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Re-forming the ambulatory care clinic

If the health care delivery system is a pond, then the Affordable Care Act was a boulder dropped into an already chaotic surface, generating ripples and counter-ripples that will take years, if ever, to diminish.  A recent article in Health Facilities Management, an e-magazine published by the American Society of Healthcare Engineering, discusses the effect that the ACA legislation is having on the design of ambulatory care clinics.

Patient-centered care and transparency are key aspects of the post-reform delivery system and ambulatory care is evolving to reflect those values:

  • Information technology is the stitching that holds the seamless continuum of care together: linking a spectrum of providers together through the electronic health record; bringing specialists to an on-site consultation through telemedicine; enhancing the patient experience by setting it free from the confines of the waiting room with the use of pager devices, etc.  Outpatient centers incorporate technology into every space, up to and including the broom closet!
  • The “open team center” approach has evolved to capitalize on the coordinated team approach to outpatient care.  The health care team works in clustered zones, rather than in offices segregated by profession, to increase communication, coordination of care, and elimination of duplicative processes and paperwork.
  • The universal patient room, which made its first appearance in the acute care setting, has been co-opted by ambulatory care centers that want to maximize utilization of each treatment room.
  • Patient-centeredness manifests itself in many ways: Wii games access in a pediatric waiting room (How cool is that!); separate entrances for patients needing urgent care versus routine care; college campus clinic kiosks that allow for self-scheduling and include interactive programs for patient interviewing; etc. 

The future is here – c’mon in!


Source: Sweetland, Deborah.  Elements of care: ambulatory design in a post-reform world.  Health Facilities Management.  January 2012.  http://www.hfmmagazine.com/hfmmagazine_app/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/01JAN2012/0112HFM_FEA_Elements&domain=HFMMAGAZINE 



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