This document provides an overview of the Acute Care and Ambulatory Procedures Service (ACAPS) at a military medical facility. ACAPS provides active duty acute care, urgent care, minor surgical procedures, sports medicine, and women's health services. It operates with 12 medical teams that serve over 75,000 enrollees and conduct over 100,000 outpatient visits annually. ACAPS aims to provide prompt care for patients while also educating medical residents and staff. It performs a variety of common procedures on an average week and works to establish the benefits of its services for both patients and the family medicine department.

1. UNCLASSIFIED
ACAPS
ACUTE
CARE &
AMBULATORY
PROCEDURES
SERVICE

2. ACAPS Mission
• Active Duty Acute Care (Sick Call)
• Urgent Care
• Referrals from Emergency Dept.
• Sports Medicine / Office Orthopedics
• Ambulatory Minor Surgical Services
• Dermatology Services
• Women’s Health Services
• Curbside Consults

3. Medical Home
• 12 “Teams”
– 3 Physicians, 2 PA/NP
– 3 Residents, 1-2 RN, 2 LPN, 2 HM
• 75,000 enrollees
• 6,500 AD personnel + 8,000 dependents
• Foreign Military, DoD, State Dept
• USUHS, TDY, training, visitors
• 100,000 outpatient visits / year

4. Medical Home
• METC
• Nutritional Service
• Behavioral Health
• Diabetes Care
• ACAPS
16-24 AD Acute Care (Sick Call)
8-10 Urgent Care
3-4 ER Transfers
6-8 Scheduled Procedures
6-8 Urgent Procedures

5. Here to Serve our Patients

6. Minor Surgical Services
• Skin biopsies
• Excision of skin lesions
• I&D (Abscess, Hemorrhoids)
• Ganglion Cyst
Aspiration/Injection
• Heel Spurs, Plantar Warts,
Ingrown Toenail
• Skin Foreign Bodies
• Genital Lesions
• Oral lesions
• Vasectomy

7. Sports Medicine
Office Orthopedics
• Ganglion Cysts
• Trigger Points
• Joint Effusions
• Joint Injections
• Sprains/Strains
• Minor Fractures

8. Women’s Health
• Colposcopy
• Cervical Polyp
• Endometrial Biopsy
• IUD
• Breast Cyst Aspiration
• Vaginal Lesion Biopsy
• Bartholin Abscess

9. Average Week in ACAPS
(a few selected procedures)
 20 Joint / TP Injections
 18 Skin biopsy/excisions
 8 I&D
 10 Ultrasounds
 5 Toenail Procedures
 2 Vasectomies
 4 IUD insertions
 6 Colpo/EB/Cx Polyp
 10 Fracture/splints/casts
 15 IV hydrations
 2 Breast cyst asp / FNA
 2 I&D Thrombosed Hemorrhoid
 4 Corneal Abrasion / FB
 4 Ear Wax Removals

10. Additional Services
• Travel Medicine
• FAA Flight
Physicals

11. ACAPS GOALS
• Protect the Fighting
Force
• Prompt and convenient
Care for our Patients
• Education of Attending
Staff, Residents,
Corpsmen/Medics,
Nurses & Students

12. MEDICAL EDUCATION
• Transitional Year
Residents
• General Medical
Officers
• Mini ER Residency
• Minor Surgery
• Operational Medicine
• Readiness Standards

13. Focus on Common Procedures

14. Some of our graduates

15. How to Refer?
• Stop by Rm 2715
• Call us 295-7763

16. Comparison
Typical Medical Home Team ACAPS
• 3 Physicians • 1.5 Physician
• 2 PA/NP • 1 PA
• 1 Resident/day • 2 Residents
• Avg 48 patients / day • Avg 36 patients /day
• Avg enc 1.3 RVU • Avg enc 2.5 RVU
• Avg 4000 RVU / qtr • Avg 5800 RVU / qtr

17. Advantages of Establishing
ACAPS
For Patients For Family Med Dept
• Faster Care • Reduce Dx to Tx time
• Less ER Visits • Fewer ER Visits
• Fewer Appointments • More Training
• Lower costs • Better Patient Satisfaction
• Familiar Clinical Setting • Better Resident Satisfaction
• Better Reimbursement
FOR THE HOSPITAL:
Less upstreaming of low revenue procedures
Less cost of patient intakes
Better overall patient satisfaction

18. Questions ?

19. Thank You