2017 Bright Idea
County of Wake, NC
January 1, 2017
North Carolina

In 2008, Wake County EMS developed a program in which specially trained Advanced Practice Paramedics (APPs) respond alongside ambulances to select EMS call types, including mental health and substance abuse crises. If no other immediate medical care requiring the emergency department is needed, the ambulance returns to service and the APP remains with the patient to coordinate transportation and direct entry into a mental health-specific treatment facility. Patients and health-care systems are better served by APPs providing the right care at the right time at lower cost, and by ambulances and emergency departments retaining capacity to address other medical emergencies. In 2009, Wake County EMS APPs began responding to calls and providing a diverse array of novel services to the system’s ambulances and hospital systems.