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AHA: Realign Inpatient, Outpatient Services to Patient Needs

The guide calls for hospitals to reallocated their inpatient and outpatient services according to patient demand.

An AHA guide says hospitals should realign their inpatient and outpatient service offerings by patient demand.

Source: Thinkstock

By Sara Heath

- The American Hospital Association (AHA) has released a guide to better align inpatient and outpatient healthcare services to meet patient needs.

The one-page resource highlights the challenges healthcare organizations face in balancing their inpatient and outpatient volumes. As of late, facilities have been seeing a waning inpatient volume as their outpatient caseloads increase AHA, reported.

The inpatient/outpatient transformation strategy (IOTS) calls for hospitals to reduce their inpatient capacity and increase their outpatient capacity to meet patient needs. Healthcare organizations should conduct a thorough assessment of inpatient and outpatient trends in their specific community and then adjust their capacities accordingly.

Organizations should also reallocate their clinician resources to ensure there are no doctor shortages in a certain care area.

Amidst this transformation, healthcare organizations should also continue to offer emergency services.

AHA cautions that despite reallocating inpatient and outpatient capacity and services, hospitals will still be subjected to certain regulatory requirements such as quality reporting standards, the Medicare Conditions of Participation, and other various requirements pertaining to volume and quality of services rendered.

Hospitals will also need to engender community and staff buy-in to successfully implement the IOTS, AHA explained.

“Hospitals should start by engaging their boards in conversations related to the amount and type of services currently offered by the hospital to the community,” the organization wrote in the guide.

“Then, hospitals should determine what services they should be providing based on the health needs of the community,” the guide continued. “This includes proactively fostering relationships with community organizations focused on improving the community's health.”

Organizations should conduct community outreach to help reinforce priorities on general health and wellness. Hospitals should coordinate with local governments, schools, churches, and health departments to partner in this message of overall patient health.

These entities can be integral in reaching patients between office visits and activating patients in certain wellness activities such as improving diet, becoming more physically active, and receiving regular chronic illness screenings, AHA said.

AHA also acknowledges the investments healthcare organizations will need to make to successfully reallocate resources for inpatient and outpatient services.

“In order to transition to this strategy, like others included in the task force report, hospitals will need to invest time, effort and financial resources,” the organization noted. “In many cases, hospitals will need to make facility renovations or improvements to restructure how and where it offers its services.”

While not all hospitals have the financial means to make these investments, AHA says organization leaders should consult with local, state, and federal governments for additional resources.

AHA created this guide as a part of its series on at-risk community care access. Over the course of several months, the organization will be publishing nine resources to help communities at risk of losing basic and essential healthcare services.

AHA issued a guide last month on how to increase healthcare access and care coordination for those served by the Indian Health Services (IHS) as a part of that series. AHA explained that IHS and non-IHS facilities should assess which services patients utilize most frequently and collaborate to fill service gaps. Additionally, the guide called on the federal government to offer more support to the agency.

These resources were informed by a previous report from AHA’s Task Force on Ensuring Access in Vulnerable Communities, published at the end of 2016. The general guide offers several suggestions for organizations serving in vulnerable communities to strengthen their care offerings for patients.

Specific strategies include addressing the social determinants of health, reallocated workforce and patient volumes, and enlisting telehealth and digital care options.

AHA acknowledged that most healthcare organizations, least of all those serving vulnerable communities, have the resources to implement these changes. Community partners, federal policymakers, and other healthcare leaders must therefore collaborate to help these practices flourish.

“This is only the beginning,” AHA concluded in its 2016 guide. “To fully ensure access to essential health care services, we will all need to do our part — vulnerable communities, the hospitals that serve them, and the association that serves us all.”

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