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By Elijah McKee

Photo: CC via Bing

July 15, 2022 (El Cajon) — It is no secret that 9-1-1 medical calls are sometimes not placed for life-threatening emergencies — yet for lack of any other system, those moments are often forced to be treated with urgent responses, such as ambulance rides to emergency rooms. 

Such has been the case in El Cajon, but residents there will soon have another option for medical care. After approval from the San Diego County of Emergency Services on June 24, the City may now move forward with a one-year Nurse Navigator Pilot Program that will refer appropriate callers to a triage nurse line instead of 9-1-1 dispatch. 

Steve Swaney, Fire Chief at Heartland Fire and Rescue, estimates about 20 percent of calls to their 9-1-1 dispatcher will now go through the 24/7 Nurse Navigator program, or roughly 3,500 callers. 

“Now they get the appropriate care,” said Swaney in an update given to the El Cajon City Council at their July 12 meeting. “They can get into a doctor’s appointment — because they’ll allocate some slots for us — and get them the care that they need instead of ending up at the ER.” 

Mayor Bill Wells and Councilmember Gary Kendrick were absent, but the other three councilmembers were in agreement that dispatching the correct level of resources to callers is vital. 

They unanimously approved $300,000 to be spent on the pilot program, covering the setup of the connection to the call center and a 90-day implementation period, and essentially subscribing to a certain number of calls with them. 

Yet in the long run, the program will provide some buffer and savings to the City on things like increasing demand for new ambulances, fire trucks, and staff, plus their contracts with emergency teams like American Medical Response.

“Instead of having a fire truck and an ambulance respond to a call that is not life threatening, we can triage it through this nurse,” reflected Councilmember Phil Ortiz. “And they can dig a little bit deeper as to what are the symptoms, what’s going on.” 

The redirect is in no way a refusal of responding to dire or painful medical needs — but under the program, certain 9-1-1 callers who would benefit more from care in a non-emergency healthcare setting will be able to follow that route, improving both their quality of care and streamlining the abilities of emergency responders. However, participation is optional, and no one will be turned away from emergency services if they so choose. 

“The long-term goal is to improve the patient's long-term health care literacy, reduce their reliance on 9-1-1 for non-emergency needs, and improve their health outcomes by facilitating their access to primary care,” states the City’s staff report.

The nurses will be based at a call center in Texas run by Access2Care, a branch of Global Medical Response focused on innovating the delivery of medical care. No other California City has used Access2Care’s Nurse Navigator program. 

Through the Access2Care triage system, nurses deliver “the right resource at the right time, in the right setting to achieve the right outcome at the right cost,” according to their website.

Using local protocols and physician’s guidance, this team can learn more about what people are experiencing and guide them to the appropriate level of care, even by setting up transportation to services using a rideshare app like Uber or Lyft. 

Indeed, Councilmember Michelle Metschel saw the impact of people’s lack of transportation during her time as an EMT. 

“Not to denigrate that person for not having transportation, but you take a unit out of service to take a person to an emergency room for something that could have been taken care of in clinic,” she said as she voiced her support for the program. 

“It leaves our paramedics and our EMTs to do a higher level of care,” she continued. “Versus these low-level calls constantly going, because they will burn you out.”

Councilmember Steve Goble also noted that Heartland Fire and Rescue is a Class 1 ISO agency, meaning they are rated in the top one percent nationally by the Insurance Services Office. “If anyone can pull this off, you can,” he said encouragingly. 

To learn more about the program, visit www.access2care.net/services/nurse-navigation

“I think this is an excellent benefit to the citizens,” affirmed Councilmember Metschel. “You’re going to get better care.” 

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