123 Setting up a new pathfinder service—peaks and pitfalls

Abstract Background Pathfinder is a team of advanced paramedics, physiotherapists and occupational therapists which responds to low-acuity 999 calls to provide alternative care pathways to hospital emergency departments. Pathfinder originated as a joint initiative between Beaumont Hospital and the National Ambulance Service (NAS). Since then, Pathfinder has been rolled out nationally with the aim of expanding the service further in the future. The geographical landscape and available acute and community services vary in each organisational context, requiring each new service to identify its needs individually. This research highlights the peaks and pitfalls of rolling out a nationwide initiative within a local context. Methods This new Pathfinder service implementation was structured using a Plan, Do, Study, Act Cycle. This included the development of structured organisational processes between the NAS and the hospital. The creation of terms of reference documents, relevant policies and a risk register to guide service implementation. The promotion and education of the service and appropriate referrals. The establishment of integration between the service and existing acute and community resources. Results A group of local stakeholders were identified and monthly operational meetings with an agreed terms of reference were set up. Relevant policies and risk registers were developed. Eleven information sessions were completed to increase awareness and to aid in discussions regarding the integration of services. Referral sources were identified, and education of the service took place through information leaflets, emails, presentations, communication and informal feedback to staff. Local referrals to Pathfinder service increased post local education by 83%. Ongoing challenges include the separate Information Technology systems and communication channels within acute and community settings. Conclusion Setting up national services within different organisational contexts requires further thought and consideration. Close working relationships and good communication with key stakeholders are essential in setting up services. Education and networking lead to increased awareness of the service and appropriate referrals.