Excellence in EMS Integration Award: This award recognizes a non-EMS organization that has developed and implemented a partnership with EMS organizations that have demonstrated enhancement of patient experience of care, improved patient outcomes, or reduced the cost of healthcare.

McMaster University Department of Family Medicine Community Paramedicine at Clinic (CP@clinic)

Description
Community Paramedicine at Clinic (CP@clinic) is an evidence-based robustly researched chronic disease prevention, management, and health promotion program that was developed in response to the high 911 call rate and high needs of low income and vulnerable older adults living in social housing in Ontario, Canada. The standardized research-based program is implemented in partnership with local paramedic services. Paramedics with program-specific training provide regularly scheduled sessions in common rooms of social housing buildings. Older adults attend these one-on-one sessions with paramedics who use evidence-based validated tools to assess patient risk factors in the areas of chronic diseases and social determinants of health. Decision-support algorithms guide paramedics to provide tailored health education and referrals to appropriate health and community resources based on patients’ assessment results. With consent, patient assessment results are shared with their primary care provider to support continuity of care.

Organization Overview
McMaster Community Paramedicine Research Team, McMaster University Department of Family Medicine

Date of Implementation: Ongoing since February 2014

Number & Demographics of Patients/Members
4,288 patients enrolled in CP@clinic

Description of Outcomes / Utilization / Change
The CP@clinic program has been rigorously evaluated through a multi-site pragmatic cluster RCT (randomized controlled trial) methodology, qualitative research and health economic analysis, followed by linkage with health administrative datasets and health system impact analysis. The program has reduced 911 EMS calls by 20%, increased patients’ Quality Adjusted Life Years, reduced blood pressure to normal levels among 40.5% of patients with high blood pressure, improved diabetes risk scores among patients. In turn, CP@clinic has increased the capacity of the emergency health care system through cost avoidance and reallocating health resources such that the estimated benefits of the program outweigh its costs at a ratio of 2:1. Net savings per social housing patient participating in CP@clinic are $88 CAD.

Supporting Links
CP@CLINIC WEBSITE:

https://cpatclinic.ca      

PUBLICATIONS:   

Development of a community health and wellness pilot in a subsidised seniors’ apartment building in Hamilton, Ontario: Community Health Awareness Program delivered by Emergency Medical Services (CHAP-EMS) https://doi.org/10.1186/s13104-015-1061-8      

Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial https://doi.org/10.1503/cmaj.170740      

Reducing 9-1-1 Emergency Medical Service Calls By Implementing A Community Paramedicine Program For Vulnerable Older Adults In Public Housing In Canada: A Multi-Site Cluster Randomized Controlled Trial https://doi.org/10.1080/10903127.2019.1566421      

Cost-effectiveness analysis of a community paramedicine programme for low-income seniors living in subsidised housing: the community paramedicine at clinic programme (CP@clinic) https://doi.org/10.1136/bmjopen-2020-037386      

Feasibility of implementing a community cardiovascular health promotion program with paramedics and volunteers in a South Asian population https://doi.org/10.1186/s12889-020-09728-9      

Effects of a community health promotion program on social factors in a vulnerable older adult population residing in social housing  https://doi.org/10.1186/s12877-018-0764-9      

The CHAP-EMS health promotion program: a qualitative study on participants' views of the role of paramedics https://doi.org/10.1186/s12913-016-1687-9      

INFOGRAPHICS

• The Community Paramedicine at Clinic (CP@clinic) Program http://hdl.handle.net/11375/27351     
• Tsunami of Neglected Health Conditions http://hdl.handle.net/11375/27373     
• Long Term Goals for Long Term Care http://hdl.handle.net/11375/27379        
• Data ownership and security for CP@clinic http://hdl.handle.net/11375/27378      
• Beneath the Tip of the pandemic Iceberg http://hdl.handle.net/11375/27380     
• Virtual CP@clinic / Virtuel PC@clinique http://hdl.handle.net/11375/27405     
• The CP@clinic and CP@home Programs Can Help Older Adults on the Long-Term Care (LTC) Waitlist Stay Safe at Home http://hdl.handle.net/11375/27406     
• CP@clinic Long Term Care Info Brief http://hdl.handle.net/11375/27408    
• Introducing the Community Paramedicine at Home (CP@home) Program http://hdl.handle.net/11375/27409