AMBULATORY CARE

FAMILY MEDICINE
GROUP B2
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GROUP MEMBERS
• NANA ESI KWOFIE
• SARAH M.A.K. ESHUN
• EBENEZER BOATENG ACHEAMPONG
• DENNIS BREMPONG
• IDA BAFFOUR GYAWU
• KOFI AMOAH LARBI
• AARON TAWIAH
• EMMANUEL NDEMELE
• HAMDARATU OPATA MATEKO
• DAVIS AKAI NETTEY
• JACOB WILSON
• AMA AMO COBBIAH
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OUTLINE
• DEFINITION
• TYPES OF AMBULATORY CARE
• PILLARS OF AMBULATORY CARE
• AMBULATORY CARE SENSITIVE CONDITIONS
• MODELS OF AMBULATORY CARE
• SWOT ANALYSIS FOR AMBULATORY CARE
• RECOMMENDATION AND CONCLUSION
• REFERENCES

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DEFINITION

• It’s a practice of providing medical services in an out patient setting.

This type of care includes diagnosis, observation, consultation,

interventions, treatment, and rehabilitation without requiring

patients to step foot into a hospital.

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 Types of Ambulatory Care

Treatment Centers Virtual care Wellness Clinics

• Same day surgery
Telemedicine • Primary health care
• Cancer treatments eg • Preventive and basic
chemotherapy
• Substance treatment facilities Rehabilitation •
medical care
Counselling centres for
Services weight management
• Post operative therapy
Illness Diagnostic • Occupational therapy
• Very common services
• Physical therapy
• Scans and X- rays • Addiction
• Blood tests rehabilitation
AMBULATORY CARE TEAM

• Medical Doctors
• Physician Assistants
• Nurse Practitioners
• Pharmacists
• Other Allied Health Professionals
• Administrators

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PILLARS OF AMBULATORY CARE
• CLINICAL QUALITY
• ASSESS, MONITOR AND IMPROVE CLINICAL OUTCOMES
• PATIENT ACCESS
• ACCESSIBILTY AND QUALITY PATIENT CARE
• CLINICAL CARE
• STANDARD CLINICAL CARE AND REGULATORY BODIES
• SERVICE AND REFERRALS MANAGEMENT
• ENSURE COORDINATED AND CONSISTENT PATIENT STATISFACTION AND
PROCESS

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Ambulatory Care Sensitive Conditions
(ACSCs)
• Health conditions where appropriate ambulatory care prevents or reduces the
need for hospital admissions.

• Relatively common ACSC include hypertension, vaccine preventable diseases,

asthma, diabetes, PID, pneumonia, dental conditions.

• Medical investigations and treatments for acute and chronic illnesses and
preventive healthcare eg endoscopy, biopsy etc.

• Appropriate ambulatory care could help prevent the onset, control an acute
episode, or manage chronic disease.

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 Models of Ambulatory care

 Smartphones, Computers and the Internet

• The commonest site is the Internet where patient can get in touch with
their caregivers through medical websites, portals or even through online
zoom meetings.
• Patients can also assess care through phone calls or even medical apps
such as Teladoc.
 Mobile Care
• Brings needed health services directly to the patient
• Consists of converted vans, buses or trailers
• This mode of delivery increases accessibility
 Models of Ambulatory care

 Convenient care and retail clinics

• Typically located in an existing retail drug and big-box stores where limited
number of conditions are treated and staffed by mid-level providers on a
first come first seen basis.
• Ease of parking and one stop shopping for over the counter items makes
these sites appealing for many patients
 Urgent Care
• Clinics that provides general radiography, small lab, sutures and extended
hours
• Part of larger health systems and for-profit companies
 Models of Ambulatory care

 Free standing emergency departments

• A licensed facility structurally separate and distinct from a hospital and
provides emergency care (ACEP,2020).
2 types;
Hospital Outpatient Department (HOPD)/ Satellite ED
Independent Freestanding emergency centers( IFECs)
Key features:
Open 24/7
Qualified emergency physicians
Registered nurses with minimum certification in ACLS and PALS
Effective and efficient transfer to a higher level of care if needed
 Models of Ambulatory care
 Work- based Clinics
• Also known as on-site clinics
• Provision of preventive care and treatment of employees at workplaces
• Formerly, they existed at larger companies to primarily treat occupational
injuries
Current focus: health promotion , wellness and primary care services
Pros:
Decreased cost
Timely diagnosis and treatment of diseases
Increasing preventive care
Cons:
Breech of privacy and confidentiality
Benefits and Limitations of Ambulatory Care

Benefits Limitations
To the patients load 1. Outpatient
1. Shorter wait time procedures only
2. Reduced exposure to
infections
To the health service 2. Some patients do
3. Increased privacy and
7. Increased patient access not qualify
convenience 8. Decongestion of hospitals 3. Complications and
4. Increased satisfaction 9. Targeted health service emergencies require
To health workers 10. Revenue generation transfers
5. Increased employment 4. Decreased fundings
opportunities
6. Decreased patient work
5. Poor sustainability
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 RECOMMENDATIONS
• Health service provision in Ghana, a developing country setting, should be tailored and
adapted towards providing more of ambulatory care services to take advantage of reduced
costs when services are provided on an outpatient basis.

• For example, considering the country's struggles with infrastructure development, our focus
could be redirected towards developing the system towards one that is ambulatory care-
focused. eg. mobile care, telemedicine, more diagnostic centers, specialty clinics, etc.

• In-service training on ambulatory care for healthcare providers

• Ambulatory care has its disadvantages, and current forms of it in Ghana maybe be
manned by unqualified persons. eg. pharmacy settings, diagnostic centers. Strict
regulation of these centers and services are needed.

• Access to health records and Interoperability to ensure continuity of care.

 CONCLUSION

• Considering all the disadvantages associated with in-patient care, including reduced
ambulation, risk of nosocomial infections, increased cost to patients and healthcare system,
ambulatory care can be an effective alternative to the traditional in-patient care model with
other added benefits. In Ghana, already existing forms of ambulatory care should be
developed to achieve the best results, while other newer forms, including mobile clinics and
virtual care should be introduced.

Note: An effective and highly patronized ambulatory care system reduces the incidence of
emergency cases and improves health outcomes
REFERENCES
• Rakel RE, Rakel D. Textbook of Family Medicine. Elsevier Saunders; 2016
• ´ Aliber J. Ambulatory care settings. Retrieved on June 4, 2022 from
• ´ https://www.trustees.aha.org
• ´ Goodell S., Ambulatory patient services. Retrieved on June 4, 2022 from
• ´ https://webmd.com
• “Ambulatory Care: What It Is and How to Get Involved.” Western Governors
University, ‌
www.wgu.edu/blog/ambulatory-care-what-it-is-how-get-involved2205.html#close.
Accessed 23 November 2022
• “Defining Ambulatory Care.”Www.ipfcc.org,www.ipfcc.org/bestpractices/ambulatory-
care/defining-ambulatory-care.html. ‌Accessed 23 November 2022
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