Ambulatory emergency care - improvement by design

Area of Science:

• Emergency Medicine
• Healthcare Management
• Clinical Operations

Background:

• Ambulatory emergency care (AEC) provides emergency services without traditional hospital bed allocation.
• AEC operates in a clinic setting, maintaining care access during high hospital bed occupancy.
• This model alleviates hospital bed pressures and ensures timely treatment for specific patient groups.

Purpose of the Study:

• To outline the core principles and operational characteristics of Ambulatory Emergency Care (AEC).
• To highlight technological advancements influencing AEC service delivery.
• To emphasize the role of risk stratification in patient selection for AEC.

Main Methods:

• Review of common principles across various AEC models.
• Identification of key technological enablers in AEC.
• Discussion of patient selection criteria and risk stratification tools.

Main Results:

• Common AEC principles include senior decision-maker access, demand-matched hours, diagnostic access, inter-service collaboration, mixed workforce, and patient selection.
• Technological advancements such as high-sensitivity troponin assays, low-molecular-weight heparins, and CT pulmonary angiography have been crucial.
• Risk stratification tools are vital for determining AEC suitability.

Conclusions:

• Ambulatory emergency care (AEC) is a flexible model adaptable to local needs.
• Effective AEC relies on established principles and integration of modern diagnostics and treatments.
• Risk stratification is essential for optimizing AEC's role in patient care pathways.