- Associated Press - Sunday, January 4, 2015

FORT WAYNE, Ind. (AP) - Multiple 911 calls from the same place on the same day, week or month aren’t uncommon.

Paramedics may get summoned several times in the same day in the most extreme cases, likely for the same reason each time.

Some callers and potential patients, though, aren’t in need of any medical care. Those instances are people who just want some interaction with others.

Repeat locations are common enough that in four area counties - LaGrange, Noble, Whitley and Huntington -they account for more than one-third of calls, The Journal Gazette reported (https://bit.ly/1vO0ea0 ).

“Thirty-five percent of our 911 calls are people who call multiple times,” said Tom Shoemaker, EMS director at Parkview Noble Hospital.

To help alleviate the demand for ambulances at these repeat locations, Parkview has joined a national trend to revive the house call, only now it’s paramedics making the phone calls and follow-up visits to people’s homes.

Whether someone gets a phone call or an in-person follow-up depends on their history and needs.

For those who call 911 repeatedly but don’t end up going to the hospital or having any pressing medical needs, phone calls from medics have greatly reduced or eliminated 911 calls.

The paramedics may ask if the person is doing well that day, if their pets are OK or if there is anything the person feels they may need.

In one instance, someone calling 911 in Whitley County multiple times in a month would get transported by ambulance to the hospital and await a family member so the patient could return home, according to Duane Ginder, EMS director at Parkview Whitley Hospital.

Phone calls from paramedics late in the evening to check on that person eliminated those near-daily calls.

“We’ve found that over and over with multiple patients, there are patients who just need someone to check on them,” he said.

Ginder piloted Parkview’s entrance into the house calls realm and Shoemaker quickly joined with him.

Connie Cummins, special projects coordinator at Parkview Noble, has also seen firsthand how beneficial a quick phone call can be to someone.

An elderly woman in Noble County would frequently call 911, often twice a day.

A paramedic added her to the list of calls and the requests for an ambulance stopped so long as she got a phone call.

“I didn’t call her, I knew we’d get an ambulance run,” Cummins said.

It’s not just a program to give people the socializing they need in a day, though.

It originated when EMS leadership in those four counties mined patient data and found the 35 percent figure for repeat calls.

Breaking that down further revealed falls and breathing problems were about 90 percent to 95 percent of 911 calls, Shoemaker said.

Falls are so prevalent nationwide that they accounted for more than $30 billion in direct medical costs in 2012 for older adults, when adjusted for inflation, according to the Centers for Disease Control.

With fall prevention as the objective, Cummins started to receive daily reports on 911 calls for falls the previous day.

Some people who experience a fall suffer serious injuries and need medical care but many others only need help getting off the floor.

“The majority of these fall patients, we don’t transport to the hospital … we essentially go and pick them up,” Ginder said.

Sometimes a local fire department will also go to the patient to help, other times it’s only paramedics.

For those who frequently fall and need an ambulance, the house call program aims to stop the causes of the falls and prevent one that may result in a serious injury or death.

With the patient’s permission, Cummins, Shoemaker, Ginder or another representative will visit the person’s home and look for fall hazards.

The most common are area rugs, cords or walkways that are somehow otherwise obstructed. Nutrition and general health care will also be a focus.

Whitley County had one frequent repeat patient who called up to six or seven times in a week when he would fall after he tried to transfer from a motorized scooter to a sofa or chair.

Ginder said the man hadn’t been to a doctor in years, and a subsequent evaluation revealed some medical and nutrition issues.

That was in November 2013.

“In the last year, we’ve made one run to his house,” Ginder said.

Though the program has reduced calls to certain homes on a repeat basis, it has not decreased the number of overall 911 calls the counties get for falls.

“We have a steady supply. The baby boomers are getting older,” Shoemaker said.

Despite not having fewer calls to take care of, the program has not been without its benefits to its administrators.

In the year since house calls started, the response time in Noble County has decreased.

Response time compliance in 2014 was 7 percent better than 2013, Shoemaker said.

He and Ginder attribute that to ambulances not being tied up so frequently or for longer periods of time at repeat locations. They are instead now available to more quickly respond to other 911 calls for heart attacks, breathing problems, strokes and traumatic injuries.

It’s also been accomplished in a way that paramedics can work the phone calls or home visits into their regular day without affecting responses to emergencies.

Much of what they provide could be considered almost a case manager role.

Cummins said she helps with or completes applications for food stamps, housing assistance and other needs that are addressed on the social services side of the house calls program.

She and others involved with the house calls stressed they aren’t trying to compete with other private ventures involved in home health or nursing care. Instead, they are trying to fill a niche for patients who are a good fit for the program.

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Information from: The Journal Gazette, https://www.journalgazette.net

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