Beyond the Back of the Ambulance: How Paramedicine is Evolving to Fill Gaps in Care

In this episode, we sit down with Angela Sereda, a senior leader in Mobile Integrated Health (MIH) with Medavie West, to discuss the shift happening in paramedicine. Angela shares her 33-year journey from a high school athletic trainer to a leader in community-based paramedicine. We explore how paramedics are expanding their role from being a purely reactive 911 service to becoming a proactive, integrated part of the healthcare system—meeting people where they’re at with the services they need.  

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 Resources & Links

Medavie Video

Promising Practice: Medavie Community Paramedicine (Report from Health Excellence Canada)

Medavie Integrated health

Medavie Integrated Care Facility Programs

Withdrawal Management

Hospital at Home (Vancouver)

Transcript

SPEAKER_01 0:12

Hi everyone, thanks for joining me today. When most people think about paramedics, they imagine the flashing lights of a 911 emergency and a patient being rushed to the hospital. But as our guest today argues, a paramedic is not defined by the back of an ambulance. In this episode, I chat with Angela Sarita, a senior leader in mobile integrated health with MetaVee West Ambulance Service. With over 33 years of experience in the field, Angela has been a driving force behind specialized programs across Saskatchewan. Today, Angela shares her journey and explains why building community paramedicine services into our system is a key piece of connecting care for patients who are in need of services. In this model, known as Mobile Integrated Health, they focus on meeting patients where they are, whether that's in a private home, a community shelter, or a public space, to provide the right care at the right time. This approach lines with the growing movement towards health care at home, which seeks to provide care services, traditionally only provided in the hospital, directly in the patient's own environment. By focusing on how to keep and treat individuals at home rather than accessing emergency departments, mobile integrated care effectively extends the reach of the hospital into the community. A prime example of this is the Withdrawal Management Program, where paramedics provide specialized medical support and monitoring for drug withdrawal within the comfort and privacy of the patient's own space. These initiatives aim to improve patient comfort and health equity while easing the burden on hospital facilities. I enjoyed learning about this program in my conversation with Angela because I had no idea these services even existed. We need more conversations about how this model can be expanded to everyone who might need it. Here is my conversation with Angela.

SPEAKER_02 1:52

Hello. Good morning. How are you? Look at you five minutes early, like a real healthcare professional.

SPEAKER_00 2:00

Well, I I'm not always the best with technology, so I thought I'd better like get on a little bit early.

SPEAKER_02 2:06

Yeah. Yeah. Nice to meet you. Thank you for doing this with me. Well, thank you for inviting me. This will be really great. Do you know? Did I tell you who recommended you? Jen. Yes. Yeah.

SPEAKER_01 2:19

We were at a 50th birthday party. And then I was like, was there any like movers and shakers in the paramedicine field? And she was like, I got the woman for you and sent me your contact information right away. So yeah.

SPEAKER_00 2:34

Hilarious.

SPEAKER_02 2:35

That's that's funny.

SPEAKER_00 2:36

Yeah, she's a very good friend of ours. Yeah. And um uh my husband and her are starting a business, they're doing the bricks matter. What's that? It's using Lego meth methodology, yes, you know, into leadership and yeah, like Lego serious play. Yeah, yeah. They actually both went to Denmark. Okay, and did trained and they have their course. So yeah, now they're starting to get into that. So that's who you should have on next, is I should, yes.

SPEAKER_01 3:11

And you've been super busy lately, hey. Like you've had a lot of traveling and stuff going on.

SPEAKER_00 3:17

Yeah. So mobile integrated health is wherever Medivy acquires a new, like maybe 911 system. Okay. If there is community programs and they fall under the Mobile Integrated Health Division, so we have programs like we have six programs here in Saskatoon, and we have one program in Wushja, we have a program in Wadena, and now we're launching a new program in Yorkton.

SPEAKER_01 3:46

Okay. Okay. All right. Okay. So I want to hear more about that, and I'll ask you more about that to the end. Um, but at first I thought I'd get to know you a little bit more and about your journey and all the things you've done that have gotten you to this place in your career and the work that you're doing. Um, my journey started back 33 years ago.

SPEAKER_00 4:07

Uh, I was in high school and I was an athletic trainer back then. And in grade 10, um, a national wrestling competition came to our high school, and someone got hurt, and I had to phone an ambulance and I watched the ambulance come. And at that moment, that's I knew that that's what I wanted to do with my life. Wow. So I was very privileged very early on to know kind of my why, I think. Um, and so really just kind of progressed from there. I was born and raised in Regina, and then I went down to North Dakota to do all my education. So I did my EMT, my EMT advanced, and then my paramedic training in the states. And then when I came back, I had to do some challenging of the exams and things like that. And my first job in Canada was in Strasbourg, Saskatchewan. So I worked there for about a year. And then my journey took me to Yorkton. And um, I always say that was the pivotal moment of my career because I met my husband, who's also a paramedic. And from there, we have really just progressed and moved throughout the province. Uh, from Yorkton, we moved to Big River, where we were the managers of Big River Spiritwood Ambulance. And at that time, they didn't have advanced care paramedics there. Um, and my husband was a primary care paramedic. So I went with a hope and uh and faith that they promised me that they would work with me to get advanced care paramedics up in that area. And so when I moved up there, started that process of working with a health region at that time and the ministry. And within 10 months, we were able to get advanced care paramedics up in that area. So that was probably my first um big uh challenge, I think, in healthcare um was to get that. And then we were there for 10 years and we had the opportunity to move to Moosha. And so my husband became the director of operations again. I didn't have a job because they were a unionized environment. So I I could go as a casual paramedic. Uh, but then I got on in Saskatoon here at the Royal University Hospital. Um, so I would commute back and forth. So I worked as a paramedic in the emergency department while living in Musha. And then July of 2011, we had the opportunity um and we acquired Musha EMS. And so we were the new owners of Musha EMS, and we did that for 10 years. So, and then in August of 21, we really, well, before that, we really started to ask ourselves how do we want to spend the last 10 years of our career? Because we seem to work in 10-year chapters. Right. Yeah. Um, and it wasn't being an owner, it was wanting to maybe make a a difference in the system in another way. We really didn't know what that was. Um, you know, we were very successful as business owners, we had amazing staff. You know, we weathered COVID quite well with our team and but just kind of wanted something differently, I think. Um, and then we started to really look at it wasn't about just selling to anybody, it was really trying to find either someone or an organization that really matched our personal values. You know, we spent a lot of time, energy um building the company to what it was today. And so really wanted to ensure that it was going to someone right. Um, and that's really where the conversations with Medav Health Services started. And um, they really aligned with our personal core values and knew, especially in the integrated care sector of health, that they were really making some significant advancements out in Atlantic Canada and knew that they would be able to be a really great resource in our province to really expand what I had originally started in Musta into on a bigger platform. And so we sold to Medavia.

SPEAKER_01 8:54

I feel like there's a time in people's lives towards like not the end of their career, but a little bit before the end of their career where they've spent so much effort doing, and then they get to the point where they're like reflecting on the doing and how far it's gotten them or how not far it's gotten. Yeah. And then there's a real shift to people thinking about it as a system and understanding the system and knowing how that system operates and feeling like they maybe want to change it at a different level. Do you is that what you kind of experienced? Absolutely.

SPEAKER_00 9:28

Yeah, absolutely. Because we really looked at, you know, and I I talk about my husband a lot and obviously the first, you know, 30 years of my journey because we've done it together. You know, he was the 911 side, I was more of the integrated care side. Um, but we've kind of evolved and we looked at every opportunity as stepping stones, right? And it was like, where do we want our last kind of stepping stone to be? And it was on a greater system.

SPEAKER_02 9:57

Yeah.

SPEAKER_00 9:58

You know, we were able to impact our teams very well in a positive way. Um, but it was just how do we impact the system in a greater way?

SPEAKER_01 10:08

Yeah. So what was the tension or what were you feeling like needed to change or needed to shift in paramedicine that you wanted to get involved in in moving it forward?

SPEAKER_00 10:22

Really kind of looking at, you know, we're such a reactive system.

unknown 10:27

Yeah.

SPEAKER_00 10:28

And we're, you know, we're always responding to people's emergencies, you know, which is what our role has really been. But I think it's beginning to start to shift to trying to listen to understand to why are individuals accessing the 911 system. Obviously, there's um emergencies everywhere, um, and and some people need to access that system, but there are many individuals that are accessing the 911 system that maybe don't necessarily need the 911 system, but they just need some sort of access to care. And that's the only way that they know um how to access that care. Right. Um, you know, we're a 24-hour business. So of course, you know, we get that ingrained into our systems from a very early on age of doing, you know, school presentations in public, you know, if you have an emergency, call 911. But we don't necessarily even define what an emergency is to someone, and everyone defines it differently for themselves.

SPEAKER_01 11:35

So, were there things that you were seeing in Saskatchewan or across Canada that intrigued you that you could see addressing some of these issues?

SPEAKER_00 11:46

Yeah, so I, you know, I was really grateful. Um, I was in the very first intake of the uh community paramedicine advanced certificate program at SaaS Polytechnic. And that actually started in 2015. So before that, there were pockets of areas in in Canada um as well as internationally that were starting to really kind of evolve and move into this community paramedicine space. So, you know, I think what intrigued me initially was I had worked up in Northern Health Clinics uh decades before, um, and really looking at a shift of how you define a paramedic. Um, you know, uh, and really starting to change the narrative of a paramedic is not defined by the back of an ambulance. A paramedic can be in many different pathways in healthcare and offer a significant resource to the system that's, you know, if there's currently lacking different areas. So for me, it was really looking at it from an individualized approach for every individual to say, what type of care do you need? And really, I guess, embracing the equity part of it to say, you know, where do you want to see and how and where do you want to choose to receive care?

SPEAKER_01 13:19

And how do we make that happen? So, how does a community paramedic work differently than a traditional paramedic? So I would assume a traditional paramedic is basically waiting for the emergency call. They hop in their ambulance, they go, they treat, they rescue. But what's what what does a day look like for a community paramedic?

SPEAKER_00 13:40

So here within Mediv, and again, there's different pockets of community paramedicine, whether it's in Saskatchewan, across Canada, internationally, and even within Saskatchewan outside of Medavy. Um, some of the programs obviously will run different, but for ours within Mediv, um, all of the calls come in through the 911 system and they just ask to speak to the community paramedicine. So, you know, we have multiple different teams. So we have three separate community paramedic teams on that really have a different focus or mandate. So one is on withdrawal management, so mental health and addictions, one supports some facilitated discharges out of the emergency department and kind of supports the 911 low acuity calls that are coming in and are tied to our secondary triage with a nurse in our 911 center. And then we have another team that focuses with primary health care and continuing care or long-term care. So really any of those non-urgent calls can come in through our 911 system and just ask to speak to a community paramedic. And then the dispatchers just send the calls over to that team. Um, and then we respond from that point. Again, everything is non-urgent. So we work very closely with, you know, physicians, ER physicians, family physicians, nurse practitioners, anyone that needs some type of community support that maybe can't access or we don't want them to access the emergency department. Um, our community paramedics will really just go meet them where they're at within the community, whether that's their home, a shelter space, a public place. Again, wherever they want and choose to receive care, we really become quite adaptive to that and pivot to kind of meet what that individual wants.

SPEAKER_01 15:35

And are you linking them to social supports as well, or are you primarily just connecting them with medical resources?

SPEAKER_00 15:44

So I say we often act as navigators and um community paramedics, I say, is more of that seven to 10 day window where we provide support to individuals. We don't duplicate services, we're not replacing services that are currently in the healthcare system. We're there to augment and to help fill in the gaps within care. So for us, it's individuals that, you know, maybe can't access the emergency department or going to clinics, we'll go meet them there to provide that care.

SPEAKER_01 16:18

Okay. And so could you do, could you assess and give them an IV if they were dehydrated?

SPEAKER_00 16:23

We're still licensed paramedics, uh, so, but with an additional skill set of 18 months of additional training in the advanced certificate of community paramedicine. So we really dive deeper into those community-based care models. So primary health care, mental health and addictions, palliative care, geriatric care, chronic disease management. So really working on prevention and how do we keep and treat individuals at home versus accessing the emergency department.

SPEAKER_01 16:56

Angela, I'm pretty like tuned into what's going on in healthcare. And I had no idea this was. I mean, I I had heard about like a little pilot project, you know. I think Regina had heard about one when I was working on the ED weights and patient flow initiative. They were starting to build a bit of a program there, but I didn't know it was as extensive as it is and was so integrated into the system.

SPEAKER_00 17:19

Yeah, you know, it's um, we've really evolved what this model of care looks like in the province. It's pretty exciting. Um, even within Mediv, you know, really anything that is not the 911 falls within Mobile Integrated Health. So we have paramedics in Saskatoon Police Service Detention, and they're in there 24 hours a day. So there's one paramedic in there that falls under the Mobile Integrated Health Division because it's more of that connected care model. So they're um evaluating and monitoring detainees in SPS detention. But one of the unique things is when they are released, our paramedics can then connect them to further resources in the community, whether that's primary health care, whether that's actually our community paramedics on the street, whether that's mental health and addictions, whether that's maybe it's some of the social determinants of health, like food insecurity or housing insecurity, we can actually connect them to resources before they leave. So it's it's pretty remarkable how all of our teams are very interconnected together to really wrap those supports around those individuals in the community that need them. And again, for us, we have the trust of the clients and relatives that we serve. So it's really about building, continuing to build that trust and then referring them and connecting them to more long-term supports within the community because that's not us, but we'll always be there to connect individuals. Yeah, and guide them. Yeah. And, you know, we do withdrawal management, let's say, um, in the community in Saskatoon. So individuals that may relapse during that process will often automatically connect back to our community paramedics, and then we connect them back into the overall system.

SPEAKER_01 19:15

Okay. And I know, you know, from trying to do system change work, there's often some resistance or there's some a lot of work and helping people feel comfortable with this change and these new roles. What have you experienced in this journey? Um, either like in terms of people welcoming and taking up the change, or maybe people being a bit reluctant to the change?

SPEAKER_00 19:43

Uh well, change management is always um, it can be challenging at times, but it really, I think the success that we have had, and there's also been challenges, and there's still currently challenges, right? On how do we how do we ensure that community paramedics are connected into the system and are deemed as a valuable partner in the solution to what we're trying to solve. But when I look at from even frontline staff, um, I think what it is is one, the leaders within the programs need to lead by example. So I think that's the first buy-in piece. But it's also involving those closest to the work to be part of that change management. So it's really about, you know, we bring in the frontline staff anytime that maybe a new partner connects with us to say, how can we use community paramedics in our program or through a community-based program? We actually bring in the frontline workers into that design and model from the very beginning. Because I think as all as leaders, we often don't involve those closest to the work. Um, and then the change management becomes more challenging to create that buy-in, but it's a lot easier when um you bring them in right at the foundational level to start building that and building the the partnerships alongside you. I always say it makes my job as a senior leader a lot easier when staff are the face of the program and they are champions of it. Um, it makes my job easier.

SPEAKER_01 21:25

Yeah, for sure. Do you have um any stories or examples of where you've seen the model working really, really well and and staff have bought into it based on what they're seeing or the changes that they're making?

SPEAKER_00 21:40

You know, I think um withdrawal management is probably the best one. Um before we had sold to Medivh, I actually um was approached by the SHA and mental health and addictions to see how community paramedicine can support those. On the wait list getting into social detox. So this was again right around COVID time. They had heard that, you know, I had completed the community paramedic program. And really that's where the conversation started. And from there, I really worked to evolve the program. I worked in it frontline by myself for the first three months to really get a feel of it. It was the first of its kind in Canada. No other community paramedics had been doing that withdrawal management. And we call it withdrawal management. We used to call it home detox, but really from an equity standpoint, not everyone has a home. And so we really changed it to withdrawal management. So really kind of worked with our partners and many other community partners at that time on how does how will this program work? And then as new staff came on, really working alongside the staff on kind of what the vision was until they kind of understood it and had that buy-in. And then we scaled to Saskatoon. So once we um once Medavie acquired Musha, we scaled this program. And initially we were working with the Saskatoon Tribal Council on this, as they had a grant. And when that grant expired and wasn't renewed, we really looked at the value of this program and how can we continue to move this program forward. And then it this program really took on a different lens in Saskatoon, really bringing on a prescriber. So we partner with the Saskatoon Community Clinic and a nurse practitioner who works with our community paramedic teams as a prescriber. But recognizing that what worked in Wooshdaw, you can't clone and bring into Saskatoon because there's different resources, different programs and different access points. So the Saskatoon program eventually evolved and worked really closely with the RAM clinic here. So the Rapid Addiction Medicine Team. Okay. And as well as other community partners and really kind of took on just a new twist of the program, and which is where we're now under the mental health and addiction treatment space beds initiative that this program is in. So we work very closely with the SHA and the Ministry of Health on what this program looks like. And now, because of the success of that program and really building it with a frontline team here, we'll now be scaling this to Yorkton as well in the coming months. And again, utilizing the frontline workers that helped build the Saskatoon program will also be very crucial in building the Yorkton program once it gets launched. So we're taking that frontline team and putting them into Yorkton to work alongside the New Yorkton team so that they can really have some learned experiences and you know continue to be champions of the program from the outset.

SPEAKER_01 25:13

I worked with a project called Releasing Time to Care, where we did improvement work with um nursing units in all the hospitals. This was years ago. And that was our strategy, too, to use the nurses who had initially done the change work and the program to then mentor, share, coach the other groups. And it was such an effective that peer-to-peer learning is really quite powerful.

SPEAKER_00 25:40

You know, it is because it it takes down that perceived top-down approach. Um, and it's really, you know, even though I try to still work frontline, I'm not frontline every single day.

SPEAKER_03 25:55

Yeah.

SPEAKER_00 25:55

Um, and so um some of the shared learnings that they're learning, some of the challenges, successes that they've had, partners that they've engaged with, it really just becomes, you know, this is what worked for me. But you know what, let's see how this can work within your area because some of the things may be different. And I think it's just a different um willingness as well to listen to someone who does it every day versus, you know, sometimes we look at management as, well, how do you truly understand? Um you're you're not living our world. Yeah. And I think that's the uniqueness to about our mobile integrated health leadership team here that we have within Saskatoon is that we are all still licensed frontline paramedics and advanced community paramedics. So we actually will jump in with our crews quite regularly. We backfill some of the shifts if there's vacancies. So we are still very integrated in. And I think that has been a true success of our programs today.

SPEAKER_01 27:03

And how are you sort of navigating the conversations that have to happen to get these things rolling or moving or what does because often people are struggling with where do I begin? How do I start this idea or this change initiative that I have?

SPEAKER_00 27:22

Yeah, you know what? I think it's it's really again, I'm gonna go back to for us, the education of training our paramedics as a community paramedics is that one of the pieces of that education is doing their final assessment is a gap analysis. They need to pick a community and they need to do a gap analysis on everything from population to services that are being available, and how can community paramedics come into that community and be a source to help be part of the solution to some of the healthcare challenges. So once they have that, they now have a different lens. And so with them being out in the front lines, they are now able to take that training and be able to identify how community paramedics can actually be part of the solution or how we can help fill in gaps and where maybe our program, what is meant was for today, needs to pivot to adapt what the current trends or uh gaps are today. And so it's that's really being done at the front line.

SPEAKER_01 28:36

Yeah, it's almost like their education beyond just the training of the skills has really helped to shift or shape their paradigm of how they approach their work and what they see and and that appreciative inquiry kind of lens that they're looking at, their communities. Absolutely.

SPEAKER_00 28:53

And we have um frequent touch points. We'll just go into our team meetings and just have a sit down and have a coffee and ask somebody just on a random day that they're working to say, you know, how are things going? They they can approach us again at any time to say, I think we need to shift what our program looks like. And then we start to have those conversations with the right partners to kind of look at shifting. We, you know, and I think that's really important to have that mindset in healthcare. You know, how community paramedicine started in 2015 when it was specifically long-term care and how do we prevent unnecessary transports? Um, that's not the gap that's current today, you know, and we have to be constantly evolving to where the current gaps are. And our current gap today, I believe, in healthcare is primary health care and mental health and addictions. And so, how can we provide those wraparound supports with all of our teams to really work with those individuals?

SPEAKER_01 29:57

Amazing. And the what's your thinking around future expansion of the role? I'm assuming right now you're focused on sort of spreading what works. Do you have thoughts about like what the next level will look like? Or is this kind of keeping your plate full enough for now?

SPEAKER_00 30:17

Always keeping our plate full, but healthcare doesn't, um, you need to constantly evolve with healthcare. And so, you know, I always tell our teams too if if you're absolutely against change, I don't know if healthcare is for you. Absolutely. Um, because you have to continually evolve. It's healthcare is very much an individualized approach. And so we always have to be looking at how we can change how we're looking at our clients and relatives today and their families, and how are we going to maybe pivot and change that tomorrow when their needs change tomorrow, and when our healthcare system needs change tomorrow. If I could predict or would want to write the future, I think for me, paramedicine today would be an integrated practice. So right now we are very much still in a siloed approach that we are contracted out to provide a service, but we're not truly integrated into the healthcare system. And so when I say that, it is, you know, being at the table during discussions on how do we advance primary healthcare in the community. It's how do we get integrated practice where we're documenting all on the same system so that everybody can see what everybody is doing, which it ultimately is, you know, patient and client safety as well. But to me, I think that is where we really need to strive for is more of that integrated practice and not an add-on of a person. Yes.

SPEAKER_01 32:05

And that's the challenge of everything right now, right? Is how do we integrate information? How do we integrate teams? How do we integrate roles? How do we, I mean, that is the challenge of the day. Yeah. And I think, oh, go ahead.

SPEAKER_00 32:18

I was just gonna say, and I think, you know, paramedicine is um uh a very instrumental pillar in healthcare. And um, it's really starting to shift and kind of redefine what a paramedic is. Um, yes, we have the 911 response, but we also have a lot of other streams where paramedicines are, you know, impacting our communities and those that we serve in a very meaningful way, um, and have a different skill set like no other health discipline has. Yeah. And um, and so it's a unique model of care. Um, and it's a unique mobile um model of care. Yeah. Where, you know, we have to, we have to start to reenvision people not coming to us or expecting people to come to us in healthcare.

SPEAKER_02 33:11

Yeah.

SPEAKER_00 33:11

We really need to meet people where they're at at that moment and where they choose to receive care.

SPEAKER_01 33:16

Yeah, that choice is so fundamental. And I, and also that customized approach of what do you need, what matters to you, what would work best in your life and your context, and being responsive to that, but then also noticing the patterns and the trends of all of these individuals collectively, and then building supports and programs around that to address needs at a community or a population level as well.

SPEAKER_00 33:42

Yeah. And I think that's for me why I still value and prioritize working frontline. Um, I think it will one, it reinforces my why every day, but I think it also gives me an opportunity to truly listen, to understand with the clients and families and relatives that we are that we're serving so that I can maybe help lend a voice into a system, you know, that they may feel like they don't have a voice.

SPEAKER_01 34:18

Yeah. And is there any words of advice for anybody that's wanting to change the system or to push forward on something that maybe seems a little nuts right now, but would actually be like the solution for our challenges in the future? Do you have any words of wisdom?

SPEAKER_00 34:37

Well, I'd say, you know, just start small and let your work speak for itself. Um, when you keep the patient and families in the center, everything will be the right decision in the end. And that's what, you know, your work will speak for itself when it is very patient-centered. Um if we don't keep patients and families in the center, um, then it's harder to to prove, you know, the meaningful work that we have. So um I don't know. That's how change really works is um just keeping those individuals in the center. Yeah.

SPEAKER_01 35:16

And I think what I can tell from just knowing you for this last half hour is that you're really committed to relationships and building trust and being there and seeing for yourself and you know, being with your your staff and those patients and really having a deep understanding of what that world looks like so that you can offer things that fit the need. That's right. Yeah.

SPEAKER_00 35:42

You know, and I I go back to launching uh that's new program in Yorkton. It's um, you know, when we started planning it, it's you know, a significant amount of time and probably the majority of the time needs to be dedicated to community engagement. Yeah. Um, and I say that if you do community engagement right, which means bringing all of your partners and players together to listen to how this fits into their daily work and how this can benefit the patients and relatives that they're serving as well. The day you launch is seamless. Yeah, we've done all the foundational work. That's right. And so community engagement and relationships are probably the most important piece when it comes to that.

SPEAKER_01 36:32

Well, Angela, you are the exact type of person that I wanted to highlight on this podcast. The people that are doing the work every day, building those relationships, moving the system forward, being creative, thinking outside the box, understanding your role and how you can make a difference. And I just feel like there's so many people like you in Saskatchewan and across Canada that are quietly going about doing these huge things and sort of don't get the recognition for it. And I just want to thank you for all the work that you do, all the work that your teams do. I know it's really probably challenging right now with the addictions and overdose crisis that's going on. We hear about the paramedics, the work that they're doing, hundreds and hundreds of overdose calls. And um, I just personally want to thank you and all of them for everything that you're doing to support our communities and keep people healthy and adjust and change to fit the needs of our communities right now. I think it's such important work. And I'm so glad you're you're leading it.

SPEAKER_00 37:36

Oh, well, thank you. It's easy work when you have passion and when you truly listen to the stories um from clients and relatives, it's easy to show up to work um and and lend your voice to that because you know everyone has a story in life. Um, and you know, some stories take an unfortunate turn. Um, but I think that's why we all got into healthcare was to care. Absolutely, yeah. Right. Um, and I think we need to really focus on bringing caring back into healthcare because I think that's the time that meaningful change happens. Yeah, yeah, absolutely.

SPEAKER_01 38:17

Well, thank you so much for your time, Angela. That was great. I learned a lot. I really didn't know much about this at all. And I'm so glad we connected because I think a lot of people are going to be interested to hear about this role and how it's shifting and consider how it could be incorporated into their communities as well. Sure. Yeah.

SPEAKER_00 38:38

And if you want, um, we do have a website. Okay. If you just Google mobile integrated health Saskatoon, okay, all of our programs are on there. So you can actually see a little bit more any client and patient or families. We always direct them to this website because all of the access points for withdrawal management or how to connect into a community paramedic are all on there.

SPEAKER_01 39:04

Okay. Awesome. I will have that link in the show notes as well for people to get easily. Yeah, for sure. It was really nice to meet you. Yeah, you too. Thank you so much for joining me in this conversation with Angela Sarita. Did you know this was happening? I sure didn't, but I'm super excited about the possibilities of what their services can offer. So much about health system improvement is trying to close gaps, trying to connect services. This offering from Mediv is a clear innovation in addressing some of those gaps. Angela reminds us that at the heart of this innovation is seeing the patient as an individual and trying to meet a need for them and their family. That's her why, and you can see how it's driven her to make system change throughout her career. By doing what's best for patients and family and not just making a bit about what's convenient for healthcare providers, we open up a whole range of new possibilities and how we can redesign care services. If you'd like to learn more about the mobile integrated health program discussed today, check out the show notes with links to everything we discussed. And if you enjoyed this episode, please subscribe and share with a friend. You can also follow us on Shift Podcast Canada on LinkedIn or Facebook. And now it's time for another Shift Shout out. Today we are highlighting an incredible team in Montreal at St. Mary's Hospital who are tackling a major challenge. The fact that traditional emergency rooms are often not designed for the elderly. Research shows that for an older adult, spending just 12 hours in a noisy, brightly lit ER can lead to delirium, a serious state of confusion that can extend hospital stays by weeks. Even worse, for every single day an elderly patient spends in a hospital bed, it takes an average of three days to recover. The team at St. Mary's are proactively screening and assessing seniors right in the ER. Their goal is simple but transformative. Prevent the bounce back. Instead of just treating a symptom and sending a patient home, this team performs detailed intakes that look at the patient's medical history, physical strength, and how they manage at home, provides immediate interventions like fitting a patient with a walker right there in the ER so they can move safely, ensuring follow-up care is in place, faxes to family doctors, and appointments with specialists are confirmed before the patient leaves. Oh yeah, faxes. Anyways, by treating the ER not just as a place of crisis management, but as a gateway for coordinated community support, they are reducing the risk of them falling through the cracks. So a massive shift shout out to the geriatric team at St. Mary's. You are proving that with the right team and proactive approach, we can make the ER a safer place for older adults in the community. Just another creative way of working upstream in our system. So with that, remember, systems don't change unless we do. This is Shift. See you next time.