Ambulatory care is the self-directed care that does not rely upon institutional access. According to the MedPac website: “Ambulatory care refers to medical services performed on an outpatient basis, without admission to a hospital or other facility.” (2016). Therefore, ambulatory care has a wide variety of possible settings and applications. An ambulatory care nurse must be able to adapt to many situations. Or, according to the website from the American Academy of Ambulatory Care Nursing (AAACN): “Ambulatory care includes clinical, organizational and professional activities engaged in by registered nurses…for individuals…who seek assistance with improving health…” (AAACN, 2016).
Five ambulatory care settings
Five common ambulatory care settings include dialysis clinics, ambulatory surgical centers, hospital outpatient departments, and the offices of physicians and other health professionals, (“MedPac”, 2016). One of the fundamental differences between ambulatory care and that of an admitted patient to a hospital facility, is the difference in the manner that insurance is paid. In the following five settings private insurance and sometimes group plans are more attractive to the average patient. This financial attraction, and the freedom to pursue one’s own methods of care are making ambulatory care settings more and more attractive to patients.
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Some of these types of ambulatory settings are regimented maintenance of pre-existing health conditions. These dialysis clinics are outpatient clinics that are designed to maintain the patient’s regiments, however, these clinics are independently owned businesses. Hospital outpatient departments are half-way between admission and discharge. There are some of these outpatient departments that are on the same grounds as the main facility, and there are many that are not on the same grounds. Physician’s private offices are another ambulatory care setting that is temporary and not long term. Private offices are not governed by any board of directors, such as at a hospital, therefore, the ambulatory care setting of a private physician’s office will vary greatly from physician to physician.
The differences between a hospital outpatient clinic and a private physician’s office include that there is a board of directors who govern the decisions of the hospital, whereas a private physician does not have any board of directors to make decisions. There are differences in the way that a patient’s insurance is charged for an inpatient hospital visit versus an outpatient physician’s office visit.
Future predictions for ambulatory care
Based on trends in ambulatory care today, the future of ambulatory care will look like an expansion of private offices. There are more patients who are reacting to the financial benefits of ambulatory care: “Inpatient stays are dropping while outpatient visits are rising, as a result of new technologies, reimbursement rules and payment models.” (Vesely, 2014). It seems that the attraction to ambulatory care will only increase as these payment models become more restrictive for patients who otherwise would have been admitted to a hospital facility. Becoming well-versed in ambulatory care nursing is a productive quest for new nurses because the future of nursing is in ambulatory care.
Conclusion
Ambulatory care is a popular alternative to inpatient hospital visits, primarily because the manner in which insurance pays for the care. Additionally, patients are able to tailor their care more specifically by using private physicians instead of hospitals. The future of nursing is in ambulatory care because the trend to save money and have freedom of choice in one’s medical care is not going to change. Nurses must be astute because ambulatory care settings carry high liability since the care is provided by individuals instead of groups. Ambulatory applies to all types of care in an outpatient setting. Ambulatory care needs will grow.
- American Academy of Ambulatory Care Nursing. (2016). What is ambulatory care? Retrieved from: www.aaacn.org/
- MedPac. (2016). Ambulatory care settings. Retrieved from: www.medpac.gov/
- Vesely, R. (2014). The great migration: Moving more care from inpatient to outpatient settings is a transformative trend for hospitals. Hospital and Health Networks. Retrieved from: www.hhnmag.com/
