Ensuring access to care requires input from facility professionals

An American Hospital Association (AHA) task force has laid out nine strategies to protect access to care in struggling urban and rural settings. According to the report, “Task Force on Ensuring Access in Vulnerable Communities,” there are more than 2,000 rural community hospitals and more than 2,000 in urban ones. But while these institutions many times serve as community cornerstones, issues threatening access to care for the surrounding populations continue to grow. For instance, rural hospitals deal with remote locations, limited workforce and constrained resource. Inner-city hospitals have to find ways to achieve financial stability while keeping charitable missions intact.

Among the nine strategies in the report, several affect health care planning, design, construction and infrastructure, including:

• Inpatient/outpatient transformation. This strategy involves a hospital reducing inpatient capacity to a level that closely reflects the needs of the community. The hospital would then enhance the outpatient and primary care services it offers.
• Emergency medical center (EMC). The EMC allows existing facilities to meet a community’s need for emergency and outpatient services, without having to provide inpatient acute care services. EMCs provide emergency services (24 hours a day, 365 days a year) and transportation services. They also would provide outpatient services and post-acute care services, depending on a community’s needs.
• Urgent care center (UCC). UCCs allow existing facilities to maintain an access point for urgent medical conditions that can be treated on an outpatient basis. They are able to assist patients with an illness or injury that does not appear to be life-threatening, but requires care within 24 hours.
• Virtual care. Virtual care strategies may be used to maintain or supplement access to health care services. These strategies could offer benefits such as immediate, 24/7 access to physicians and other health care providers, the ability to perform high-tech monitoring and less expensive and more convenient care options for patients. 

“Many hospitals face challenges maintaining access to health care services in their communities and this report provides a pathway to ensure every hospital has an opportunity to be an access point and an anchor of service,” says AHA President and CEO Rick Pollack. “The strategies outlined in this report can serve as a roadmap for all communities as hospitals begin to redefine how they provide more integrated care.”