Facility Research and Selection Term Paper

Facility Research and Selection

The report describes the facilities, need and services offered in an Ambulatory Care Clinic.

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Health practitioners should expect some very dramatic changes in the area of ambulatory care within the next decade. Driven by different factors, which include double digit improvement in some major outpatient areas, health care managers should expect the trend that began in the 80s to continue. The issue of ambulatory care is now a major issue for health care providers. A lot of health care institutions experienced some growth, spanning double digit in major outpatient sectors and significant changes in some major inpatient services to the modes of outpatient only. Hospitals are expected to adopt a new philosophy and plan of action for system redesign, carrying out a scrutiny of the traditional way of making the needed care available with the aim of surviving in the future. While these hospitals keep experiencing significant growths in ambulatory services, the financial viability of most of the programs in the future will still play an integral role.

The profitability of ambulatory care depends mainly on the large visit and procedural volume. The operating margins are quite slim when compared to the returns inpatient admissions generated. The average charge for procedures falls below $200 for each patient, as compared to the $5,000 average charge for each severe care admission. This fact emphasizes a situation which many providers will face in the future. Prior to recent times, all payments made for most outpatient services were mainly cost-based. Nevertheless, the FY 1991 budget law, which was signed by President George Bush, alters the way physicians and hospitals are paid for the outpatient services they provide to medical beneficiaries (Matson, 1991).

Types of Facilities and Services offered

The procedures adopted for ambulatory care align with more than two distinct and separate categories, tagged Type I & Type II ambulatory services (Allen & Weber, 1995).

The procedures adopted in Type 1 are fairly predictable when it comes to the amount of time needed to carry them out, in addition to not being likely to involve any serious complications. Some common examples of surgeries that fall within Type I include: several orthopedic surgeries; nose, ear and throat procedures; some gynecological surgeries; eye surgeries; and certain all-inclusive surgical procedures, such as the inguinal repairs for hernia. Examples of procedures for Type I imaging include: X-ray of the chest region and all other routine radiography procedures such as mammography, orthopedic tomographic scans, as well as perinatal ultrasound. Performing Type I procedures in an inpatient environment is not a must. Therefore, the efficiency utilization of Type I facility is always higher than the efficiency utilization of Type II or an inpatient facility.

Contrary to the Type I ambulatory services procedures, Type II ambulatory services procedure are less predictable due to their complex nature. Difference in the time needed for the performance of these ambulatory procedures, coupled with their attendant, increased the risk of complications, given accurate definition of the Type II procedures, which equally tend to adopt more complicated or expensive technologies as well as extensive anesthetics. Some Type II ambulatory surgical procedures include endoscopically performed procedures (e.g., hernia repairs, cholecystectomies, nephrectomies and hysterectomies) and all other procedures that may possibly become ambulatory with the availability of inpatient backup and appropriate short-stay efficiencies (e.g., jaw bone surgeries and prostate surgery). Some examples of Type II procedures for ambulatory imaging include: fluoroscopy, radiography, non-orthopedic tomography, non-obstetrical ultrasound and CT scans, stereotactic biopsies, cardiac catheterization and angiography and MRI.

Nurses make use of evidence-based data and care quality, while making improvements on patient outcomes. Some examples of ambulatory care include: organizational, professional and clinical activities registered nurses engage in, for and with populations, groups, and individuals who desire some assistance for health improvement and/or are in need of care for health-related issues (What is Ambulatory Care Nursing? n.d).

Facility Description health preventive initiatives along with accountable care have been driving the development of ambulatory care services. Instead of visiting a doctor or hospital only when required, the healthcare business is focusing on preventive medication, together with community awareness, diet as well as health supervision (Dailey, n.d). Furthermore, Modular layouts as well as healthcare unit’s space are being designed for flexibility as well as to enhance effective workflows. A number of clinics overlook private doctor spaces for central cases wherein caregivers distribute space, together with exam rooms emanating off the pod. Clinical staff as well as Physicians may easily access pertinent patients in the open team-centered surroundings. At the same time as the particular programming as well as layout might change from one clinic to another, the overall site usage is considered to be higher when private spaces are removed. This provides clinics to being right-sized in order to acquire higher usage, and as a result cutting down operational funds and enhancing income.

Need for Ambulatory Care Design

In order to predict future needs effectively, it is important for the organization to first try to identify inefficiencies and make corrections where necessary, with the aim of streamlining processes to utilize space better. This can go a long way in maximizing the instant space utilization by the organization and minimizing any future need for complete space. Taking time to understand how other organizations deliver care can give a very useful external view on all available possibilities for both facility and process design.

Health care organizations should think about the type of visits they plan to offer patients and include the right exam rooms for each. If e-visits or group visits are made part of the visits, in choosing the design, areas that can easily meet the logistic needs of these services should be put into consideration. When it comes to determining both current and future needs, benchmarks are available. This is due to the fact that some areas of specialization naturally have higher level of patient throughput than other specialties; the number of exam rooms every physician should be assigned based on specialty is a very important basis for designing ambulatory care (Stouffer et al., 2013).


Allen, David. W, and Weber, Daniel (1995). ‘Ambulatory Care Planning for a Hospital’. Healthcare Strategic Management 13.2 (February 1995)

Dailey, David (n.d). ‘Ambulatory Care Facilities: The Evolution of Healthcare’. Medical Construction and Design. Extracted from http://mcdmag.com/

Matson, Ted (1991). ‘Ambulatory Care to Drive Hospital Services in 1990s’. Healthcare Strategic Management 9.3 (March 1991)

Stouffer, Jeff; Frank Kittredge, Ashley Dias (2013). ‘Eight Ambulatory Design Trends’. Health Facilities Management. Extracted from http://www.hfmmagazine.com/

What is Ambulatory Care Nursing? (n.d). American Academy of Ambulatory Care Nursing. Extracted from www.aaacn.org

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