Mindset Matters How To Transition from 911 to MIH

After working in the intense, fast-paced 911 emergency response environment, some paramedics begin looking to change to a patient-focused role. Being a community paramedic on a mobile integrated health (MIH) team provides a change of pace, which also requires a change in mindset.

MIH teams can help paramedics make this shift through onboarding and training at the start. But what’s the big difference in moving from 911 to community paramedicine?

Differing Approaches to Care

911 emergency medical responders provide immediate, on-scene emergency care to people with life-threatening emergencies. The goal is to get someone stabilized to transport to the nearest medical facility. 

Community paramedicine, on the other hand, focuses on taking steps to treat the patient at home and to keep them there. 

Chelsea Lennon, Management Associate of Mobile Health for Atrium Health in Charlotte, NC, says it’s a transition from “‘treat and transport’ to ‘stay and play’.”

“You stay in the home and figure out everything possible to keep that patient from being transported,” she said. “That mindset shift is a struggle for some of our seasoned paramedics.”

MIH teams focus on delivering preventive, ongoing health services to people in the community. This may include chronic disease management, home-based care, preventive screenings, connections to social services, nutrition guidance and more. 

For example, if you get a call for high blood sugar. As a 911 responder, you’ll stabilize the patient and transport them to a hospital for treatment. However, as a community paramedic, you stabilize the patient at home and can look around to notice the chips and cookies. You educate the patient and connect them to a social worker if they need nutrition assistance or other support.

How to Shift the Mindset

Lennon said that many of the paramedics who join Atrium’s MIH team do so because they want to build relationships with patients. They want to see the outcomes. MIH paramedics also can expand their skill sets. They’re able to administer care and education or make connections across the health system that they wouldn’t on a 911 service.

To help make this transition, MIH teams hiring paramedics should be prepared to offer training. Atrium, for example, has a large MIH program with more than 40 employees across many disciplines. Their orientation lasts about 6 weeks and includes ride-alongs and shadowing different team members to get a deep understanding of the purpose of MIH. They also learn protocols to know what care they can provide patients at home. 

Atrium requires paramedics they hire to have worked on a 911 transport for at least 3 years. Paramedics working for Atrium Mobile Integrated Health are required to get their community paramedicine certification within 18 months of hire. However, Lennon said they encourage new hires to wait at least 6 months before sitting for the exam. 

“It’s drastic going from that 911 perspective to that MIH perspective,” Lennon said. “We tell staff when they sit for the exam to think more like a social worker than a paramedic.”

Shifting from 911 to MIH gives paramedics a chance to follow patients, see the outcomes and expand their skills.

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