgent care -- emergency services -- triage -- case vignettes; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860618800582
• Languages: English
• ISSNs: 1062-8606

Abstract

The Acute Community Care Program (ACCP) initiative sends specially trained paramedics to evaluate and treat patients with urgent care problems in their residences during evening hours. ACCP safety depends on making appropriate triage decisions from patients' reports during phone calls about whether paramedics could care for patients' urgent needs or whether they require emergency department (ED) services. Furthermore, after ACCP paramedics are on scene, patients may nonetheless need ED care if their urgent health problems are not adequately treated by the paramedic's interventions. To train clinical staff participating in all aspects of ACCP, including these triage decisions, ACCP clinical leaders developed brief vignettes: 27 represented initial ACCP triage decisions and 10 the subsequent decision to send patients to EDs. This report describes findings from an online survey completed by 24 clinical staff involved with ACCP triage. Clinical vignettes could be useful for staff training and quality control in such paramedic initiatives.