ASSESSING PARAMEDICS' PERSPECTIVES ON AN EMERGENCY DEPARTMENT VIRTUAL OBSERVATION UNIT FALL PREVENTION PROGRAM.

Introduction: Falls are the leading cause of fatal and nonfatal injury for older adults. We created the Emergency Department Virtual Observation Unit (EDVOU) to provide observation level care for older ED patients in their homes and better assess their fall risks. Mobile integrated health (MIH) paramedics visited patients' homes where they conducted a multicomponent fall evaluation and facilitated an emergency medicine telemedicine consult. We aimed to understand paramedics' experiences in our EDVOU Fall Program. Methods: We conducted a qualitative study through semi-structured interviews of EDVOU Fall prevention paramedics to determine how comfortable they were with implementing the EDVOU fall program. Interviews were transcribed, independently reviewed by multiple team members, and subsequently coded into themes. Results: Fifteen of thirty-six (42%) paramedics were interviewed. Three main themes emerged: 1) learning new skills otherwise not included in paramedic training, 2) having unique perspectives and interactions with patients in the home environment where most other clinicians do not have insight, and 3) being more integrated in a team to play a bigger role in patient care. Discussion: MIH paramedics had an overwhelmingly positive experience with the program. Paramedics felt they played a pivotal role in fall prevention, as the program allowed them to learn more skills, form and share unique relationships and clinical perspectives given their role, and feel more valued as part of a patient team/care continuum. Paramedics' unique role of entering the home to provide medical care are an untapped resource in preventative care, particularly as part of a virtual fall program.