Finding Innovative Solutions

Operation CareThe Baltimore city fire and ambulance service never turns down a call and must respond, even when many of the calls come from a handful of residents who call over and over again.

Many of those calls tie up medics at the scene and at hospitals. Emergency management crews refer to those patients as frequent fliers, and they’ve identified 115 of them, including Margaret Joyce.

“If the hospital was filled up, they would take me to another one. Sometimes, I would stay there all day, or if I wasn’t feeling too bad, they would bring me home,” said Joyce.

She said she called for an ambulance 68 times over the last year.

HealthCare Access Maryland linked Joyce and nine other repeat callers to caseworkers under a pilot program called Operation Care. “A lot of people that we worked with just did not have the support they needed on the outside, such as food. Some of our clients needed assistance just around the house,” Kathy Westcoat, President of HCAM, said.

Like the majority of frequent fliers, Joyce has medical insurance through Medicare but needed help navigating the health care system. “I just don’t think we do a very good job of communicating with primary care doctors outside of the hospitals, because there were clear problems with managing people’s care, particularly those with chronic disease such as diabetes and hypertension,” Westcoat said.

“She’s here five days a week. She comes two hours a day now,” Joyce said of her HealthCare Access Maryland caseworker.

The caseworkers assess the circumstances of each frequent 911 caller and provide alternatives to using EMS crews as primary care physicians and a city ambulance as a taxi to the emergency room.

A recent article published in the online version of the Journal of Emergency Medicine reported a 32% reduction in calls along with over $14,000 savings to the City Fire Department in just 12 weeks.

“Now, instead of calling 911, they call us when they have a problem and it is a much less expensive way to go,” Westcoat said.

There are still more than 100 others who were identified as frequent fliers but Operation Care, now a permanent program at HCAM, is beginning to make a difference by connecting people to the care they need in the community.

Excerpts from WBAL TV – 11 Investigates – David Collins