Emerging Models of Ambulatory Care
Emerging Models of Ambulatory Care
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The dramatic shift of healthcare delivery to outpatient settings is accelerating. Within three years, it is expected that revenue from ambulatory or outpatient care will nearly double the revenue of inpatient acute care for most hospital systems (Truven, 2016). This session will examine projected growth over the next decade, as derived from analytical sources. This growth is across broad specialties and in varied settings including micro-hospitals, ambulatory surgery centers, freestanding emergency departments, urgent care, and other outpatient locations. Advanced surgeries once thought to only be within the realm of inpatient acute care hospitals and involve several days of post-operative stay, are now being done on the same day with minimally-invasive techniques. This presents clear benefits as to patient experience and may limit risk of infection, but also this creates diverse challenges for the IP, such as lack of staff knowledge and insufficient resources to properly review practices. The need for oversight is highlighted by several ambulatory outbreaks in the last 40 years. Some of the earliest were Hepatitis B infections in outpatient hemodialysis patients, published in 1976. There have been many preventable transmissions of Hepatitis C due to unsafe injection practices. In addition, other organisms such as nontuberculous mycobacteria, Group A Strep, MRSA, Tsukamurella, Pseudomonas, Klebsiella, and Streptococcus salivarius have caused infections. In the past, IPs could focus efforts on one main hospital but now they may be tasked with multiple facilities spread across broad geographies. Leading larger health systems have devoted staff specifically to ambulatory or outpatient settings. APIC and other organizations including CDC, ASHE, and SHEA have developed tools and other resources to assist. This presentation will review key findings and guidance from these multiple sources.Learning Objectives:List trends and project growth in ambulatory/outpatient care across broad specialties and in varied settings.Describe the typical patient profile, procedural capabilities, physical environment, and staffing structure of these locations and their relationship to traditional hospital systems.Identify strategies, best practices, and practical tools to support patient safety for IPs working in these new settings.
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