Preventing Emergency Department Visits with Fire-Based Urgent Medical Service

Abstract

Background: Emergency departments (EDs) are misused for non-emergency health conditions. Mobile integrated healthcare (MIH) is an alternative healthcare delivery system that provides healthcare to those with non-emergency needs and decreases non-emergency ED visits. Green Valley Fire District (GVFD) utilizes a MIH model called fire-based urgent medical service (FBUMS) that utilizes a family nurse practitioner (FNP) to provide mobile urgent care. Purpose: Evaluate the GVFD FBUMS in decreasing ED visits for non-emergency conditions. Methods: Patients seen by the GVFD FBUMS FNP during a six-week period between July 2018 and August 2018 completed a survey to determine: why participants contacted the FBUMS; if participants would have utilized the ED if the FNP was not available; if they would have sought care elsewhere; how participants heard about the FBUMS program; and what treatment/service was provided. ICD-10 codes were correlated with survey results to determine diagnoses treated. Data analysis: Descriptive statistics were used to analyze each of the answered survey questions and associated ICD-10 codes in Microsoft Excel. Results: A total of 44 surveys were completed (n=44). The majority of participants (90.9%) called GVFD FBUMS hotline number compared to four (9.1%) that called 911. Of the 34 participants that stated they would not have gone to the hospital if the FBUMS FNP was not available, 20 (58.8%) stated they would have gone to urgent care. The most common diagnosis treated by FBUMS was fever (ICD-10 class R). Conclusion: A FBUMS lead by a FNP decreases ED visits. The FBUMS FNP treats patients from non-emergent to chronic health conditions. Increasing community awareness of the services provided by the FBUMS program would be beneficial.