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What is an Ambulatory Care Setting?

An ambulatory care setting is a healthcare facility that provides outpatient services to patients who do not require admission to a hospital. Ambulatory care centers are designed to provide timely, cost-effective, and coordinated care, focusing on preventive services and managing chronic conditions. Examples of mobile care settings include clinics, urgent care centers, outpatient surgery centers, diagnostic centers, and physician offices. Here are some examples of ambulatory care settings:

• A primary care physician’s office, where patients can go for regular checkups, vaccinations, and treatment of minor illnesses and injuries.
• An urgent care clinic that treats non-emergency illnesses and injuries, such as sprains, strains, and infections.
• An ambulatory surgery center, where patients can have minor surgeries, such as cataract surgery or knee arthroscopy, without having to stay overnight in a hospital.
• A hospital outpatient department, where patients can go for follow-up appointments after a hospitalization or to receive specialized care, such as cancer treatment or physical therapy.
• A community health center that provides healthcare services to low-income and uninsured patients.
• A school-based health clinic that provides healthcare services to students.
• A telehealth clinic that provides healthcare services to patients using video conferencing or other telecommunications technology.

What types of services do these centers provide? 

Some standard services ambulatory care centers provide include blood tests, biopsies, x-ray imaging, CT scans, ultrasounds, colonoscopies, mammograms, minor surgical procedures, radiation treatments, and chemotherapy. Such a wide array of services strikingly stretches across multiple healthcare focal points, from overall wellness to diagnoses and treatments; these centers undeniably provide many essential life-saving health services.

Ambulatory wellness services are meant for prevention and primary medical care. These are services mainly associated with visits to physician-run clinics, such as one’s primary care doctor, mental health counseling resources, and weight loss centers.

Outside of prevention, the importance of diagnostic services, such as x-rays, patient lab work, MRIs, etc., are invaluable for early screening, detection, and thus treatment of various illnesses. These treatments can range from same-day surgeries at designated ASCs, to cancer-fighting chemotherapies at specialized clinics and substance abuse counseling and rehabilitation.

However, such rehabilitation services do not stop at the gates of substance abuse. Ambulatory care centers often include many rehabilitation-focused services, including postoperative therapies and occupational and physical therapy. And with the rise of technological advancements and telemedicine, many of the services provided by ambulatory care are more accessible than ever before.

Some of the most common services provided by ACCs include:

• Preventive care: ACCs can provide routine checkups, immunizations, and screenings for chronic diseases such as diabetes, hypertension, and cancer.
• Acute care: ACCs can treat minor illnesses and injuries, such as colds, flu, and cuts.
• Chronic disease management: ACCs can provide ongoing care and support for patients with chronic diseases such as diabetes, heart disease, and arthritis.
• Diagnostic services: ACCs can perform a variety of diagnostic tests, such as blood tests, imaging studies, and biopsies.
• Minor surgical procedures: ACCs can perform a variety of minor surgical procedures, such as cataract surgery, colonoscopy, and knee surgery.

Ambulatory Care vs Acute Care 

Ambulatory care differs from acute care in that critical care is provided to patients who require hospitalization for a severe or life-threatening condition. Acute care focuses on diagnosing, treating, and managing acute illnesses or injuries. In contrast, ambulatory care is focused on providing preventive care, managing chronic conditions, and addressing minor acute diseases or injuries.

What is Ambulatory Surgical Care? 

Ambulatory surgical care, also known as outpatient or same-day surgery, refers to surgical procedures that do not require an overnight stay in a hospital or other inpatient healthcare facility. Instead, patients receive surgical care in an ambulatory surgery center (ASC) or other outpatient surgical facility and return home on the same day as their surgery. ASC documentation requirements are crucial in this setting to ensure that all procedures, patient interactions, and billing processes are accurately recorded and compliant with relevant regulations.

Ambulatory surgical care is used for a wide range of surgical procedures, including diagnostic tests, minor surgeries, and some significant surgeries that can be performed safely on an outpatient basis. Examples of operations that may be performed in an ASC include cataract surgery, hernia repair, and knee arthroscopy.

Ambulatory surgical care is generally preferred over inpatient surgery for several reasons. It is often less expensive than inpatient surgery since it does not require an overnight stay or the use of other inpatient resources. Additionally, ambulatory surgery centers often provide a more comfortable and convenient patient setting, shorter wait times, and more personalized care.

However, not all patients are candidates for ambulatory surgical care. Patients with certain medical conditions or who require more complex surgical procedures may require inpatient surgery in a hospital or other inpatient healthcare facility. Healthcare providers will evaluate each patient’s needs and medical history to determine the most appropriate setting for their surgical care.

The Connection Between Ambulatory Care and Chronic Disease Management

Chronic diseases are the leading causes of death and disability in the United States, accounting for 70% of all deaths and 86% of all healthcare costs. Ambulatory care is critical in managing chronic diseases and providing patients with access to preventive care, screening, and treatment.

How does ambulatory care support chronic disease management?

Ambulatory care providers (ACPs) can provide a variety of services to help patients manage their chronic diseases, including:

• Preventive care: ACPs can help patients identify their risk factors for chronic diseases and develop plans to reduce their risk. This may include recommending lifestyle changes, such as quitting smoking, eating a healthy diet, and exercising regularly.
• Screening: ACPs can screen patients for chronic diseases, such as diabetes, hypertension, and cancer. Early detection is essential for effective treatment and management of chronic diseases.
• Treatment: ACPs can treat chronic diseases with medications, lifestyle counseling, and other therapies. They can also coordinate care with specialists and other healthcare team members.

Statistics

• Chronic diseases account for 70% of all deaths and 86% of all healthcare costs in the United States.
• Ambulatory care settings account for over 80% of all healthcare visits in the United States.
• Patients with chronic diseases make up the majority of ambulatory care visits.
• Ambulatory care can provide many benefits for patients with chronic diseases, including improved access to care, continuity of care, patient-centered care, and reduced costs.

What is an Ambulatory Care Pharmacy?

An ambulatory care pharmacy is a specialized pharmacy that provides medication management services to patients in an ambulatory care setting. This may include medication therapy management, reconciliation, and patient education on proper medication use. Ambulatory care pharmacies also work closely with healthcare providers to ensure patients receive safe and effective medication regimens.

Which Category is Used to Report Services for Patients Seen in Stand-Alone Ambulatory Care Centers?

Healthcare providers and facilities must use the appropriate Category of Service (COS) code to accurately report the services provided when submitting claims for reimbursement for services provided in stand-alone ambulatory care centers. This ensures that claims are processed correctly and that patients receive the appropriate refund for their healthcare services. COS code 49 is used for ambulatory care centers not associated with a hospital or other inpatient facility, including freestanding clinics, urgent care centers, and other outpatient healthcare facilities. Using the correct COS code distinguishes these services from services provided in hospitals or other inpatient facilities, which are reported using different COS codes.

Benefits of Ambulatory Care

Ambulatory care benefits patients, healthcare providers, and the healthcare system. These benefits include improved access to care, reduced healthcare costs, increased patient satisfaction, and better management of chronic conditions. Ambulatory care also helps reduce the burden on hospital emergency departments by providing more appropriate care for patients with minor acute illnesses or injuries.

Which Organization (s) Accredit Ambulatory Care and Physician Office Settings?

In the United States, several organizations accredit ambulatory care and physician office settings. These organizations help to ensure that these facilities meet certain quality and safety standards in their patients’ care. Some of the major accrediting organizations for ambulatory care and physician office settings include:

1. The Joint Commission is the largest accrediting Organization for healthcare facilities in the United States. The Joint Commission offers accreditation for various healthcare settings, including ambulatory care and physician office settings.
2. Accreditation Association for Ambulatory Health Care (AAAHC): This Organization focuses on accrediting ambulatory healthcare facilities. The AAAHC has been accrediting ambulatory care facilities since 1979 and has certified thousands of facilities across the United States.
3. National Committee for Quality Assurance (NCQA) accredits physician practices and medical homes. The NCQA focuses on ensuring that these practices provide high-quality, patient-centered care.
4. American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) accredits ambulatory surgery facilities. The AAAASF ensures that these facilities provide safe, high-quality surgical care.
5. Healthcare Facilities Accreditation Program (HFAP): This Organization is one of the oldest accrediting organizations in the United States and offers accreditation for a wide range of healthcare facilities, including ambulatory care and physician office settings.

These accrediting organizations use various standards and criteria to evaluate and accredit healthcare facilities. Their accreditation is widely recognized as a mark of quality and safety in the healthcare industry.

Who is behind ambulatory care?

So, now that the “What” behind ambulatory care has been established, it will be pretty beneficial also to show the “Who” behind such care. Ideally, ambulatory care centers, such as ambulatory surgical centers (ASCs), are managed by highly-trained professional health personnel, including nurses, physicians, radiographers, administrators, and health technicians. Not only must professionals oversee the practice of the life-saving medicine their patients need, but they must also keep an ambulatory care-centered practice running smoothly to do so. Consequently, running a thriving ambulatory care center is not without its challenges.

What Would Nursing Function be Most Commonly Found in an Ambulatory Care Facility?

In an ambulatory care facility, nursing functions can vary depending on the type of facility and the services provided. However, some of the most common nursing functions found in ambulatory care settings include the following:

1. Patient Assessment: Nurses in ambulatory care facilities often perform initial assessments of patients, which includes taking vital signs, reviewing medical history, and documenting current symptoms. This helps providers make an accurate diagnosis and develop a treatment plan.
2. Patient Education: Ambulatory care nurses are critical in educating patients about their health conditions, medications, and self-care practices. They provide information on preventive measures, lifestyle modifications, and how to manage chronic conditions.
3. Medication Administration: Nurses in ambulatory care facilities are responsible for administering medications to patients, ensuring correct dosages, and monitoring for any adverse effects.
4. Coordination of Care: Ambulatory care nurses collaborate with other healthcare professionals, including providers, pharmacists, and social workers, to ensure patients receive comprehensive and coordinated care.
5. Patient Follow-up: Nurses in ambulatory care settings often follow up with patients to monitor their progress and adjust treatment plans as needed. They may also schedule appointments, order tests, and refer patients to other healthcare providers if necessary.

Common challenges within ambulatory care and potential solutions

It is essential to address the common challenges one might encounter within ambulatory care, as they will often affect both those providing service and those on the receiving end, creating the problem of patient risk. Some recurrent hazards that affect patient safety in ambulatory care settings include diagnostic testing errors, medication mistakes, and security-related incidents.

Patients can experience several negative consequences due to diagnostic testing errors, such as missed or delayed (potentially life-saving) diagnoses, delayed interventions, and duplication of services. Another common yet unnece sary source of mistakes in ambulatory care is the prevalence of medication errors, which can occur both in prescription and maintenance.

Luckily, all of these errors and the subsequent challenges they create for an ambulatory care center can be prevented and solved through the emergence of advanced managerial technologies, such as EMRs (electronic medical records), meant to streamline such processes to take the error out of humans, resulting in safer and more efficient patient care. One such cutting-edge technology is the unique, autonomous, and user-friendly EMR known as Ambula. Unlike traditional, outdated EMRs, Ambula’s unmatched customization features, such as the modern form builder and distinctive workflow designer, allow users to completely tailor the workflow of an ambulatory practice to meet the specific needs each specialty requires to treat their patients effectively.

To limit diagnostic testing errors, an ambulatory care center should consider some of the following preventative measures, all of which Ambula’s EMR can aid in achieving:

1. They are setting up decision support tools to help clinicians order appropriate tests.
2. We are organizing guidelines for standard operating procedures, such as specimen collection, preparation, and delivery.
3. It establishes processes for communicating test results, such as a chain of command with reporting provisions and a hierarchy of task delegations. All of these measures can help prevent life-threatening errors in a center.

Some preventative methods meant to reduce medication errors that Ambula’s EMR can assist with include tasks such as:

1. We identify priority areas for medication safety improvements, such as medication-event reporting and education.
2. It establishes procedures that feature the best practices for each phase of the medication management process.
3. I am organizing and solidifying the management processes for high-alert medications, such as chemotherapy drugs, including storage and administration outlines.

The benefits of Ambula’s customizable EMR options go beyond preventing and minimizing common practice errors and deepening the real-life, everyday effects that save lives. To learn more about how Am ula can improve the efficiency and ease with which one’s ambulatory care practice runs, please get in touch with the Ambula Healthcare team at (818) 308-4108.