SWIFT delivers care beyond the hospital walls

By Leslie Feldman

A vision rooted in community need

Established in 2017, the SWIFT program was developed through a partnership between TidalHealth Peninsula Regional and the Salisbury Fire Department, with TidalHealth’s Community Wellness team playing a central role in shaping and sustaining the program.

The idea for SWIFT emerged when community paramedic David Phippin recognized a troubling pattern while responding to 911 calls. Many of the same individuals were calling repeatedly — not because of true emergencies, but because they lacked access to basic supports. 

“They needed more than a trip to the ED. What they truly needed were safe, stable housing, transportation, food, utilities and healthcare access,” said Katherine Rodgers, EdD, MPH, director of community health initiatives and population health management at TidalHealth. “This insight aligned closely with TidalHealth’s focus on addressing social determinants of health, leading to the development of an innovative mobile integrated health model that treats the whole person, not just the immediate medical concern.”

Reducing emergency use

SWIFT was designed to reduce unnecessary use of 911 services and the Emergency Department by addressing people’s medical and psychosocial needs.

Through the program, TidalHealth’s Community Wellness team supports adults who frequently rely on emergency services for low-acuity medical needs, often due to barriers such as limited transportation, financial challenges or lack of access to primary care.

“Rather than defaulting to Emergency Department visits, SWIFT focuses on prevention, stabilization and connection to ongoing care, helping participants access the right services at the right time,” Rodgers said.

A TidalHealth-led, interdisciplinary care model

SWIFT is powered by TidalHealth’s Community Wellness Department and features a highly collaborative, interdisciplinary team that includes:

• Nurse practitioners
• Registered nurses
• Community health workers
• Social workers
• Salisbury Fire Department paramedics

Together, the team works to connect participants to primary care, behavioral health services, chronic disease management, medication support and critical social services such as housing, transportation, food assistance and utility support.

Clinical oversight and administrative leadership are provided by TidalHealth leaders, ensuring the program is fully integrated into the health system’s broader population health strategy.

Building trust, creating lasting change

One of SWIFT’s greatest strengths is its relationship-based approach. Team members invest time in building trust with participants who are often individuals who have experienced fragmented care or difficulty navigating the health system.

“The team builds trust with participants over time by showing up, meeting them where they are and helping them get the support they need to stay well,” Rodgers said. 

This consistency allows TidalHealth practitioners to address underlying conditions and social needs that, if left unmet, often result in repeated emergency calls and hospital visits.

Expanding TidalHealth’s reach

In 2021, TidalHealth expanded SWIFT’s capabilities by adding a part-time nurse practitioner and a full-time paramedic to respond in real time to low-acuity 911 calls.  This expansion enables the team to treat patients on scene, reduce unnecessary emergency department transports, and enhance the overall patient experience while preserving critical emergency resources.

The team is stationed at the Salisbury Fire Department and is equipped with starter packs of prescription medications, advanced wound care materials, point-of-care laboratory testing and other clinical resources to address a wide range of conditions typically managed in primary or urgent care settings. 

“Collaboration with the Salisbury Fire Department, including strong buy-in from fire and EMS crews, has been essential to the program’s ongoing success,” said SWIFT Nurse Practitioner Aaron Sebach, Ph.D., DNP, MBA, AGACNP, FNP, CNE, CNEcl, SFHM, FNAP, FAANP.

Measurable outcomes, meaningful impact

In 2025, the Salisbury Fire Department had 81 opioid-related calls, down from 92 in 2024, Salisbury Fire Chief Rob Frampton told the Salisbury City Council in a presentation earlier this year.

While SWIFT is not focused on opioid overdose response, it has demonstrated measurable success in improving care access and reducing strain on the health system.

Program data consistently shows:

• Increased access to primary care
• Improved post-discharge follow-up
• Reductions in Emergency Department visits, inpatient admissions and readmissions
• Increased referrals to social and community-based resources

“These outcomes reflect TidalHealth’s commitment to delivering high-quality, compassionate care that extends beyond hospital walls,” Rodgers said.

Looking ahead

Today, SWIFT is an approved Maryland Institute for Emergency Medical Services System, or MIEMSS, Mobile Integrated Health – Community Paramedicine Program and a cornerstone of TidalHealth’s Community Wellness initiatives. The organization is actively working with EMS partners in surrounding areas to explore opportunities to scale the SWIFT model and bring this innovative approach to additional communities across the region.

By addressing medical needs and social drivers of health together, TidalHealth’s SWIFT program demonstrates how health systems can lead meaningful change — one patient, one visit and one relationship at a time.

Leslie Feldman is a seasoned content strategist specializing in healthcare systems, with a passion for crafting patient-centered, clinically accurate and impactful content. With extensive experience bridging the gap between medical expertise and audience engagement, Feldman helps healthcare organizations communicate complex information clearly, building trust with patients and practitioners, and driving meaningful health outcomes.