The NAS (National Ambulance Service) has extended its Pathfinder service – which it has designed to safely keep older people who phone 112/999 in their own homes rather than taking them to a hospital emergency department – to other counties.
The service – which aims to reduce ED attendance for older people – now has teams across Limerick, Tallaght and Waterford.
Pathfinder has already been working as a collaborative service between the NAS and Beaumont Hospital occupational therapy and physiotherapy departments since May 2020.
According to the NAS, Pathfinder improves outcomes for older people by providing safe alternative care at home rather than in hospital.
National Ambulance Service staff working with colleagues from HSE acute hospitals provide the service.
The Pathfinder ‘Rapid Response Team’ respond to 999/112 calls for older people (65 years and older) in their homes.
An advanced paramedic and occupational therapist/physiotherapist assess the older person.
Where safe, the team supports the older person at home rather than transporting them to the emergency department, by linking with a wide range of alternative hospital and community services.
Pathfinder also operates a ‘follow-up team’ (physiotherapy & occupational therapy) which provides immediate home-based rehabilitation, equipment provision and case management in the subsequent days following a 999/112 call.
According to the HSE, on average, two-thirds of patients seen by Pathfinder following a 999 call have remained at home rather than being brought to the ED.
Care in homes rather than hospitals
Robert Morton, director of the HSE National Ambulance Service, said the Pathfinder model “improves” outcomes for older people by minimising unnecessary ED attendances and offering “safe” alternative care pathways for older people in their own homes rather than in hospital.
“We know that the Pathfinder Model demonstrates that pre-hospital services can help to safely keep older people, who have phoned 112/999, in their own home rather than transporting them to a hospital ED for assessment.”
“Many older patients can be safely and appropriately managed in their own home rather than being transported to the ED when they dial 112/999 with low acuity complaints.”
Grace Rothwell, general manager, University Hospital Waterford, said that many patients who present to the emergency department have non-urgent care needs that could be treated elsewhere.
Overall, Rothwell added, Pathfinder has shown that it is a “safe and acceptable” service for older people who dial 999/112 with “low acuity” complaints.
Lucy Nugent, Chief Executive, Tallaght University Hospital, added that Pathfinder aims to reduce congestion in busy EDs and makes for a “better” environment for patients and staff on the floor whilst improving overall flow through the ED.
“The service enables increased ED capacity to care for other patients by supporting this cohort of complex, frail patients at home.”
“The service is particularly welcome as we approach the winter. We know that our older citizens are particularly vulnerable to adverse events and poor outcomes during emergency department attendance and hospitalisation.”
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