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Community Paramedicine at Home (CP@home):

Paramedic Services Delivery Model Expansion adapting the CP@clinic Program to an in-home visit: CP@home

CP@home includes all assessments and tolls of the CP@clinic Program. The paramedics:

  • conduct several evidence-based health assessments
  • provide referrals to primary care and community resources
  • assist participants in navigating the health care system
  • provide participants with tailored health education
  • engage participants in healthy lifestyle discussions
  • set health goals with participants

With consent, the participant’s health assessment results are shared with their primary care provider. Paramedics will connect with any community resources to help facilitate participant referrals. Participants are encouraged to continue CP@home sessions to follow up regarding risk factors and program referrals.

Populations that will benefit from this adaptation include:

  • frail older adults
  • individuals referred by paramedics (including frequent callers)
  • individuals referred by hospital discharge planners at risk of readmission to hospital
  • individuals with limited mobility
  • individuals on a Long-Term Care Waitlist
  • individuals receiving remote patient monitoring

Infographics

Infographic titled Introducing the community paramedicine at home program CP at home. The title banner includes the mcmaster department of family medicine logo and the mcmaster community paramedicine logo. The top left shows the CP at clinic logo next to an icon of an apartment building. Underneath that says the community paramedicine at clinic or Cp at clinic program is innovative, evidence based, and cost effective. A chronic disease prevention, management, and health promotion program. Held in common spaces in social housing buildings. Offered on a drop in basis. To the right of this blurb is an arrow pointing to the right that says adapted to be delivered in patients homes. To the right of the arrow is a similar blurb with the CP at home logo next to an icon of a house. Underneath this is text that says the CP at clinic program has been adapted to be delivered as an in home visit, referred to as CP at home. CP at home features all of the same assessments slash tools that are familiar to CP at clinic community paramedics. Underneath these blurbs is a series of interlocking hexagons shapes. The hexagon furthest to the left says populations that can benefit from CP at home. The following hexagons from left to right list the populations as individuals with multiple chronic conditions, vulnerable and frail older adults, individuals with limited mobility, populations prioritized by the Ontario Health Teams, individuals on the Long Term Care waitlist, individuals referred by paramedics which includes frequent callers, individuals receiving remote patient monitoring, and individuals referred by hospital discharge planner, for example at risk for readmission. To the bottom left of this is a list of benefits of the CP at home program which are improved patient quality of life, identifying and managing chronic diseases, help patients stay healthy at home, educating and empowering patients to look after themselves, and connecting back to primary care. To the right of this is a list of features of the out of the box CP at home program, which are evidence based program grounded in 10 years of robust research, standardized online paramedic training, uses appropriate validated assessment tools slash questionnaires, standardized electronic database with decision support, standardized reports for monitoring and quality assurance, and customized impact reports for services needs. Underneath benefits and features there are three bubbles with arrows pointing to the right between them. The bubble furthest to the left says CP at home first visit, completion of patient intake assessments. The middle bubble says CP at home follow up visit, patient check ins with assessments as needed. The bubble on the right says CP at home program discharge, definite end point for in home visits. At the bottom is the Twitter handle at CP at clinic, and website cp at clinic dot CA.

CP@home

Older adults on the Long-Term Care waitlist or who have limited mobility are just some of the populations who can benefit from CP@clinic delivered as a home visit, also known as CP@home.
Infographic. Top banner includes CP at clinic logo in the top left and CP at home logo at the top right. The title on the banner is Long Term goals for Long Term Care: Why should my paramedic service implement CP at clinic slash CP at home for the LTC waitlist. Below this is another banner that says CP at clinic slash CP at home prioritizes long term impact for patients and the healthcare system. CP at clinic slash CP at home is the only evidence based wellness program for older adults that have been proven to reduce chronic illness and improve health system outcomes. Below this is text that asks the question Is CP at clinic slash CP at home sustainable. Yes. Below that it says What to expect when you implement CP at clinic slash CP at home. There is a list of characteristics with checkboxes next to them. The characteristics are cost saving, better community health outcomes, won’t go out of date, demonstrate your impact to funders, and long term database maintenance and data storage. Another banner below this says Here is how, With two icons of interlocking gears on either side of the text. Underneath are four ovals, with text, aligned vertically on the left under a title that says Paramedic Service Investment. There are four respective rectangles aligned vertically on the right, with text, under a title that says program components. Each of the four ovals are connected to one rectangle on the right by an arrow pointing to the right. The first diagram from the top describes CP at clinic slash CP at home program implementation. The oval under paramedic service investment says: community paramedic service capacity, implement program for long term care waitlist populations. The arrow is overlaid with an icon of buildings, and two paramedics. The rectangle under program components lists, Community paramedics certified in CP at clinic slash CP at home training, CP at clinic slash CP at home adapted for long term care waitlist population, New Ontario government funding available for long term care, community resources. The next diagram describes data collection and storage. The oval under paramedic service investment says current, free of cost. Database supported through research grants. Future, cost paid directly to EMR providers. The arrow is overlaid by an icon of a desktop monitor with wifi and a cloud icon. The rectangle under program components lists, easy to use SMART database with up to date decision support, data privacy and encryption compliant with EMR standards, New Integration with paramedic EMRs, including Interdev March 2021 and PreHos coming soon for data sustainability. The next diagram down describes CP at clinic slash CP at home training. The oval says free of cost. The arrow is overlaid with an icon of a person pointing to a pie graph on a chart behind them. The rectangle lists, updated annually to reflect best practices, up to date research; annual audits to keep community paramedics up to date, New refresher courses underway, New accredited by global paramedic higher education council, or GPHEC. The last diagram describes impact reporting. The oval says free of cost. The arrow is overlaid by an icon of a report with text and graphs. The rectangle lists, automated LHIN report generation built into database, quarterly customized stakeholder reports including successes, updates, new developments, McMaster Community Paramedicine Research Team uses results for quality improvement of training and development. The bottom banner of the infographic has the twitter logo with Twitter handle at CP at clinic and an internet logo with website cp at clinic dot CA.

Sustainability of CP@clinic and CP@home

CP@clinic/CP@home prioritizes long term impact for patients and the healthcare system. CP@clinic /CP@home is the only evidence based wellness program for older adults that has been proven to reduce chronic illness and improve health system outcomes.
Infographic titled the CP at clinic and CP at home programs can help older adults on the Long term care LTC waitlist stay safe at home. The top corners have the mcmaster community paramedicine research team logo and the VIP Research Lab logo. On the left there is a subheading that says older adults in social housing. Below this says up to 5 times the rate of transfer to LTC. an asterisk links this text to a footnote at the bottom that says compared to the general population of older adults, based on preliminary analysis on data gathered from ICES 2017 and 2018. Below this is an icon of a person with a walker and text that says 52 percent problems with mobility. An icon of a person falling and text that says 35 percent had at least 1 fall in previous year. An icon of a person doing laundry and text that says 34 percent problems doing daily activities. An icon of a shower head and text that says 19 percent problems doing self care. An icon of a person with a cane and text that says 14 percent classified as frail. In the middle is a box with text that says 2019 waitlist is 34, 834 older adults. We hypothesize that 16,380 social housing older adults could qualify for LTC. A double asterisk links this text to a footnote at the bottom that says based on problems doing self care. More text in the middle says If 50 percent are on the LTC waitlist, 23 percent of the LTC waitlist is social housing older adults. On the right side text says CP at clinic and CP at home are evidence based, cost effective programs that will benefit older adults on the LTC waitlist and keep them safe at home by. The list below has an icon of a pair of hands holding a heart with a first aid symbol on it, and text that says improving health and quality of life. An icon of a checklist on a clipboard and text that says identifying and managing chronic diseases before they become unmanageable. An icon of two fists raised in the air and text that says empowering and educating older adults to look after themselves. An icon of a doctor and text that says connecting back to primary care. The bottom of the infographic has the website cp at clinic dot CA, twitter handle at CP at clinic, McMaster University Department of Family medicine logo, and citations.

LTC Waitlist (social housing/CP@home)

CP@clinic and CP@home are evidence-based, cost-effective programs that will benefit older adults on the LTC Waitlist and keep them safe at home.

COVID 19 Pandemic and CP@clinic

CP@home is an adapted version of the CP@clinic program. Its implementation includes Virtual, home visit, and in-person program sessions/clinics in accordance with public health guidelines, guided by the advice of the CP@clinic Executive Committee and our CP@clinic partners, and based on the following principles:

Safety

The safety of Community Paramedics implementing the program and older adults participating in the program is paramount.

Compliance

We will comply with mandates and recommendations from the government and our partners.

Adaptability

We recognize the evolving circumstances and are ready to adapt and respond quickly. Regular communication between the McMaster Community Paramedicine Research Team and its partners will help facilitate program adaptations to ensure safety and accommodate capacity.

Virtual

To protect the vulnerable populations we work with, we will offer virtual program delivery options to reduce the risk for exposure to the COVID-19 virus and to provide equitable access to our program.

Especially during these unprecedented times, we are making it our mandate to provide equitable access to our program to all older adults connected to our CP@clinic program sites. Both existing and new CP@clinic participants are welcome.

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