Ambulatory shift transforming care models for high-acuity patients

Editor's Note

As hospital systems seeing a significant jump in outpatient care, they are also seeing a rise in patient acuity across inpatient care. This increased patient acuity for inpatient care is driving changes to care models across both settings, an October 27 article in Becker’s Clinical Leadership reports.

Clinical leaders are working to redesign care delivery models across all settings to enable teams to focus more of their time on direct patient care that is safe and efficient for the patient population. For example, inpatient care is shifting toward reimagining a role caring for the most critically ill patients and developing new strategies to accommodate this shift, one chief medical officer described in the article.

This work is involving strategic use of technologies such as virtual nursing and AI to simplify frontline providers’ administrative burden. One doctor interviewed in the article noted that AI technology can support safety optimization and efficiency by detecting patterns of redundant work to give time back to nurses. Predictive analytics and digital tools are being used more frequently to better support clinicians with early identification of patients whose condition may be deteriorating, per the article.

Scheduling is another key focus noted in this shift to new models of care for high-acuity inpatients. One interviewed leader described a scheduling model that accounts for historical unit acuity, while allowing team members to choose how and when they want to work. She said it’s essential to provide nurses with a sustainable career focused on direct patient interaction that also supports a truly healing environment for patients. In rural settings, this high acuity shift for inpatient care means building a broader skill mix across staff, the article reports. For example, a leader working in a rural center in Ohio explained that nurses are being trained to work across medical surgical and high-acuity units.

Leveraging advanced practice providers to address preoperative health and safety for surgical patients with comorbidities such as diabetes and heart failure is another trend discussed in the article. One interviewed health system leader noted their system is exploring ways to leverage hospitalists to better co-manage preoperative comorbidities so that surgeons can focus more fully on the surgical procedure.