Lessons learned from an EMS treatment in place pilot program

Abstract

Emergency medical service providers are ideally positioned to help reduce unnecessary use of emergency department care. To report a qualitative analysis conducted on a “treatment in place” pilot program designed to treat low-acuity medical patients on-scene that was operated by an academic medical center and a city fire department. We conducted focus groups with fire department personnel to identify program benefits, implementation challenges, and suggestions for improvement. We reviewed 911 call notes to identify barriers and facilitators to providing on-scene care. Poor communication and training caused uncertainty about team members’ roles and how to provide care on-scene. A barrier to program success was not having an Emergency Medical Dispatch system that could identify low-acuity patients. Program benefits were its potential to save patients and insurance companies money and to educate the community about the purpose of emergency medical care. Differences in culture, communication, and resources create challenges and opportunities to interprofessional treatment in place programs.