The changing nature of healthcare

Dr.Mohamed Ahmed Hamdy,MBBch, EMBA, LGBSS, OSHA

Healthcare& Hospital Management Consultant, MedEx healthcare, Egypt.

Micro-hospitals(Definition)

• While no micro-hospital is identical to another, most micro-hospitals are acute care hospitals that meet all federal and state licensing and regulatory requirements.

• They focus on treating low-acuity patients and providing ambulatory and emergency services, leaving more complex surgeries and service lines for their larger counterparts.

• They also have fewer beds, usually around eight to 12, and don't take up much space — according to the Advisory Board, they typically are only 15,000 to 50,000 square feet.

Micro-hospitals(Common locations)

• Micro-hospitals are similar to community hospitals and small, rural hospitals, but location is what sets micro-hospitals apart.

• Health systems are placing micro-hospitals in larger metro areas in communities where patients may not have easy access to acute or emergency care.

• The micro-hospital, in theory, seeks to fill that care gap and provide better access to care.

Micro-hospitals(Value based care)

• Many health systems are pursuing the micro-hospital model now because of the industry's increased focus on providing care at the right time in the appropriate setting.

• The model allows the system to deliver hospital services closer to home, and in a way that is more appropriately sized for the population compared to larger, more complex facilities.

Micro-hospitals(Upgrade from a freestanding ED)

• Micro-hospitals and freestanding emergency departments are similar in that they both provide emergency care; however, micro-hospitals can also admit and guide patients to other appropriate care settings.

• Micro-hospitals are designed to provide access to comprehensive care as part of a broader network, more so than a bed-less ED.

Micro-hospitals(Faster, cheaper)

• Another reason micro-hospitals are exploding in popularity is because they are less of a financial burden for health systems than a traditional hospital.

• Building a micro-hospital can cost anywhere from $7 million to $30 million.

• Additionally, micro-hospitals have a shorter build time, allowing the health system to bring healthcare services to patients in the community faster.

Micro-hospitals(Long-term survivability)

• Micro-hospitals have the potential to be stalwarts in the industry if they're done right.

• They complement a larger care footprint and can connect patients with different levels of care when they need it.

Micro-hospitals(Conclusion)

Stand –alone Emergency Center

Stand-alone ER(Definition)

• In most states, a licensed freestanding emergency center is a health care facility that provides emergency care, but is completely separate from an acute-care hospital.

• Typically, these facilities will have transfer agreements with area hospitals so they can transfer patients who need to be admitted.

• Some freestanding emergency centers are owned and run by hospitals, and the hospitals operate these ERs as a department of the hospital.

Why are more and more patients choosing freestanding emergency

centers?• Access: Freestanding emergency centers provide access to

emergency medical care for every patient who comes to them.Ÿ 

• Quality: Freestanding emergency centers provide consummate quality of care. They are licensed, closely regulated, fully equipped for all medical emergencies and required to have an ER physician on-duty at all times.Ÿ 

• Convenience: Freestanding emergency centers provide unparalleled convenience. They are frequently closer and wait time is consistently quicker than hospital ERs, and unlike urgent-care facilities, they are required to be open 24/7 to provide all levels of care.Ÿ 

• .

Why are more and more patients choosing freestanding emergency

centers?• Cost: Freestanding emergency centers charge

equal to or less than hospital ERs for emergency care that often exceeds the hospital ER standard.Ÿ 

• Satisfaction: Among all urgent- and emergency-care providers, Freestanding emergency centers receive the highest satisfaction scores from everyone involved patients, physicians and staff.

Stand-alone ER(Statistics)

Additionally, according to the American College of Emergency Room Physicians:

•Only 8% of emergency patients have non-urgent conditions,•Emergency departments have a federal mandate to treat everyone, regardless of their ability to pay; two-thirds of emergency visits occur after business hours or when the doctor’s office is closed.•The growing elderly population is driving necessary access to emergency care.•Freestanding emergency centers can meet these needs while reducing hospital overcrowding and letting hospital ERs focus on taking care of the most serious cases.

Get a new body part and go home the same day:

The rise of the ‘bedless hospital

Bedless Hospitals(Definition)

• As treatments get less invasive and recovery times shrink, a new kind of hospital is cropping up — the “bedless hospital.”

• They have all the capabilities of traditional hospitals: operating rooms, infusion suites, and even emergency rooms and helipads. What they don’t have is overnight space.

Bedless Hospitals(Pros)

• It reduces cost, and it reduces the risk of infection.• People go home to a less-risky environment, where

they tend to get better faster.• Outpatient visits, experts say, subsidize more

expensive inpatient treatment.• The rise of bedless hospitals has also tracked the

development of streamlined treatments, efforts to create standardized protocols for routine surgeries that could be done without prolonged hospital stays.

Bedless Hospitals(Cons)

• There are serious concerns that patients will not get quality care at these strictly outpatient surgery centers.

• As readmission rates are higher than ever at traditional hospitals, many industry specialists believe these new medical centers would push patients out too early, or not admit patients to hospitals that require an overnight stay.

• Many patients referred to these facilities are under Medical insurance coverage, and there are concerns that they would be getting the cheapest – though not necessarily best – care at these centers.

• Currently, no data are available to determine the cost savings of bedless hospitals over traditional facilities.