Ronnie McInnis and his partner, Brittany Poulette, have been transforming healthcare delivery in the First Nations community of Eskasoni for nearly a year. Their community paramedic program is all about delivering better medical care—and comfort—right to residents’ homes. Ever since October, McInnis has made this the center of his activity. His intentions are to improve patient care and ease the burden on local emergency responders.
The program allows paramedics to assess and treat patients in their own surroundings, which contrasts sharply with traditional ambulance services that prioritize transport. On a typical day, McInnis and his team might complete three home visits. They spend all the time they need, up to four hours of undivided attention with each patient. This deeper engagement allows for a more tailored approach to patient care, enhancing ongoing monitoring and encouraging comprehensive management of health.
A New Approach to Home Healthcare
The Eskasoni community paramedic program has received substantial media attention for its capacity to deliver in-home follow-up care after discharge from hospitalization. McInnis is particularly proud of the fact that patients are less likely to return to the hospital—or need to call 911—once they start receiving at-home follow-ups. He hopes the program is a sign that the traditional house call model is making a comeback. In this way, it harkens back to the days when family medicine meant home visits.
McInnis quickly noticed the great need for support in primary care, especially here in Eskasoni. They targeted their efforts at supporting people after a recent hospital discharge. The local chief and band council are very enthusiastic about this idea. They know that a historic, rural Mi’kmaw community like Eskasoni stands to receive huge returns through this uniting, down to Earth, community building healthcare approach.
Our staff is now better prepared to respond should an emergency arise. This allows them to address a wide range of medical problems immediately, without having to expedite patients to the emergency room. McInnis explains that although their equipment is “not sexy, it’s all the stuff you need to take care of you.” This pragmatic approach allows paramedics to do triage, health assessments, and preventative work that normally would need an ambulance ride.
Building Stronger Connections with Patients
Community paramedics can be an integral component of closing the loop between patients and their access to the care continuum. By meeting patients where they are in the home, they’re able to catch problems sooner and better support patients in managing their care to avoid costly interruptions. As McInnis notes, a large portion of the people who find themselves on an emergency trip need information or guidance that doesn’t require summoning an ambulance.
They think it’s their only option. He talked about how the call is mostly focused on medication. Occasionally, it’s to relay news about new efforts underway to better prepare patients coming home from the hospital. This individualized approach greatly alleviates anxiety for patients and enables them to get treatment in the comfort of their own community.
McInnis functions as a communications conduit between patients and their doctors. If a patient isn’t improving after several visits, he can communicate directly with their doctor to discuss necessary adjustments in care. And so we decided that I should come visit them for three weeks. If I’m not noticing any changes, I’m calling their doctor up and looping them in.
Impact on Emergency Services
The community paramedic program improves patient care while easing pressure on scarce ambulance resources. By tackling urgent medical needs right in a patient’s home, we can avoid preventable calls to the emergency department. This approach reduces unnecessary wait times and overcrowding at the local emergency room. McInnis continued, “The majority of them only require information or assistance that doesn’t involve an ambulance.”
Brittany Poulette is currently out on maternity leave. In the meantime, McInnis continues to demonstrate fierce commitment to the core mission of providing high-quality, compassionate care. He summarizes his role succinctly: “To me, this is the image of what a small-town doctor does. This program is an extension of a physician in your home. As a community health worker, I’ve trained myself to be your family physician’s eyes and ears within the walls of your home. I’m here to bridge the gap between you, your community, and the healthcare system.
The efforts of McInnis and his team exemplify a significant shift in how healthcare can be delivered in rural communities, creating a more sustainable model that prioritizes patient comfort and effective care management.
