Bringing back the “House Call”

This article first appeared in the Rushville Republican on August 6, 2019.

Coming home from the hospital can be a scary experience. In the hospital, it’s easy to feel safe. Nurses are there 24/7 to watch over you. Your doctor is only a phone call away. If you don’t understand how to do something, or feel too awful to get it done, someone is there to do it for you.

Once you get home, you may be on your own. Friends and family who offered to help may not always be available. If you need medicine, you may not feel up to driving to get it. You may not remember how to do something new you learned in the hospital, such as how to give yourself a shot of insulin or change a dressing properly. If you feel as if you can’t get immediate help anywhere else, you may go right back to the hospital, becoming another of the many U.S. patients with unplanned readmissions to the hospital or Emergency Room.

In order to help patients recover securely at home, hospitals across the country have community “paramedicine programs”, featuring paramedics who make “house calls.” Rush Memorial Hospital is one of these hospitals. The paramedicine program at RMH allows healthcare providers to refer patients to the paramedics, requesting that they make house calls to check on their patients. After a referral, the paramedics call the patient and ask for permission to make the house call. Paramedics also make house calls to homebound patients who need to have blood drawn or other lab materials collected. This is much more comfortable for the patient than a trip to the hospital lab. It is also much easier for caregivers.

Jason Scheiderer is the Coordinator of Paramedicine, Transportation for the program. Jason, who has a Master’s Degree in Emergency Services Management, has been a paramedic for 10 years. He has been a full time Emergency Medical Services instructor in Indianapolis, as well as a training director at Eskenazi. He is also a board member of the National Association of Emergency Medical Technicians.

When asked about the need for the new program Jason explained, “There are a lot of things you don’t think about while you’re sitting in a hospital bed that can be a problem when you get home.”

In the hospital, where all their needs are met, patients may not realize that once they get home, they could be missing some of the resources they need to recover. Or they may unrealistically imagine themselves going right back to doing everything they were able to do before they became ill. With their permission, Jason visits patients in their homes after they are discharged from the hospital or the emergency room. He takes stock of their needs and looks for safety hazards. He checks on their physical condition, to make sure that they are making progress.

After making an initial assessment, Jason says, “We may ask other personnel for help and coordinate care to make sure they (his patients) get what they need…..We want them to be successful at home. We want them to be improving.”

This can include helping patients get transportation to appointments, medications, follow-up appointments, rehab therapy or nutritional services.

Jason is proud of the new paramedicine program. He is also very aware that paramedicine alone is not enough; multiple local services are needed to provide a continuum of care. Jason particularly admires the work of home health care services in Rush County.

He comments, “Paramedicine is a short term bridge between the Emergency Room or hospital and home health care, which is usually a long term service that stays in place until the patient is able to function independently, or until the patient goes to a long term care facility. Paramedicine is never going to take the place of home health care. We have a lot of home healthcare here and they are very good at what they do.”

With this spirit of “community teamwork” and putting the patient first, Jason is a great fit for his new position.

Brad Smith, RMH CEO, believes the paramedicine program is a natural outgrowth of the RMH philosophy of patient care. He said, “Patient needs don’t stop when they leave the four walls of the hospital.”