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Nurse partnership aims to give N.C. county EMS providers ‘breathing space’

The Wake County program will use-of-state nurses to help EMS staff determine the care needed for non-life-threatening emergency calls


Aaron Sánchez-Guerra
The News & Observer

RALEIGH, N.C. — Wake County is getting new help with taking and routing 911 calls for medical attention and emergencies.

As call centers and emergency services face high demand and staffing shortages, Wake County Emergency Medical Services announced on Tuesday the launch of the Nurse Navigation Program, a partnership with Global Medical Response, a national medical services company.

Aiming to “help route 911 calls to the right care at the right time at the right place,” the program will use-of-state nurses to help stretched Wake County EMS staff determine the care needed for non-life-threatening emergency calls.


While life-threatening emergency calls will get routed immediately by a 911 operator to emergency workers, callers with non-life-threatening emergencies will get routed to a “nurse navigator” at a call center.

“The nice part about having a nurse being able to walk through with these callers, is that the nurse is able to take time and be heard,” said Lisa Edmondson, a registered nurse with Global Medical Response, during a news conference at the Wake County Justice Center. “The nurses will also call these patients up the following day to see how they are and to get a patient satisfaction score from them.

The nurse operators can determine a caller’s needs and offer medical advice, connect callers to their primary-care providers, to transportation to a clinic or to telehealth services. They also can direct a life-threatening emergency to emergency workers.

The operators will also screen callers to see if they need help in a language other than English, Edmondson said.

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Calls the nurses will be able to handle include headaches, toothaches, medication refills, sore throats, minor cuts or skin rashes that may not require emergency medical attention, Wake County EMS director José Cabañas said.

The program comes as Wake County EMS faces unprecedented call volumes and staff shortages, which has made some 911 callers in non-emergency situations wait longer for service.

The program was recently implemented in Seattle and has been in effect in DeKalb County in Georgia.

“By enhancing our service delivery, we’re able to have operation efficiencies of time, so we have more assets and resources available for that potentially next life-threatening call,” Cabañas said.

“Health care and emergency providers across the country and our community have been through a lot in the past several years with the pandemic,” he explained. “So we’re making sure that we’re maximizing our resources and access points to allow some potential breathing space for (our staff) to manage their workload.”

The Nurse Navigation Program will be a “win-win” that solves for operational efficiencies and the pressure on exhausted workers, he said.

When the 911 call system is overwhelmed, a shift commander determines which calls need immediate response, leaving some non-emergency callers to wait up to two hours, The News & Observer reported previously.

Helping the burnout situation in the medical field

In a presentation, Wake County Commissioner Matt Calabria said Wake County EMS responds to about 130,00 911 calls on average. The county estimates that 5% of those calls will be routed to nurse operators in the first year of service, or 25 to 30 calls per day. In the next year, the county expects to double the number of calls routed to nurse operators.

The program is projected to save anywhere from 25 to 30 hours daily for EMS staff who field calls, said Calabria.

“I think this system will help the burnout situation in the medical field right now, I think this will help alleviate stress in emergency situations ... because everybody’s short-staffed right now,” said UNC Rex Healthcare physician Brian Quigley. “It’s been really hard. The pandemics’ really taught us some lessons. If we’re going to take good things from this pandemic, it’s programs like this. Adapting to people’s needs and doing it in an efficient manner.”


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