ED staff, paramedics work to reduce readmits.

Duke Raleigh Hospital's emergency department staff and the county's team of advanced practice paramedics work together to prevent readmissions among patients who are high utilizers of the healthcare system. Working with Medicaid managed care organizations, the team has developed care plans to help get at-risk patients the right care at the right place. The team involves the patients in setting goals and creating the care plans. The paramedics assess the home situation and psychosocial needs and alert the hospital's case management staff.