community paramedics instead of home care nurses?

Any thoughts on why AHS would have laid off 200 home care nurses last year and coincidentally started a community paramedic program? It sounds like they are doing home care nursing to me. See below for the article:

Program brings care to Calgary seniors, prevents ED visits

December 16, 2013

Community paramedics made nearly 1,500 home visits in past year

Glad Bury is grateful that house calls are not a thing of the past. When the 85-year-old Calgary woman was discharged from the Peter Lougheed Centre earlier this year, she returned home knowing her chronic conditions would still be closely monitored without having to step outside her front door.

Bury is one of hundreds of Calgary seniors who have received medical care by specially trained paramedics as part of Alberta Health Services' Community Paramedic Program, which launched in the city one year ago.

"The care I received from the paramedics who treated me was superb," says Bury.

"They were able to do many of the things I otherwise would have had to go to the doctor for, like getting my blood taken or making sure I'm getting the right medications. But perhaps more important, the paramedic gave me confidence everything was under control and I wasn't alone."

Ten specially trained paramedics within the Calgary-based Community Paramedic Program made 1,480 trips to seniors' homes over the past 12 months. Most of those trips were for the treatment of conditions such as infections, breathing problems or pain management that, if left untreated, would likely have required a visit to an emergency department.

"The Community Paramedic Program delivers mobile health care before emergencies begin. Community paramedics do that by providing patient-focused care in a home setting which reduces EMStransports and emergency department and hospital admissions," says program operations manager Ryan Kozicky.

"By bringing care to patients who have difficulty accessing traditional primary care services, we are providing a service that prevents serious issues before they arise."

Referrals are made by family physicians, specialty clinics, and caregivers primarily for seniors living in supportive living facilities, community lodges and at home.

The Complex Chronic Disease Management Clinic at the Peter Lougheed Centre referred Glad Bury to the program.

Dr. Ian Scott, the clinic's lead physician, worked with the paramedics providing care to Bury.

"The advanced assessments and specimen collection performed by the paramedics allowed us to add and adjust medication, and obtain lab results while the patient remained at home. They administered an injection she otherwise would have had to travel to receive," says Dr. Scott.

"Collaboration with the Community Paramedic Program was an invaluable extension of the work our clinic normally does in supporting the health needs of many complex clients."

Treatments provided by community paramedics include electrocardiograms (ECG), vital sign monitoring, blood collection, administering oral and IV medication, providing wound care and focused assessments, all under the medical direction of a physician.

In addition to their past training and experience, these specialized paramedics also undergo six additional weeks of classroom training, followed by a four-week practicum with nurse practitioners in supportive living facilities.

Ty Eggenberger, one of the community paramedics who cared for Glad, says working as a community paramedic is very rewarding.

"It lets me bring in-depth care to my patients that is not possible as a traditional paramedic," he says. "I am able to spend more time with them to provide thorough assessments, treatments and followup care. Treating health conditions before they result in a trip to the emergency room is less stressful for my patients and their families."

Community paramedics are not part of the traditional Calgary Metro EMS fleet. They travel in SUVs that carry the equipment and medications they need but do not have lights or sirens and cannot transport patients.