Ambulatory Care Case Study

Ambulatory Care Case Study
The process of strategic planning is to develop a viable strategy that can expand clinical services
and attract top residents, and fellows to the faculty. In creating such a plan Mt. Sinai's department of
ambulatory care expresses where it wants to be in the future with a plan of action. Once the general
hospital and the department reach some sort of a consensus on its long–terms goals a plan of action
can be developed and launch. Creating sustained viability is the basis of all–personal involved. The
Ambulatory Care department has pushed for further educating doctors though means on requiring
practicing physician to receive CME(continuing medical education)certificates. This will keep
physicians up to date with the latest research and findings
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Hmgt 395 Hgmt 310 Final Project Ambulatory Surgery Center...
HGMT 310 Final Project AMBULATORY SURGERY CENTER strategic Planning and New
Service Development UMUC
Click below link for Answer http://workbank247.com/q/hgmt–310–final–project–ambulatory–
surgery–center–s/21157 http://workbank247.com/q/hgmt–310–final–project–ambulatory–surgery–
center–s/21157
Assignment 3: (20 points) Final Project– AMBULATORY SURGERY CENTER CASE STUDY
(Power Point Presentation).
In the final project, students will apply the knowledge gained in this course to a case example.
Each student will select a SPECIFIC real Ambulatory Surgery Center and apply one of the scenarios
below and develop a 10–12 slide PowerPoint presentation to discuss the current status of the
organization, provide an overview of the ... Show more content on Helpwriting.net ...
What are some strategies you would use to increase referrals to your ASC while maintaining high
patient satisfaction scores?
Another challenge facing ambulatory surgery centers is the recruitment of new physicians.
Following a national trend, many local hospitals and health systems are purchasing physician
practices, which could eventually lead to doctors referring surgical cases to a hospital's same day
surgery department. Assuming there is ample opportunity to increase surgical volume, how do you
intend to recruit physicians to practice via your ASC? What are some strategies/offerings you could
employ?
The ASC you are currently managing is experiencing out of network challenges. Additionally, the
proposed reimbursement rates from payers do not match Medicare rates for your market. Most of
your ASC contracts are based on the Medicare fee schedule and because many of your surgeries are
not on that schedule, you have to negotiate a fee schedule on a case–by–case basis. What strategies
could you employ as you work with payors to contract for reasonable rates that could save you both
money in the short term?
In this changing environment, you are required to do more with less. Reimbursement rates are
declining; supply and implant costs, taxes, utilities, rent, salaries and benefits and other operating
costs are increasing and there are more regulatory requirements i.e.,

Ambulatory Care Nurse Essay
What is an Ambulatory Care Manager?
An ambulatory care managers are health care professionals who supervise ambulatory care nurses,
centers and departments. Keep reading to learn what an ambulatory care manager is and how to
become one.
What is Ambulatory Care?
According to the American Academy of Ambulatory Care Nursing (AAACN), ambulatory care is a
complex and collaborative practice that unites different health care fields. It is a comprehensive
practice that is built on a knowledge base of nursing, health care and applied clinical science. In
order to ensure and achieve quality patient care, ambulatory health care professionals use evidence–
based research and information. Ambulatory care settings include clinics, surgery centers, hospitals
... Show more content on Helpwriting.net ...
They must assist with purchasing, inventory management and contract reviews and approvals. They
must maintain financial documents related to operations, expenses, personnel, administration and
maintenance. Therefore, they must oversee the budget and provide regular reports to upper
management. Related to this, they must maintain applicable state, federal and regulatory licenses
and permits. Consequently, they will be involved in internal, external and re–certification audits.
Therefore, they must have excellent analytical, administrative and problem–solving skills. They will
also perform standard HR tasks, such as interviewing, hiring, coaching, disciplining and firing
employees. Excellent interpersonal and legalistic skills are needed to keep employees satisfied while
maintaining compliance with performance regulations. Thus, they may also assist with new
employee orientation, benefit enrollment and the exit process for terminated employees. Many
senior–level ambulatory care managers act as liaison with the HR department heads. Senior–level
ambulatory managers will be the public face of the center or department and serve as community
outreach coordinator. They must ensure that patient revenues are accurately captured, processed and
posted within set time frames. They will oversee day–to–day operations involving customer service,
patient flow, facility management and staff

Types Of Ambulatory Care Settings And Describe What They Do
list seven different types of ambulatory care settings and describe what they do,
1. Asc Development Company, LLC is the Spine Center it provides all surgical treatments through a
third party, in which they perform over 24 different services on the nervous system as its specialty.
The company provides and average services per patient of 4.7 overhauled, this is an excellent rating
according to the top ambulatory health care facilities, pain provider in Maryland.
2. Plastic Surgery Center of Maryland this facility is known around the area, and is largely in
demand, taking into consideration the plastic surgery procedures and cosmetic non–surgical
procedures, such as breast augmentation, breast lift, and reduction. Also, face Blepharoplasty, brow
lift, facelift, and rhinoplasty. Next the body image in general abdominoplasty, calf implants and
liposuction, and other non–surgical procedures (Plastic surgery center).
3. Snowden River Surgery Center is an ophthalmologists group with the best doctors dedicated to
improving the quality of life for people challenged by vision problems. They perform cataract
surgery, pterygium surgery, YAG capsulotomy, glaucoma, macular degeneration, contact lenses, and
they also provide a complete eye exam. As well as performing restor lenses, tecnis Multifocal
lenses, and other minor treatment for eye conditions (Snowden Surgical Center)
4. Summit Ambulatory Surgical Center–Chesapeake Urology they offer patients high–quality care
in a comfortable,

Essay On Ambulatory Care
Introduction
Health care organizations are motivated by social transformations that occur in their environment
that affect economic, demographic and technological aspect of care and services in a positive way.
More so, health system innovation process is directly linked to the degree of consistency of
professional, technological, organizational, personal and social skills. The combination of this
process and management will help create a valid strategic plan that will be based on measure of
performance, benchmarking, and continuous improvement. Every health care organization clinical
support must be consistent with the organization mission and strategic plan; which can be
determined by its annual goals that are approve by the governing board. This report covers the
concept of Ambulatory care center that will be using a free market perspective as a pattern to design
the new ... Show more content on Helpwriting.net ...
Also the article will be addressing the economic, social, political problem face and its role in
ambulatory care system. Economic, Political advantages of Ambulatory Care System in a Free
Market.
The influence of policy and law on health care system is incontrovertible, past view; health care
market has been embedded in freedom of market place and market competition. In 1990s health care
market competition becomes a ruling force till this day. A free market health care system argues that
the system is more effective where government regulation and laws are less paramount, making it
easier for consumer empowerment and commercial competition to increase efficiency in health care
system. Government needs the private market sector to operate effectively in any economic. Before
the affordable Care Act was signed into law; funding of health insurance, payment and delivery
functions are control by private sectors; similarly ambulatory care center financed by

Case 34 The Complaining Doctor And Ambulatory Care
Case 34: The Complaining Doctor and Ambulatory Care
1. You are the assistant director for ambulatory services. An attending physician complains, "The
clerks are no good in this clinic, and neither is the director of nursing." What do you say to him?
Assume that the physician is an important customer. According to Pidgeon (2017) conflict
resolution is a competencies that all leaders must acquire to successfully lead a group of people.
Specifically, "conflict resolution is defined as the ability to find amicable solutions to a conflict
when it occurs between multiple parties" (Pidgeon, 2017, p. 340). As the assistant director and
leader for ambulatory services, it is my responsibility to respond to the complaint made by a
physician, who is also an important customer, about the clerk and director of nursing (DON). ...
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If his suggestions are within reason, I would make every attempt to make that happen. Conversely,
if his suggestions were entirely unreasonable, I would ask that he talk with the director supervisor(s)
for the clerk and DON regarding his concerns. Regardless, of the physician being an important
customer and employee, if his behavior and/or complaints are unsubstantiated or out–of–line, his
behavior needs to be address as well.
2. Later during the week, he is still not satisfied. Now you are the problem. What do you do? If the
physician continued to be dissatisfied later in the week and felt that I was now the problem, I would
begin by letting the physician know what has been done up to that point to address his original
concern. Next, I would apologize that he feels the way he does. Moreover, I would make sure that
the director of ambulatory care, my direct supervisor, is aware of the physician's complaints so they
can appropriately investigate and address

Hospital And Ambulatory Care Case Study
Hospitals and Ambulatory Care
1) The traditional management style of hospitals have been hierarchical and internally focused.
What are the three important challenges that hospitals face to accommodate new payers and
consumer expectations?
These hospitals are using the manual approach of relating with consumers as will as payers.
Remittance to providers and disburse paper checks is prone to errors, costly and time consuming. It
is required of payers to adopt the standardized electronic healthcare transactions according to the
regulatory mandates. Electronic funds transfer (RFT) and Electronic Remittance Advice (ERA) are
the recommended digital healthcare transactions that would reconcile the crisis at hand and reduce
the administrative costs.
While the digital migration is implemented in the healthcare system, payers, health providers and
consumers are faced with the challenge of ... Show more content on Helpwriting.net ...
What were some problems with the peer review process in judging the quality of hospital medical
care?
Conflict of interests is a common problem associated with peer review process, which is contributed
to by the internal politics. Economic competition and partner relationships also contribute to
conflicts of interests because of the big focus on facts while ignoring the personal feelings and
biases. Criticizing colleagues and eventually censuring the friends is a big challenge among doctors.
This is because the process involves a lot of work which goes uncompensated. In addition, the
process consumes time meant for attending to patients, leading to worse and substandard care. 3)
Almost two–thirds of all surgical procedures are now performed in ambulatory surgery facilities.
Discuss the reasons for this shift of surgery from the inpatient setting and its effect on hospitals and

Ambulatory Health Care
A. Health is the component of the consumption that we spent a much greater percentage in 2011 in
comparison to 1967. During the 21st century, health care systems throughout the world are
concentrating strategy efforts on enhancing the aspect of healthcare provided to the society. The
health care quality that have improved during the years accommodated with the adjustment of
output variables such as morbidity rate, mortality rate (also during infancy), and life expectancy of a
certain population. Inputs such as healthcare consumption and services, and the amount of
healthcare professions and facilities also developed throughout those years. For example,
ambulatory healthcare facilities are so prevalent today because it creates competition in the market
with hospitals care facilities. It is more convenient, as it is likely easier to be found and make
appointments rather than going into a large health care facility to get the care people need. It is also
efficient with the cost of getting the treatments and care patients seek with an offer of a lower co–
payment in comparison to hospitals. The development in these given inputs and outputs regulates
the percentage of GDP. ... Show more content on Helpwriting.net ...
The component of total GDP that I see having the most impact due to the technological
breakthroughs are still the consumptions, especially on heath cares. The major investments of
technology include the developments of new drugs, new medical devices, and new treatments and
surgical procedures would require a high cost of spending for getting the supplies and equipment,
and the test needed to obtain those developments. For instance, there are some healthcare facilities
that are now using surgical machines or so–called robots as a means to accomplish better accuracy
and precision on their surgical procedures. Even prosthetic limbs are making a remarkable
improvement for those people who needs

Accreditation Association For Ambulatory Health Care...
Charles HaydenTatia Green, onlineMB208–ICD–1012/3/2015Accreditation Association for
Ambulatory Health CareIn 1979, a nonprofit organization was established to assist ambulatory
health care organizations in improving the quality care provided to patients. This organization which
some may know of is called Accreditation Association for Ambulatory Health Care, Inc. which:
"Encourage and assist ambulatory health care organizations to provide the highest achievable level
of care for recipients in the most efficient and economically sound manner. The AAAHC
accomplishes this by the operation of a peer–based assessment, consultation, education and
accreditation program." American College Health Association, Ambulatory Surgery Foundation,
The American Group Practice Association, Group Health Association of America, Medical Group
Management Association and the National Association of Community Health Centers are the six
founding members of AAAHC. A few things that this association does are measure performance,
provide consultation and education, review and revise standards. AAAHC accreditation means the
organization participates in an ongoing self evaluation, peer review and education to continuously
improve its care and services. Not only does this organization live up to its standards, but commits
thorough onsite survey by AAAHC surveyors whom are also health care professionals. When
surveying an organization, the AAAHC includes the following as listed: Patient RightsAre
patients

Ambulatory Care Essay
Most hospitals, medical practices across the United States are transitioning to electronic health care
record system to improve quality measures and manage the number of patients they can generate,
retrieve, and accumulate. However, the ambulatory care providers usually don't use EHR technology
to the full extent of its power because it associates barriers that stand in the way of changing
medical practices. In this case, the EHR will also examine some of the advantages and
disadvantages while medical practitioners make their decision. In ambulatory care, there are many
advantages of using electronic medical records, such as increasing the cyber security level and
privacy safety, eliminating medical errors, and improving the quality of care. ... Show more content
on Helpwriting.net ...
This system includes the patient's history, their medication and allergies, and the notes that's were
token by their doctor of physician. This system can also be integrated into the EHR software, which
could put health care organizations at risk and potentially violate privacy protocols. Buying
electronic material will have a high cost in the ambulatory environment, although it could be
extremely effective. Creating and updating patient's medical records would take some pressure off
the doctors and physicians who are not capable of analyzing electronic material on new devices. In
order to secure and record patients effectively, hospitals would need the right equipment. Hence, it
would increase the cost of the hospital expenses. In addition, new EHR ambulatory care will take
time to train people and understand the capability of the software. As you make sure that the new
technology is being used in a system that practitioners have already used. Another cost of
integrating EHR's is the maintenance cost which could be costly. A part of the maintenance costs
would be exchanging and upgrading the hardware within the technology. In addition, providers need
to support the usage of EHR's in health care organizations to improve the quality of

Urgent Care And Ambulatory Surgical Centers Case Study
For urgent care and ambulatory surgical centers, negotiating even a small increase in rates from a
current payer or arriving at a deal with a new company can result in significantly higher profits for
the period. According to WCH Service Bureau Inc, New York City's leading provider enrollment
and credentialing company, established, stable medical offices can leverage the strengths of their
structure and the advantages provided by their size to demonstrate to payers why they deserve a
higher payout. For example, an urgent care center that provides similar services to an emergency
room may be able to show that when patients come to them for services the payer enjoys lower
reimbursement or higher efficiency. In many cases, small offices who completely

Freestanding Ambulatory Care. An Ambulatory Care Facility
Freestanding Ambulatory Care
An Ambulatory care facility "provides preventative, diagnostic, and treatment services to persons
who come to the facility to receive services and depart from the facility on the same day" (The New
Jersey Department of Health Licenses).
A surgical facility in which ambulatory surgical cases are performed and which is licensed as an
ambulatory surgery facility, separate and apart from any other facility license. (The ambulatory
surgery facility may be physically connected to another licensed facility, such as a hospital, but is
corporately and administratively distinct.)
The national organization's for the healthcare standards for freestanding ambulatory care facilities
are regulated by the State, AHIMA and ... Show more content on Helpwriting.net ...
New Jersey's 8:43A–13.6 Preservation, storage, and retrieval of the medical record states that all
medical records shall be preserved by N.J.S.A. 26:8–5 et seq. Retention guidelines for all medical
records are ten years following the most recent discharge or reaches the age of 23 years, whichever
is the longer period. A discharge summary sheet for 20 years following the most recent discharge of
the patient, and X–ray films for five years.
It states that in the N.J.A.C. Title 8 Chapter 43A Standards for Licensure of Ambulatory Care
Facilities, after the ten year retention period, is over, the discharge summary sheets are removed
from the records and retained. The rest of the record is put in the destruction log. If it is a paper
record, then it has to be done one by one. All records that have been used in a certain number of
years must be kept at the office, the ones that are past that must be kept in a storage facility, and they
need to be dated so that you know when they can be destroyed. You have to keep a record of
destroyed medical records because of the HIPPA laws.
The reimbursement method for freestanding ambulatory care facilities is a fee for service which is
"a reimbursement system in which the payment is based on the type and amount of service
provided. (Peden, 2017 pg. 96).
The fee for service system uses the Healthcare Common Procedure Coding System (HCPCS). So
for each HCPCS code used, relative value units (RVUs)

Ambulatory Care Case
1. What are the financial implications of reducing unnecessary admissions to the hospital?
Diminishing readmission has turned into an order for hospitals over the United States, rushed by
execution of open revealing and money related punishments for abundance readmissions. In any
case, in spite of a quick need to enhance the nature of release arranging and transitional care, there is
restricted superb confirmation illustrating how to best achieve this.
2. How does reducing ambulatory care sensitive condition admissions and ED visits improve
quality?
For instance, with early assessment, a patient with cellulitis may get oral anti–infection agents that
could dodge hospitalization for intravenous anti–microbials. Additionally, a patient with ceaseless
heart ... Show more content on Helpwriting.net ...
To enhance quality and give a more secure and more organized care the hospital should:
– Have a group approach
– Use electronic records
– Facilitate follow–ups
– Prevent improper utilization of opiates
5. What data source(s) could be used to monitor rates?
The data source should be driven by the examination question, rates your trying to monitor. Not all
examination inquiries can be replied with existing information, and a few inquiries will hence
require essential information accumulation. Managable questions to the utilization of optional
information, observational research with existing information can be productive and effective.
6. What is the role of the professional staff in reducing unnecessary admissions and ED visits?
The role of the professional staff in reducing unnecessary admissions and ED visits should include
and it's not limited to adjustment in doctor's facility culture, more grounded staff aptitudes, better
execution administration, and obvious authority.
7. Is it reasonable to strive for zero ACSC

Essay On Ambulatory Health Care
For this week discussion, I have selected the topic Ambulatory Health Care from 2016 National
Patient Safety Goals. Ambulatory Healthcare is an outpatient medical care such as regular check–
ups, observation, diagnosis, treatment and follows ups.Proper Ambulatory health can prevent
recurrent hospital admissions as many medical treatments for acute and chronic health illness can be
done in ambulatory health care.Some minor surgical and preventive ways of many diseases and
other services can be done in ambulatory health care. In ambulatory care patient not only can get the
advantage of high–quality service in their convenient location but also with low treatment cost.
Ambulatory Health National 2016 has many goals, and one of the focused goals is to improve
patient safety by doing proper use of identification and medicine in outpatient care.
The research article I have chosen is "Adverse Drug Events in Ambulatory care" by Tejal k.Gandhi.
This article mainly focuses on adverse side effect caused by medicine error in community based
outpatient center and hospital. According to meta–analysis data recorded on 1994, hospitalization of
the patient because of drug reaction was 1 million.In outpatient care, patients take their own
medicine so that the chances to have adverse drug effect are ... Show more content on
Helpwriting.net ...
1202 patients were involved who usually need at least one prescription in a month.Among all order,
the physician used, a handwritten prescription for two practice and computerized for another two
method.Only 661 patient responded to the survey. 162 patients had adverse drug events, and just 51
patient condition was able to improve.Out of 51 improvable cases,32 incidents were because of
physician's failure to respond to medication–related symptoms and 19 were patient's failure to
inform the physicians on

Growth In Ambulatory Care
Ambulatory care is another term for outpatient services. Outpatient services consist of any health
care service which does not include "an overnight stay in which room and board are incurred"
(Shi&Singh, 2015, p.251). The changes in the delivery of health services have led to a decline in
hospital inpatient days and growth in ambulatory services in various ways. The reasons for growth
include changes in reimbursement, development of new technology, and social factors (Shi&Singh,
2015, p.259–260). Systems such as the Medicare Outpatient Prospective Payment System (OPPS)
were implemented to contain costs and lower inpatient use (Shi&Singh, 2015, p.259). New
technology includes shorter acting anesthetics, and the "diffusion of arthroscopes, laparoscopes,

Essay On Ambulatory Care
Ambulatory care, also known as outpatient care consists of care that is done outside of the hospital
setting. Ambulatory care may be of a specialized nature or not, and patients are usually not going to
stay in the facility overnight. Some examples of ambulatory care include dialysis centers, surgical
center, physicians offices, and outpatient centers. I believe that ambulatory helps by allowing for
there to be mostly patients in the hospital who are severely sick and need constant monitoring. In the
first article titled, "Outpatient Palliative Care for Chronic Heart Failure: A Case Series," it is
discussed that outpatient care for the patient with chronic heart failure is still a new subject matter.
There is a need for ambulatory care for the specific patient population which is the chronic heart
failure patient, but there is little knowledge on how to provide them with the care that they need in
the outpatient setting. Some topics that were stated to need more emphasize on so that the client can
be treated better is care coordination, advance care planning, and psychosocial issues. ... Show more
content on Helpwriting.net ...
The article explained that an increased pressure is placed on the physician to provide all that care
that the client with a chronic illness needs. The conclusion of this article is that there needs to be
maintained investment in primary health care so that those patients with multiple disease can be
cared for without an inflation of chronic conditions as they advance in age. This article displays the
need for outsourcing care of patients to outpatient care. This will affect the care that I provide as a
nurse in a positive way because I believe that as these increased needs get sorted out the care that
nurse will be able to give to the client will increase in

Ambulatory Care Center Case Study
Introduction In this assignment, we are asked to act as a chief operating officer of a hospital tasked
with opening a new ambulatory care center in my city. We will specify a perspective of choice
which are either professional autonomy, social contract, or free market. Describe at least two (2)
advantages and two (2) disadvantages of your chosen perspective. Provide at least two (2) examples
of the perspective in action to support your response. Additionally, analyze three (3) key
components sources of law related to the effects that each source could potentially have on your
healthcare organization's new initiative. Next, I have chosen the free market perspective to explain
how a new ambulatory care center in my city of Stone Mountain, Georgia would be beneficial. The
other positions of professional autonomy, and social contract are not bad perspectives but, in this
case a free market model is the best perspective that would serve the Stone Mountain community.
Overall, this assignment will focus on how the free market model allows and encourages the growth
of an ambulatory care center in this city. ... Show more content on Helpwriting.net ...
What is the free market model? Why is it needed to build this center? According Zupan (2011), 'Free
markets, based on clearly defined and enforced private property rights and the liberty of individuals
to pursue their interests, maximize the opportunities for repeat interaction across time, products,
places, and people. By creating the broadest possible opportunities for repeat interaction and thereby
a future, free markets have an edge, relative to other systems for organizing economic activity, when
it comes to promoting prosperity as well as the practice of integrity and other cooperative

Case of Perpetual Mercy Hospital
Case of Perpetual Mercy Hospital
Problem
The broad focus of this case is one of strategy planning. Perpetual Mercy Hospital has to determine
the best course of action to help the Downtown Health Clinic achieve its stated objectives of
expanding the hospital's referral base, increasing referrals of privately insured patients, establishing
a liaison with the business community, and becoming self–supporting within three years of its
opening. This last objective is jeopardized by the possibility of a competing clinic opening 5 blocks
north of the DHC's location. The underlying problem is that the DHC may not be self–sufficient
within the projected timeframe, regardless of competition.
Alternatives
The following alternatives have been ... Show more content on Helpwriting.net ...
Revenue reflects an expected 8% increase in charges across the board.
Personnel costs ($168,376)
Incremental personnel costs x 33%
Additional physician (260 days times 8 hr/day at $66/hr) + ($137,280)
Cost for expanded coverage ($192,844)
While costly, the expanded hours would also allow the DHC to support scheduling more
employment physicals.
Competition
All nearby ambulatory care clinics are servicing suburban patients. Another firm, believed to be
Medcenter, has sponsored a study to determine if enough demand exists to establish a new clinic
five blocks north of the DHC. This new clinic would compete directly with the DHC for patients in
an overlapping area covering 3,424 workers. Medcenter is fairly successful in its current location,
and has a reputation for being aggressive and market–oriented. Their current facility already offers
12–hour office days and has 2 physicians on 8–hour shifts. Medcenter appears to be interested in
developing employer services of its own.
Annualized patient visits 3,807
Current physical exam visits in northern region x 20%
Estimated loss due to competition x 33%
Personal illness/exam charge x $54
Total estimated loss to competition $13,705
Company
PROFILE

Perpetual Mercy Hospital is a 600–bed, independent, not–for–profit general hospital. It is located on
the southern periphery

Ambulatory Care Centers: A Case Study
The past decade has shown a great development in terms of strategies in delivering health care in
the United States. Many of the ambulatory care centers have separated from hospital based
outpatient care centers and established as major providers for planned surgical procedures. With
expansion of the Ambulatory Surgical Centers (ASCs) there is a clear competition between both.
ASCs are advantageous to patients in reducing their time of stay in hospital and the health care
expenditure when compared to the hospital based surgeries. Although the ASCs are able to serve
patients by addressing their surgical needs, there are many concerns arising due to the risks and
complications from the operations handled in the physician's office. The distance between the
Emergency Room (ER) and location of ASCs is also affecting the safety issues. These ASCs
primarily help the middle class families who cannot miss their work to receive monthly salaries and
cannot afford to stay longer in a hospital facility as an inpatient. This is impacting the health care
quality and safety. Government regulations along with facility safety measures are to be
implemented to prevent such errors. ... Show more content on Helpwriting.net ...
It is aimed in performing pre–planned surgeries on patients and requires less than 24 hours of
hospital care. This kind of medical care has increased in recent years. In the United States, in–
patient surgeries have replaced out–patient surgeries over the past decade and accounts for almost
two–thirds of all surgeries. In 1980, the surgical procedures that were considered to be outpatient
were only 16 percent and in 1990 it was 51 percent. Whereas in 2005, on a national scale 63 percent
of all surgeries done were outpatient and required less than 24 hours of stay in the hospital
(Hyattsville, 2008). This increased proportion has both positive and negative impacts on the
traditional hospital setups and patient

Primary Ambulatory Care Center Ehr And Meaningful Use
HIM 6640 Case Studies in Health Information Management
Name: Bayo Oshunlalu
Case #: 1 – 19
Case Title: Primary Ambulatory Care Center EHR and Meaningful Use.
Qu. 1. What major elements do you need to consider in the project to propose a selected EHR
system and become a meaningful user?
Gaining familiarity
A multi–physician–owned primary ambulatory care practice and the board of directors seek to
embark on implementing an EHR system that will enable the organization to meet the meaningful
use requirements of the American Recovery and Reinvestment Act (ARRA). The decision to embark
on the project was mainly driven by the incentive program offered by the stage I of the
HITECT/ARRA, and to provide the organization with the capability to streamline their registration,
billing, and bedside documentation process.
Recognized Symptoms
The first step necessary to begin with the EHR implementation process is the assessment of the
organization's readiness for an electronic system; these assessments will include the expectation of
the organization regarding the proposed EHR system, the clinical goals of the practice, and the
financial ramification of embarking on the EHR project. Furthermore, the assessment will highlight
various processes that will include administrative procedures, clinical workflow redesign, data
collection process and data integrity issues, how literate are staff members with computers (the need
to offer education program in basic computer usage), special

Hospitals purchase nearly 20% of the share of products and services from the industry in order to
produce other goods and services. In the overall distribution in terms of Hospitals and Health Care,
Hospitals specifically use 59.9% of the products. Ambulatory health care services takes up 21% of
share. 9.9% goes to educational services in hospitals. Nursing and residential care facilities take
6.5% and Social Assistance takes the last 2.6%. (Data USA: Beauty salons). My last driving lesson
my instructor was talking to me and was wondering what I wanted to do after high school. I
annoyedly told him "I have no idea." What I want to do after high school was unknown to me and it
sucked because in eighth grade they tell us that if we don't start taking courses in high school that
pertain to what we want to do for the rest of our lives, we will never be successful. He asked, "have
you thought about it?" I explained, "I try to avoid it." He pried on and said "well what do you like to
do?" ... Show more content on Helpwriting.net ...
He then asked me, "well have you ever thought about doing that for a living?" I shrugged my
shoulders and responded "they don't offer those kind of classes at school and there's no way that that
is actually a major in a university." I parked the car in front of the next person's house and waited for
them to come out. My instructor said, "no, but you don't have to go to a college or university, you
can still go to school for it. They make trade schools for cosmetology. Think about it." The way
home I spent time looking it up. I found a beauty school nearby in Framingham. Coincidentally on
the home page, the first thing I saw was "you've always wanted to do this... why not now?"(Empire
Beauty) I saved it and talked it over with my parents and negotiated with them to let me do this
instead of college and I asked them to tell me what else was I gonna do if they don't let me do

Ambulatory Geriatric Clinic Care Case Study
Knowing the facts, I decided to propose this project to open two Ambulatory Geriatric Clinic care
facility in Sequim and Port Angeles that will accommodate needs of elderly and will allow us wisely
distribute our limited resources we have from government funding. As you can see, the
demographics are speaking for themselves and it's an obvious the time is here and we need to act as
fast as we can to start on the project to get appropriate care our seniors deserve. Our Specialty
clinics at both, Sequim and Port Angeles, location already experiencing a lot of challenges and
pressure trying to accommodate our services to overwhelming number of patients age 65 and over.
This age group of patients requires more physician time to: Consoling

Essay A Holistic Approach to Ambulatory Care
It is apparent that treatment with pharmaceutical drugs is not always the preference of the patient. In
order for the delivery of care to be patient centered, a holistic approach to care needs to be a
standard in ambulatory care. This change would enable the assurance that patients are presented
with all options available and enable them to take control of their health.
The Journal of Dietary Supplements discusses the increased use of "Complimentary and Alternative
Medicine (CAM)" and how it is becoming a need among physicians to educate and train themselves
so that the idea of Integrative Medicine is a realization to the public (Litchy, 2011). This holistic
approach allows the ability for conventional medicine to be incorporated with ... Show more content
on Helpwriting.net ...
The use of technology will enable patients to track important health information. This can be useful
for patients changing primary care providers, meaning the redundant attempts to provide physician
offices with past medical history can be eliminated. A discussion of extensive implementation of
Electronics Health Records (EHR's) to create a service for patients is found on HealthIT.gov (Health
IT, 2014). As of now only a select few organizations include this service technology and it is called
"Blue Button." This service allows patients to retrieve all medical records through the internet rather
than having to visit the medical records office at a local facility. With the inclusion of this service, a
broad variety of services including a system wide online patient portal is a possibility to allow
patients the ability to connect mobile health monitoring devices, check current prescriptions, and
review important blood test results (Health IT, 2014). These tools can be utilized by patients to track
and take preventative actions on their health status, but unfortunately not every healthcare
organization offers this to its patients. If the inclusion of this type of service becomes a standard in
care, patients will gain access to their health records and be able to utilize them through a more
convenient effort no matter which provider is seen.
This type of technology will generally lead to improved patient satisfaction as, more control over

Ambulatory Care Research Paper
Ambulatory care comprises health care services that do not require overnight hospitalization. (Sultz,
Young , p. 129). An improved process would have the patient as its focus, considering the effective
use of varying levels of providers managing each step of the clinical visit to properly gather
information, reducing the number of interactions, and improving the patient experience while
providing a better set of outcomes (Backer & Asso). Also ambulatory care facilities are mainly for
invasive techniques that are replacing the complex, inpatient procedures.
On the other hand, this will help eliminate some of the hospital surge capacity. At the rate of
changes in the health care system, changes are in the works and an increase of the numbers

Description of Ambulatory Care and Hospitalization Care Essay
As early as the 1990's, outpatient care only made up for 10 to 15% of a hospital's total profits,
compared to inpatient care. Since the start of the twenty–first century, this figure has increased to
approximately 60%. This shift in healthcare has been occurring in different medical organizations
such as university medical centers, local hospitals, for–profit chains, and not–for–profit suppliers.
The increase in outpatient services compared to inpatient has been showing no indication of slowing
down. The main reason for the development in outpatient care is because of all the medical
advancements in techniques and technology that allow for patients to be treated less invasively.
Health care organizations are now being compensated in a ... Show more content on Helpwriting.net
...
The development of walk–in clinics at the local CVS Pharmacy or Wal–Mart are part of the
freestanding facilities that provide people in communities easier access to treatment without going
to a hospital ED. Additionally, the evident convenience aspect of bringing full emergency services
to communities, freestanding centers may be less likely to resort to hospital admissions as an outlet
to drive throughput. The incentive for ASCs is to emphasize volume and higher rates, while
hospitals are considered to regulate utilization. Looking closely, the main purpose originates from
ASCs' lower cost profile compared to hospitals with the additional benefit of the likely to evade
inpatient expenditure. Within ambulatory clinics, there are three levels of service that are preformed
based on the type of diagnosis and treatment recommendations. Level one ambulatory service is
considered an option to inpatient care with both patient and service parts that corresponds with the
point of intensity. The role of this level is to offer alleviation from acute symptom reducing
mechanisms such as less severe residential constituents such as the family treatment home for
children. Level two ambulatory services are set apart by effective treatment; regularly with a rehab
or transitional process that is built–in to the care plan. This process is complete in a staff–supported
setting that expands past the care setting into the important sections of the patient's district

SBMI Ambulatory Care Clinic: Case Study
In SBMI Ambulatory Care Clinic the new patient shows for her first new appointment at the clinic.
In which the new patient is asked by the secretary to fill out her name, the arrival time, and the
doctor she is there to see. This lets the employees know who has arrived at the clinic and which
doctor they are to see. The responsibility of employee at the front desk is to direct patients to the
correct doctor but, first Miss Chatterbox must verify her identity at the clinic by showing her
driver's license to make sure she is the one getting care. This is also done to make sure that the clinic
will be charging the correct person when seen, this also helps protect Miss Chatterbox identity. After
the license is given to the secretary she responds ... Show more content on Helpwriting.net ...
The weight is taken and recorded where Amy is asked to follow the nurse to the exam room so that
she can see the doctor so treatment can begin. The nurse leaves Amy in the exam room where she
awaits the doctor. The doctor shows where he greats Amy as, "Miss Chatterbox" and he ask her
what her appointment for today. Amy then tells him that she is looking for a new doctor and they are
recommend by her employer. The doctor then ask if she has any allergies or to any drugs. Amy lets
him know of one drug she is allergic too and strawberries. This series of questions allow the doctor
to diagnose Amy. Amy is asked if any health issues have occurred in the past, Amy goes through her
medical history with the doctor. The doctor ask if any medications are taken which he finds that
Amy is taken something for hay fever. She is asked about her family history and any problems
there, where none is found. She is then asked of any shots that have been taken in the past. She
remembers the shots but, does not remember when she took them. The doctor ask if anyone can
make choices for her if she cannot, Amy declines making a choice like that. The doctor decides that
Amy is in very good health, and ask her to call him if any issues come along within the next year
where he wants to see her. Amy schedules her next appointment in a year at the front desk, where
the secretary lets her know what time and date, and to call them if she needs

Ambulatory/Outpatient Care
1. Ambulatory/outpatient care does not meet the specific treatment needs of the recipient. Sara is in
need of residential treatment due to her history of self–injurious behaviors, and multiple attempts of
suicidal gestures. Sara requires a higher level of care which outpatient care is currently failing to
provide her at this time. Sara continues to have depressive symptoms and anxious feelings for the
last few months. The patient has had two acute inpatient admissions within the last 3 months and
requires long term stabilization. At this time Sara requires 24 hour supervision and ongoing
intervention and treatment. 2. Proper treatment of the recipient's psychiatric condition requires
services on an inpatient basis under the direction of a physician. ... Show more content on
Helpwriting.net ...
Sara has poor judgment/insight and poor decision making skills. She also demonstrates difficulty
coping with sexual abuse she endured from her biological father, and struggles to communicate her
emotions in outpatient therapy. There is also an extensive family history substance abuse and
depression. Sara requires admission to a locked residential treatment center to facilitate mood
stabilization and self–harm by addressing medication needs within the safety of a therapeutic

Lab Assignment 3-2: Ambulatory Health Care
Lab Assignment 3–2 The Joint Commission
There are 9 types of health care facilities that are accredited by the Joint Commission. The
Ambulatory Health Care accreditation, encompassing organizations and facilities that provide
outpatient services of medical/dental nature as well as diagnostic, surgical, and therapeutic services.
Other types of facilities that are accredited are critical access hospitals, hospitals, laboratories,
office–based surgical centers, and nursing care centers. There is also Home Care services, the
Opioid Treatment Program, and the Behavioral Health Care Program. Critical Access Hospitals
meet special requirements regarding patient beds and LOS. Hospitals that are accredited include
general and specialty hospitals.

Substance Abuse Therapy : Ambulatory Care Settings
Substance Abuse Treatments in Ambulatory Care Settings
Kristine Pardilla
Samuel Merritt University
July 22, 2015
There are various care settings wherein substance abuse therapy services are provided. This include
primary care clinics, urgent care center or the hospital's emergency department, freestanding
substance abuse treatment or mental health facility, intensive outpatient and partial hospitalization
programs and acute care inpatient settings. The American Society of Addiction Medicine (ASAM)
developed a clinical tool called Placement Criteria, Second edition, revised (PPC–2R), to match
patients' care needs for substance abuse detoxification and the suitable care environment. Placement
determination is evaluated according to ... Show more content on Helpwriting.net ...
Commonly abused substances include alcohol, tobacco, stimulant, cannabis and opioids. There are
different pharmacotherapies for various types of abused substances. Multiple substance abuses
require therapy for each of the drug that is being exploited.
For tobacco addiction, over–the–counter nicotine replacement therapies in the form of patch,
lozenge, spray or gum are available. In addition, prescription medications like bupropion and
veranicline, which prevent relapse, are used.
Alcohol dependence treatments include naltrexone, acamrosate and disulfiram. Naltrexone inhibits
opioid receptors that play a role in the pleasure effect of drinking and craving for alcohol.
Acamprosate is believed to have effects on reducing withdrawal symptoms like insomnia, anxiety,
restlessness and depression. This may be appropriate for patients who are severely alcohol
dependent. Disulfiram impedes the breakdown of alcohol which results in vexing symptoms like
nausea, flushing, and palpitations if the patient consumes alcohol (National Institute on Drug Abuse,
2009)
Methadone, buprenorphine and naltrexone are potent in managing opioid use disorder (OUD).
Diagnostic criteria for OUD according to Diagnostics and Statistics Manual 5 (DSM–5) is having
two or more of the following within a 12–month period: (1) persistent eagerness or failed attempts
to decrease or control use of opioid, (2) A great deal of time is spent in activities necessary to

Situation Analysis-Peace Memorial Hospital Essay
Situation Analysis–Peace Memorial Hospital
Peace Memorial Hospital is a 600–bed, independent, not–for–profit, general hospital located on the
southern periphery of a major western city. It is one of six general hospitals in the city and twenty in
the county. After doing much research, the Board of Directors has decided that they should open an
ambulatory location in the downtown area, to be known as the Downtown Health Clinic (DHC).
The clinic will have 4 major objectives: "1. To expand the hospital's referral base, 2. To increase
referrals of privately insured patients, 3. To establish a liaison with the business community by
addressing employers' specific health needs, and 4. To become self–supporting three years after
opening" (Kerin ... Show more content on Helpwriting.net ...
Exhibit 6 shows the results that they have received from these responses.
Exhibit 6 Profile of Downtown Health Clinic Patients: Personal Illness/Exam Visits Only
Occupation
Clerical 48%
Professional/Technical/Managerial 23%
Operator 19%
Other 10%
Sex
Male 30%
Female 70%
Referral Source
Friend/Colleague 35%
Employer 60%
Other 5%
Patient Origin
One block 25%
Two blocks 28%
Three blocks 22%
Four blocks 15%
Five blocks 8%
More than five blocks 2%
Direction
North of DHC 10%
South of DHC 25%
Northeast of DHC 5%
Southwest of DHC 15%

East of DHC 20%
West of DHC 10%
Southeast of DHC 10%
Northwest of DHC 5%
Have Regular Physician
Yes 18%
No 82%
Market Needs "Given their [Suburban Ambulatory Care Clinics] locations in suburban areas, these
facilities were not considered direct competition, but their existence indicated that "the city's
populace was attuned to ambulatory health care facilities," (Kerin and Peterson, 2007, p. 200).
Exhibit 4 Suburban Ambulatory Care Clinics: Operations Profile
Operations Emer Center #1 Emer Center #2 Adams Industrial Clinic Health First Medcenter
Opening March 1990 November 1992 June 1992 May 1991 June 1997
Patients/year 9,030 6,000 8,400 5,700 8,661
Hours of operation

Difference Between Large Facilities And Ambulatory Care
Healthcare systems in the united states face unparalleled pressures to change. The previous research
reveals that there is growing shift towards value–based care and providers are looking for ways to
cut healthcare costs. The residents from rural areas need to travel miles to access hospitals. The
facilities in these areas are limited and doesn't provide enough services. Most ambulatory centers
don't offer a complete breadth of services while full–scale hospitals often offer more than some
communities need. MICRO (Mobile Interdisciplinary Care Rounds) hospitals, a new care model is a
middle ground between large facilities and ambulatory care. It is gaining importance to improve
healthcare system by reducing cost and patient compliance. This

Patient-Operated Ambulatory Care
The latest research has found that the Patient Centered Medical Homes around the country have
proven to give patients the best in care and quality for primary health care services for Medicare and
Medicaid members. "Connie A. Jastremski & M. Janice Nelson (2011) reports Although the nurse
practitioner is generally thought of as providing primary care to a group of clients outside the
hospital setting, many are employed within hospital–operated ambulatory care setting, or within the
hospital itself, many times providing the initial physical assessments of patients required by
regulating agencies such as the State Health Department and the Centers for Medicare and Medicaid
Services. Primarily prepared at the master's level, these nurses in advanced

Case Study: Ambulatory Care Delivery System
Financial structure (more affordable to the patients),
Quality of care delivery: ambulatory care facilities delivery high quality of care to their patients in
more cost effective ways depending on patients conditions than hospitals because most of them are
owned and operated by the physicians. Also Ambulatory care facilities provided quality, safety, and
efficiency to their patients. Providing good quality of care is significant because they try to attract
more patient in order to become more profitable facilities. And earning a reputation
Accessibility: Ambulatory care facilities are very easy to access and most of their procedures are
done on the same day and does not required overnight stay, which is more beneficial to the patients.
It is ... Show more content on Helpwriting.net ...
Implication of this shift for hospitals is very important because hospitals inpatient have decreased.
Hospitals are losing more money due to the growth of ambulatory care facilities. Ambulatory care
facilities can affect hospital fiscal health by attracting many profitable services away from the
hospitals. Consumers are saving more money because they can get good quality of care for less
money and less hospital stay than hospitals. This can impact health care delivery system because
they will be more competition between those ambulatory care facilities and hospitals.
2– What does health care "system fragmentation" really mean? Describe the sources of
fragmentation.
From my point of view, health care system fragmentation means having different decision makers
for a set of health care decisions that would be made for better outcome through combined decisions
making.
Describe the sources of fragmentation:
Source of fragmentation comes from different network of public and private financing heath care
delivery, need of accountability for patient, deficiencies in communication between providers, and
medical

Ambulatory Care Analysis
I select ambulatory care for a new idea that I was unable to find anything close to my idea.
Traditional ambulatory care services have been viewed as the primary source of contact for most
direct patient medical care and consist of individual medical practitioners working in a private clinic
or group practice (Williams & Torrens, 2008). Although health educators have a responsibility to
teach medical students about social determinants of health and encourage them to pursue primary
care/medical practice in underserviced free community clinics, but most medical school graduates
more to more lucrative private/group practices (VanderWielen, Vanderbilt, Crossman...& Bradner,
2015). Therefore, I my new idea would be to remove all private/group ambulatory

The Agency for Healthcare Research and Quality created a survey to understand patient safety from
the healthcare provider's perspective. There are numerous surveys geared towards patient
satisfaction and quality control for the patients to participate in. However, this survey allows
healthcare to be the participant and to be proactive in improving patient safety as well. This survey
is directed to ambulatory (out–patient) surgical facilities. There are nine sections in the survey and
each are broken down into specific components. The first section pertains to available resources and
time management when working within the facility. The second section apply to to training and
collaboration of colleagues. The third section is concerned with problem

PCMH Ambulatory Care
Which populations (e.g. adults, children, or older adults) and what conditions/diseases are targeted
PCMH Ambulatory Care
Health initiatives attentions on the health outcomes of a group of patients; in the PCMH model, such
groups of patients, known as panels, may be defined as patients assigned to a care team or provider.
The basic characteristics of the PCMH model include physician–led, team–based practice;
coordinated and integrated care within the PCMH and in the patient's community; provision of safe,
evidence–based, high–quality care; incorporation of health information technology and continuous
quality improvement strategies into panel identification, documentation, and care processes;
improved access to care; and value–based ... Show more content on Helpwriting.net ...
Professional associations, payers, policy makers, and other stakeholders have advocated for the
patient–centered medical home model. Interventions to transform primary care practices into
medical homes are increasingly common, but their effectiveness in improving quality and
containing costs is unclear.
Health and Health Care Disparities: The Effect of Social and Environmental Factors on Individual
and Population Health.
Recently the existence and prevalence of health and health care disparities has increased with
accompanying research showing that minorities (African Americans, Hispanics/Latinos, Native
Americans, and Pacific Islanders) are disproportionately affected resulting in poorer health
outcomes compared to non–minority populations (whites). To this degree is due to numerous issues
including and most importantly the social determinants of health which includes lower levels of
education, overall lower socioeconomic status, inadequate and unsafe housing, and living in close
proximity to environmental hazards; all contributing to poor health. Given the ever widening gap in
health and health care disparities, the growing number of individuals living at or below the poverty
level, the low number of college graduates and the growing shortage of health care professionals
(especially minority) the goals of this paper are to: (1) Define diversity and inclusion as
interdependent entities. (2) Review the health care

Ambulatory Care
Ambulatory care is a type of medical care that is provided to patients who do not need to be
admitted to a hospital for treatment. It is often referred to as "outpatient care". It includes diagnosis,
observation, consultation, treatment, intervention, and rehabilitation services. Ambulatory care can
be delivered in a variety of settings, including doctor's offices, clinics, hospitals, emergency
departments, eye doctors, etc. This type of care tends to be preferred because most people want to
avoid staying in a hospital more than needed, and it is also less expensive. Most hospitals encourage
patients to choose outpatient care if it is possible, that way the facilities will be free for more critical
patients and to cut down on overall expenses.

Rick Ry Human Service Delivery Model
As many of you know, Rick Ryan, Human Services Cluster Deputy CIO, has retired. I have known
Rick since 1998 when, as Associate Computer Programmers, we worked together on Welfare to
Work (under Fred Teti). It is with mixed feelings that I bid Rick farewell. I am happy for him as he
enters this new phase of his life, but I will miss him both professionally and personally. As we move
forward in our transformation, there is still much change ahead and we are faced with the continuing
challenge of balancing our ongoing workload, migrating data centers, and the organizational
changes required to to address our evolving service delivery model. To help us meet these
challenges, it is my pleasure to announce that Stacy Panis has been promoted from

Hsa 405 Week 3 Assignment 1 Strayer Latest
HSA 405 WEEK 3 ASSIGNMENT 1 STRAYER LATEST
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HSA 405 WEEK 3 ASSIGNMENT 1 STRAYER LATEST
HSA 405 Week 3 Assignment 1 – Health Policy and Law Basics – Strayer Latest As a chief
operating officer of a hospital, you have been tasked with opening a new ambulatory care center in
your city.
Write a two to three (2–3) page paper in which you:
Specify whether you would utilize the professional autonomy, social contract, or free market
perspective as the paradigm to design the structure of your new center. Debate at least two (2)
advantages and two (2) disadvantages of your chosen ... Show more content on Helpwriting.net ...
Note: Wikipedia and other Websites do not qualify as academic resources.
Activity mode aims to provide quality study notes and tutorials to the students of HSA 405 Week 3
Assignment 1 Strayer Latest in order to ace their

Ambulatory Care Case Study

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