Stage of Care

A community paramedic works onsite at a homeless shelter during afternoon and evening hours 4 days a week during periods when an onsite primary care clinic is not open, significantly reducing unnecessary 911 calls and connecting shelter residents to primary care.

A city fire department offers on-the-scene video consultants between emergency physicians and non-emergent 911 callers, leading to fewer unnecessary ambulance transports and emergency department visits, lower costs, more connections of patients to primary care medical homes, and more time for ambulance crews to deal with true emergencies.

Lesbian Health Initiative of Houston, Inc., creates a gateway to medical homes for lesbian, gay, bisexual, and transgender women and transgender men through a program that combines culturally competent outreach, education, screening, and patient navigation.

Three hospitals within the University of Pennsylvania Health System succeeded in changing physician behavior through a Professionalism Committee that handles cases of alleged disruptive, unprofessional behavior by a physician, as an alternative to a formal investigation under medical staff bylaws.

Community Health Access Program helps patients who call 911with nonemergent needs. The dispatcher sends a specially trained paramedic, known as an advanced practice paramedic, to the scene along with the ambulance to confirm that the patient does not need emergency care and then either provide treatment, schedule an appointment with a primary care provider, or arrange for same-day transport to a health resource center.

Virginia Mason Medical Center created a spine clinic that provides rapid, efficient treatment for uncomplicated low back pain, with the goal of allowing patients to return to their jobs and other regular activities as soon as possible.

Home telemonitoring did not improve blood pressure or blood glucose control in diabetes patients with out-of-range values.

An electronic system allows physicians at two health clinics to easily refer patients who use tobacco to a quitline and subsequently monitor their progress, leading to more clinician referrals to the quitline and enhanced access to cessation services for patients.

A health system–community partnership offers resident-initiated programs that expand access to insurance coverage, outpatient care, health education, social support, healthy foods, and opportunities for physical activity for inner-city, low-income minorities.

A culturally tailored support group helps African-American women who are victims of intimate partner violence build coping skills, leading to reductions in depressive symptoms, levels of general distress, suicidal ideation, and suicide attempts.