Health Care and Ambulatory Care

Ambulatory care or outpatient care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technology and procedures even when provided outside of hospitals.

According to Modern Healthcare magazine, there is a new trend toward building medical facilities that focus on treating and releasing patients on an ambulatory basis. One of the big drivers of the trend toward bedless hospitals is cost. Under pressure from insurers and consumers, hospital systems have been shifting to lower-cost outpatient care, from which they generally earn higher margins than inpatient care.

But a lot of this also is driven by consumer demand and the evolution of technology. Many health systems are forgoing traditional hospital expansions and building free-standing emergency centers away from main hospitals. More details about this topic are located at this site: http://www.modernhealthcare.com/article/20150912/MAGAZINE/309129973 .

Patients do not stay overnight in the facility, according to the Virginia Department of Health. The term "ambulatory care" encompasses a large variety of healthcare settings that include but are not limited to physician offices, urgent care centers, dialysis facilities, ambulatory surgical centers, cancer clinics, imaging centers, endoscopy clinics, public health clinics, and other types of outpatient clinics. Information and studies are available at this website: http://www.vdh.virginia.gov/epidemiology/surveillance/hai/ambulatory.htm .

According to Healthcare Design, the prospect of this greatly expanded customer base, along with a focus on wellness and incentives to deliver care more efficiently, has U.S. hospitals and health systems looking at how and where they treat patients who will be more actively engaged in their own health and well-being.  Going to where the customer is—out in the community—is a primary strategy that has hospitals and health systems around the country busily forming networks of ambulatory care centers, physician practices, and urgent care centers.

To attract patients who will have a number of choices for where they receive their healthcare, providers are also upgrading facilities to support a new model of delivery that will rely heavily on technology and teamwork. Details on this topic are located at this site: http://www.healthcaredesignmagazine.com/article/ambulatory-care-centers-make-their-move .

A body of research dedicated to patient safety in ambulatory care has emerged over the past few years. These efforts have identified and characterized factors that influence safety in office practice, the types of errors commonly encountered in ambulatory care, and potential strategies for improving ambulatory safety, according to the Patient Safety Network.

Ensuring patient safety outside of the hospital setting poses unique challenges for both providers and patients. A new model for patient safety in chronic disease management, modified from the original Chronic Care Model. This model broadly encompasses three concepts that influence safety in ambulatory care:

·         The role of patient and caregiver behaviors

·         The role of provider–patient interactions

·         The role of the community and health system

Part of the overview of ambulatory care includes the quality of patient safety both during and after treatment. Improving outpatient safety will require both structural reform of office practice functions as well as engagement of patients in their own safety. While Electronic Health Records (EHRs) hold great promise for reducing medication errors and tracking test results, these systems have yet to reach their full potential.

Coordinating care between different physicians remains a significant challenge, especially if the doctors do not work in the same office or share the same medical record system. Efforts are being made to increase use of EHRs in ambulatory care, and physicians believe that use of EHRs leads to higher quality and improved safety. Tools to help track and improve patient quality of life and treatment options during and after release need continual review for efficacy and improvement.

Patient engagement in outpatient safety involves two related concepts: first, educating patients about their illnesses and medications, using methods that require patients to demonstrate understanding (such as "teach-back"); and second, empowering patients and caregivers to act as a safety "double-check" by providing access to advice and test results and encouraging patients to ask questions about their care. Success has been achieved in this area for patients taking high-risk medications, even in patients with low health literacy at baseline. More detailed info is located at this website: https://psnet.ahrq.gov/primers/primer/16/patient-safety-in-ambulatory-care .

According to the US Bureau of Labor Statistics, industries in the Ambulatory Health Care Services subsector provide health care services directly or indirectly to ambulatory patients and do not usually provide inpatient services. Health practitioners in this subsector provide outpatient services, with the facilities and equipment not usually being the most significant part of the production process. If  you are considering a career in ambulatory care, this site provides an in-depth overview of that trend in healthcare as well as the growth potential: http://www.bls.gov/iag/tgs/iag621.htm .

Additionally, the Accreditation Association for Ambulatory Health Care (AAAHC) was founded in 1979 to: "encourage and assist ambulatory health care organizations to provide the highest achievable level of care for recipients in the most efficient and economically sound manner. The AAAHC accomplishes this by the operation of a peer-based assessment, consultation, education and accreditation program." If you are a patient in an ambulatory medical facility, you’ll want to know if that location and its staff are part of this organization. More information on the AAAHC is found at this website: http://www.aaahc.org/about/history/ .

Ambulatory care is getting more traction in the medical community due to changes in the overall healthcare environment. Ease of access, quality of care, and cost are contributing factors to its growth in locations and popularity. Although not a complete answer to all medical needs, ambulatory care helps cut the expense of unnecessary inpatient medical care.  

Until next time.