Written by: Georgina R. Howard, RN-BC, NE-BC, MPA, MSN
With changes in healthcare reimbursement and health care policy, there has been a shift in access to care for patients. Fewer patients are accessing emergency rooms, opting instead for alternatives like urgent care clinics for non-acute conditions.,  At the same time, insurance carriers are heavily promoting preventive care and health maintenance to improve patient outcomes, encouraging people to rely more on their primary care physicians as the central point of organization for their overall health care. This change in the health care landscape has opened the door for the expansion of ambulatory care. In response, hospitals are now shifting their focus to ambulatory care services that include primary, specialty care, and outpatient procedural suites.
Ambulatory care models range from faculty practices to hospital-based outpatient departments. These services coordinate care for patients utilizing best practices in chronic disease and population health management. Their focus is to prevent utilization of emergency rooms, maintain health status, and encourage health prevention with immunizations and screenings. These providers work with their patients to prevent or reduce the risk of the negative impact of disease processes such as organ failure or loss of function.
Within ambulatory care, the practice model must be team based. The multi-disciplinary team works with their patient panel to become the patient’s “medical home.” This model requires a primary care provider to coordinate patient care. Many providers have implemented the Patient Centered Medical Home. The National Committee on Quality Care Patient-Centered Medical Home recognition program has been adopted across the country as the standard model of care that makes patients the priority. It builds collaborative relationships with patients and their clinical team. This approach has been shown to improve quality and patient experience while reducing health care costs. Practices that earn recognition have made a commitment to continuous quality improvement and a patient-centered approach to care. (NCQA, 2019).
 Paterick, T. E., Patel, N., Tajik, A. J., & Chandrasekaran, K. (2017). Improving health outcomes through patient education and partnerships with patients. Proceedings (Baylor University. Medical Center), 30(1), 112–113.
 National Committee for Quality Assurance. (2019). Patient-Centered Medical Home. Retrieved from: https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/.