8 Reasons Why Ambulatory Care Quality Matters More Than Ever

Cheryl Clark, for HealthLeaders Media , January 19, 2012

So here, culled from a variety of sources including the AMA report, are eight reasons why quality measures to prevent outpatient mishaps—from prescription drug errors to delayed or missed diagnoses—will soon be a much bigger issue on the ambulatory provider's radar.

1. Outpatient Visits More Numerous, Complex
The setting for more complex procedures, with greater potential for harm, has been rapidly shifting from inpatient to outpatient. And errors that take place in these settings may elude detection for longer periods.

"The things that lead to bad outcomes in ambulatory settings are more dispersed, they're harder to keep track of.  An error takes place in one setting, but isn't discovered until the patient goes to another setting," Wynia says.

In the hospital, patients remain in one place long enough for providers to see and attribute the cause of medical mishaps within minutes or days. But the consequences of an outpatient's wrong dose of medication may not be noticed for days or weeks.

2. Patients' Responsibility in Preventing Errors
Providers are increasingly aware the patient may not follow their course of care. And more now than ever, the provider is accepting the blame. The patient may be insufficiently informed, cognitively unable to grasp concepts, have limited language skills or simply be unwilling to take a prescription because of a perceived drug side-effect or lack of money. 

"Patients are also expected to explain their symptoms to clinicians accurately and completely and to provide other essential information for diagnosing and tracking the progression of their conditions," the AMA report explains.

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