Colo. city, AMR launch emergency nurse navigation program

Boulder's plan for lower acuity calls resembles those in several other states and is expected to reduce the city's call volume by 8% to 10%


Deborah Swearingen
Daily Camera

BOULDER, Colo. — As of about midday Tuesday, people who call 911 in Boulder will have access to a new emergency nurse navigation program.

The program, a partnership between the city and American Medical Response, is largely meant to ensure people are receiving the appropriate type of care, instead of being sent to the emergency room in an ambulance regardless of their situation.

Boulder is the first community in Boulder County to implement such a program into its 911 systems. Similar programs are in place in 10 other states as well as Washington, D.C.

Here's how it works:

A person calling 911 will initially speak with a dispatcher, who may opt to transfer them to a Colorado state licensed nurse for assessment.

The nurse navigator could recommend a variety of next steps, including a virtual visit with a board-certified emergency physician, home health suggestions to best meet a patient's need or a non-ambulance transport to a non-emergent local health care provider. The nurse will make recommendations based on a person's insurance coverage.

This does not affect people who call 911 with true emergencies. For example, anyone who calls in to report having trouble breathing or chest pain or an injury from a fall, a seizure, heart attack or severe allergic reaction will continue to be sent an ambulance and a Boulder Fire-Rescue engine.

However, if the dispatcher determines the call is less critical, the person will have the option to instead speak with a nurse navigator.

"The emergencies are still going to be handled as emergencies. This kind of handles what we term lower acuity type calls," Boulder Fire-Rescue's EMS Administrator Jenna Steege said.

Ultimately, the patient benefits from more direct communication and care that can save them time and money and it will reduce Boulder's call volume, potentially by 8 to 10%, Steege said.

The new service is exciting for AMR too.

"AMR has proudly served the community of Boulder for 10 years," Brittany Buss, operations manager of AMR Boulder, stated in a city news release about the program.

"Our partnership with the city is important to us, as is being able to enhance our services and care to area residents through the launch of the nurse navigation program. Together we will ensure that every patient reaches the right level of care while simultaneously making our EMS system more efficient and effective."

In making the decision to begin the program, Boulder considered data from other cities that have started similar programs. It's helpful to have a framework and information from others to go on as the program evolves.

"It's not reinventing the wheel, (but) it's really tailoring it to our community," Steege said.

According to Steege, one piece of data indicates that 20% of those who use the program reported being satisfied with medical advice from a registered nurse and ultimately did not require a medical visit at all.

"It was a no-brainer for us that it would be a really good thing to implement here in our community," she said.

Some people with mobility issues call 911 because they're unable to get to a doctor without transportation assistance. The new emergency nurse navigator program can help with that since the nurse will now have the ability to call an Uber or Lyft for a person to get to and from the doctor's office.

Additionally, the nurse navigator team with AMR will call the patients back to ask how the person is doing and whether their experience using the program could have been better.

"Normally, that's something that's kind of difficult to capture," Steege said. "If there are problems, we'll know about the problems too."

Boulder is hopeful the program will reduce its emergency response call volume while saving people time and money along the way. However, no one will be forced to use the program. If people feel more comfortable with an ambulance ride to the hospital, that remains an option, Steege confirmed.

Additionally, people are reminded that the service is not an advice hotline. People calling 911 should do so if they are experiencing an emergency. A trained dispatcher will determine whether a person might be better suited with a nurse navigator. And if a nurse navigator determines there is, in fact, an emergency, they can always dispatch a team of first responders.

The emergency nurse navigation program service begins on Tuesday. A nurse navigator will be available all day, every day. There is no additional cost to the city or community members as the service is part of the agreed-upon terms of AMR being the contracted ambulance provider for the city.

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McClatchy-Tribune News Service

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