The document discusses the changing landscape of healthcare delivery through micro-hospitals, freestanding emergency centers, and bedless hospitals. Micro-hospitals are small acute care facilities that focus on low-acuity patients while freestanding emergency centers provide emergency care without being attached to a hospital. Bedless hospitals have operating rooms and emergency capabilities but no overnight beds, allowing for lower-cost same-day procedures. While these models improve access, there are also concerns about reducing costs too much and rushing patients out of care prematurely.

1. The changing nature
of healthcare
Dr.Mohamed Ahmed Hamdy,
MBBch, EMBA, LGBSS, OSHA
Healthcare& Hospital Management
Consultant, MedEx healthcare, Egypt.

4. Micro-hospitals
(Definition)
• While no micro-hospital is identical to another, most
micro-hospitals are acute care hospitals that meet all
federal and state licensing and regulatory requirements.
• They focus on treating low-acuity patients and providing
ambulatory and emergency services, leaving more
complex surgeries and service lines for their larger
counterparts.
• They also have fewer beds, usually around eight to 12,
and don't take up much space — according to the
Advisory Board, they typically are only 15,000 to 50,000
square feet.

5. Micro-hospitals
(Common locations)
• Micro-hospitals are similar to community
hospitals and small, rural hospitals, but location
is what sets micro-hospitals apart.
• Health systems are placing micro-hospitals in
larger metro areas in communities where
patients may not have easy access to acute or
emergency care.
• The micro-hospital, in theory, seeks to fill that
care gap and provide better access to care.

6. Micro-hospitals
(Value based care)
• Many health systems are pursuing the micro-
hospital model now because of the industry's
increased focus on providing care at the right
time in the appropriate setting.
• The model allows the system to deliver hospital
services closer to home, and in a way that is
more appropriately sized for the population
compared to larger, more complex facilities.

7. Micro-hospitals
(Upgrade from a freestanding ED)
• Micro-hospitals and freestanding emergency
departments are similar in that they both provide
emergency care; however, micro-hospitals can
also admit and guide patients to other
appropriate care settings.
• Micro-hospitals are designed to provide access
to comprehensive care as part of a broader
network, more so than a bed-less ED.

8. Micro-hospitals
(Faster, cheaper)
• Another reason micro-hospitals are exploding in
popularity is because they are less of a financial
burden for health systems than a traditional
hospital.
• Building a micro-hospital can cost anywhere
from $7 million to $30 million.
• Additionally, micro-hospitals have a shorter
build time, allowing the health system to bring
healthcare services to patients in the community
faster.

9. Micro-hospitals
(Long-term survivability)
• Micro-hospitals have the potential to be stalwarts
in the industry if they're done right.
• They complement a larger care footprint and can
connect patients with different levels of care
when they need it.

10. Micro-hospitals
(Conclusion)

11. Stand –alone Emergency Center

12. Stand-alone ER
(Definition)
• In most states, a licensed freestanding
emergency center is a health care facility that
provides emergency care, but is completely
separate from an acute-care hospital.
• Typically, these facilities will have transfer
agreements with area hospitals so they can
transfer patients who need to be admitted.
• Some freestanding emergency centers are
owned and run by hospitals, and the hospitals
operate these ERs as a department of the
hospital.

13. Why are more and more patients
choosing freestanding emergency
centers?
• Access: Freestanding emergency centers provide
access to emergency medical care for every patient who
comes to them.Ÿ
• Quality: Freestanding emergency centers provide
consummate quality of care. They are licensed, closely
regulated, fully equipped for all medical emergencies
and required to have an ER physician on-duty at all
times.Ÿ
• Convenience: Freestanding emergency centers provide
unparalleled convenience. They are frequently closer
and wait time is consistently quicker than hospital ERs,
and unlike urgent-care facilities, they are required to be
open 24/7 to provide all levels of care.Ÿ

14. Why are more and more patients
choosing freestanding emergency
centers?
• Cost: Freestanding emergency centers charge
equal to or less than hospital ERs for emergency
care that often exceeds the hospital ER
standard.Ÿ
• Satisfaction: Among all urgent- and
emergency-care providers, Freestanding
emergency centers receive the highest
satisfaction scores from everyone involved
patients, physicians and staff.

15. Stand-alone ER
(Statistics)
Additionally, according to the American College of Emergency
Room Physicians:
•Only 8% of emergency patients have non-urgent conditions,
•Emergency departments have a federal mandate to treat everyone,
regardless of their ability to pay; two-thirds of emergency visits occur
after business hours or when the doctor’s office is closed.
•The growing elderly population is driving necessary access to
emergency care.
•Freestanding emergency centers can meet these needs while
reducing hospital overcrowding and letting hospital ERs focus on taking
care of the most serious cases.

16. Get a new body part and go home
the same day:
The rise of the ‘bedless hospital

17. Bedless Hospitals
(Definition)
• As treatments get less invasive and recovery
times shrink, a new kind of hospital is cropping
up — the “bedless hospital.”
• They have all the capabilities of traditional
hospitals: operating rooms, infusion suites, and
even emergency rooms and helipads. What they
don’t have is overnight space.

18. Bedless Hospitals
(Pros)
• It reduces cost, and it reduces the risk of
infection.
• People go home to a less-risky environment,
where they tend to get better faster.
• Outpatient visits, experts say, subsidize more
expensive inpatient treatment.
• The rise of bedless hospitals has also tracked
the development of streamlined treatments,
efforts to create standardized protocols for
routine surgeries that could be done without
prolonged hospital stays.

19. Bedless Hospitals
(Cons)
• There are serious concerns that patients will not get
quality care at these strictly outpatient surgery centers.
• As readmission rates are higher than ever at traditional
hospitals, many industry specialists believe these new
medical centers would push patients out too early, or not
admit patients to hospitals that require an overnight stay.
• Many patients referred to these facilities are under
Medical insurance coverage, and there are concerns
that they would be getting the cheapest – though not
necessarily best – care at these centers.
• Currently, no data are available to determine the cost
savings of bedless hospitals over traditional facilities.