Ambulatory Healthcare

New and Existing Ambulatory Healthcare Occupancies 22.Z23. New and Existing Detention and Correctional Occupancies 

New and Existing Hotels and Dormitories 30.Z31. New and Existing Apartment Buildings 

New and Existing Residential Board and Care Occupancies 34.Z35. Reserved 

New and Existing Mercantile Occupancies 38.Z39. New and Existing Business Occupancies 

Annex B Supplemental Evacuation Equipment Annex C Informational References 

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Horn, S.D. Clinical practice improvement model and how it is used to examine the availabOity of pharmaceuticals and the utilization of ambulatory healthcare services in HMOs. PharmacoEconomics 1996, 10 (Suppl. 2), 50-55. 

In addition to ambulatory care, other healthcare providers include primary care, hospitals, labs, and home care facilities, as mentioned earlier. Although ambulatory healthcare facilities make up 88% of all facilities, hospitals account for 46% of revenues and employ more than 42% of the industry (Carlson and Russ 2007). 

One factor in the reduction of healthcare expenditure is home medical care, which involves adaptations of the methods of care. These uses dictate particular requirements for sterility, safety, reliability, weight and facility of use. Plastics can bring solutions in the fields of single-use products, unbreakable equipment and weight reduction, for example, in the syringes, tubes and pumps for drug injections and apparatus for ambulatory dialysis. 

Figure 26.2 is a flowchart of appropriate, safe, effective, and efficient use of medications in the hospital setting (12). It incorporates the role of the prescriber, nurse, pharmacist, and patient in a typical inpatient environment. It also depicts the role of the organization s pharmacy and therapeutics committee and quality improvement functions, which will be discussed later in this chapter. The decision to treat a patient in a hospital or extended-care facility typically adds a nurse or other healthcare provider (respiratory therapist, etc.) to the trio described in the ambulatory care setting. Every time that individual has to read, interpret, decide, or act is yet another opportunity for a mistake to occur. Each of the steps in the medication use process provides an opportunity for correct or incorrect interpretation and implementation of the tactics that support the therapeutic plan. With this many opportunities for medication misadventures to occur, it is easy to understand why tracking and improving quality are important aspects of medication use. 

It is noteworthy that drug costs, and their impact, are perceived differently from different perspectives in the healthcare system. Each component of the healthcare system (hospital, home care, ambulatory provider) may have a different perspective on the cost of therapy. Hospitals are usually responsible for all drug-related costs (drug purchase, medication administration, laboratory monitoring, etc.) for the finite period of time that a patient is hospitalized. 

Comprehensive Accreditation Manual for Ambulatory Care. Joint Commission on Accreditation of Healthcare Organizations. One Renaissance Boulevard Oakbrook Terrace, Illinois 60181. 

Reeder CE, Kozma CM, O Malley CH. ASHP survey of ambulatory care responsibilities of pharmacists in integrated healthcare systems—1997. Am J Health-Syst Pharm. 1998 55 35-43. 

Patient education is a broad term that describes the process through which healthcare professionals attempt to increase patient knowledge of healthcare issues. Patient education can occur in a variety of environments from hospitals and long-term care institutions to physicians offices, community pharmacies, and other ambulatory care facilities. Patient education may be verbal or written, performed on an individual basis or in groups, and provided directly to the patient or caregiver. Although there are many different types of patient education, the process uses basic communication and educational techniques to achieve its goals of better health and improved health outcomes. 

Healthcare Cost and Utilization Project (HCUPnet). Rockville, MD Agency for Healthcare Research and Quality. URL http // www.hcup.ahrq.gov. Family of healthcare databases and software tools based on statewide data collected by individual hospitals and service providers across the United States. Databases include the Nationwide Inpatient Sample (NIS), the Kids Inpatient Database (KID), the State Inpatient Databases (SID), the State Ambulatory Surgery Databases (SASD), and the State Emergency Department Databases (SEDD). Searchable by diagnosis, procedure, and ICD codes. Available online. 

The pharmacist communicates the elements of the plan to the patient and/or the patient s other healthcare providers). The pharmacist shares information with other healthcare providers as the setting for care changes, in order to help maintain continuity of care as the patient moves between the ambulatory, inpatient or long-term care environment... 

Schroyer, D. (1997), Simulation Supports Ambulatory Surgery Facility Design Decisions, in Proceedings of the 1997 Annual Healthcare Information ami Management Systems Conference, AHA, pp. 95-108. 

Healthcare is like many other professions. The major academic medical centers are aggressively trying to attract the top of the class. Other service providers are trying to attract those with a mission. As 1 indicated before, there are shortages of medical personnel in virtually all areas of patient care. The ambulatory care area has been growing faster than the inpatient sector, and has become very sophisticated in its service offerings. Medical centers and hospitals have seen their revenue base go from inpatient-dominated to one split between in- and outpatient business. 

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