Fire districts join in funding community resource paramedic

In hopes of enhancing the level of patient care available to its residents, the Monroe Fire Department is partnering with two other agencies to provide Community Resource Paramedic services.

Jointly funded by Snohomish County Fire District 3 in Monroe, District 7 in Clearview and District 8 in Lake Stevens, the new Community Resource Paramedic (CRP) position was recently filled by District 7 firefighter/paramedic Scott Koch.

The CRP program takes a proactive approach to health care by identifying patient needs before an emergency occurs. Through focused patient interaction, the CRP program seeks to mitigate patient risks and bridge the gap between the patient and the plethora of services available through various agencies.

"These programs exist nationwide,GÇ¥ said Monroe Fire Department Medical Services Administrator Cindy Coker. "It's really becoming a new standard of care that we can provide for our citizens.GÇ¥

Koch will meet CRP program objectives by making house calls and checking in on patients who might benefit from the service. The program is being modeled after Fire District 1's CRP program, which has been running for about 1 -+ years in south Snohomish County.

"We watched District 1,GÇ¥ Coker said. "We saw how successful they were. We saw the impact they were making.GÇ¥

One of the goals of the CRP program is to reduce the number of patients utilizing 911 as their primary form of health management. Oftentimes, said Coker, patients with chronic health conditions become caught up in a vicious cycle of 911 calls and trips to the emergency room. This inefficient system of health management treats the symptoms, but never really gets to the root of the problem. The patient is repeatedly treated in an acute-care facility, only to be released so the cycle can begin again.

Sometimes, said Coker, the underlying issue might be something as simple as the patient's inability to get to a pharmacy to pick up medication. As the CRP, Koch will need to identify those issues before an emergency occurs, and then connect the patient with the appropriate resources.

Currently, the program is roughly halfway through a six- to eight-week ramp-up period, with districts 3, 7 and 8 collaborating on its implementation.

The CRP program dovetails with the Triple Aim Initiative, a national framework developed by the Institute for Healthcare Improvement, which requires a multi-faceted approach to healthcare optimization. The three aims are improving the overall patient experience, improving the health of the community as a whole and reducing the cost of health care.-á -á

District personnel hope the CRP program can satisfy all three through its innovative and proactive patient care tactics.

Intended to be both flexible and broad, the CRP program does not cater to any one demographic. Seniors and residents of any age with mobility issues, mental health issues or chronic illness can benefit from the CRP program, which will operate on a referral basis.

Patients meeting CRP criteria can be referred by emergency personnel, a healthcare provider such as EvergreenHealth Monroe, or through a vetting process that identifies patients based on how frequently they use 911. Once referred as a candidate for the CRP program, Koch will open up a line of communication and visit the patient in their home.

Koch has been a District 7 firefighter since 1990, starting out as a volunteer when he was 18. He was hired full-time by the agency in 1993, and attended paramedic school in 2000. He was one of five candidates to participate in the application process, which included oral interviews and a patient-care simulation.-á -á

In order to employ a sense of realism, the scenario was staged to include living room chairs, a throw rug and scattered clothing. Each of the five applicants was given a copy of the "patient referralGÇ¥ and asked to demonstrate how they would navigate the situation. The mock patient participated enthusiastically, playing the part of an elderly woman with a history of falls in the home.

"We've honestly never seen a role-player do as good of a job,GÇ¥ Coker said. "We told her if she wants to come out of retirement, we'll use her for all of our scenarios. She did a phenomenal job.GÇ¥

All five candidates were exceptionally qualified and the decision was difficult, said Coker. But in the end, it was determined that Koch was the best fit for the position.

During his training, Koch has been coordinating program logistics with medical services administrators from all three departments, and will spend time shadowing District 1's CRP. He is also working to familiarize himself with not only state and county patient resources, but resources specific to the Monroe, Lake Stevens and Clearview areas.

Koch hopes to refer patients to resources that boast a well-established level of patient care and advocacy. In order to promote this, he has tasked himself with providing a service that extends beyond just handing somebody a phone number on a piece of paper, which means taking the time to research agencies prior to recommending them.

"The public does trust us,GÇ¥ Koch said. "And that's something that we can't take lightly.GÇ¥

Koch will have a dedicated office space located in Clearview, along with necessary access to the other two departments. He is looking forward to the challenge of building the program from the ground up and excited about interacting with patients on a different level.

All three districts anticipate the CRP program will function organically, fulfilling the needs of the community as they are identified. As such, it is expected that the program will evolve and grow as it becomes more established. So far, the speed at which the program has been able to gather momentum has been quite remarkable, Coker said.

"I've never seen a program introduced to the fire department that not only was the administration behind, but every employee was behind and enthused about it,GÇ¥ Coker said. "It's been very interesting to see this happen.GÇ¥