FINAL DRAFT- 10/31/95
REVISED January 1997
Narrative
Current Direction
The VA is actively seeking sharing agreements
The VA HealthCare system provides ambulatory
with University, Army, Navy and Air Force
care in two settings:
facilities.
Obstetrics tends to be a contracted service due
Community Based Outpatient Clinics
to limited demand within the VA system.
These are simple freestanding clinics located
within the community setting to effectively
The VA has increased focus on women's
provide convenient primary care.
medicine in response to increase in the
population of women who are veterans.
Community Based Outpatient Clinics refer
patients to hospital based Ambulatory Care
A large percentage of the population served by
Facilities for diagnosis and special care.
the VA system will continue to be retired.
See the VA Design Guide of Community Based
The VA health care system will continue to
Outpatient Clinics for additional Guide Plates.
maintain a significant focus on physical therapy,
prosthetics, and rehabilitation services.
Ambulatory Care
The Ambulatory Care Facility is a hospital
Under managed care, the Veteran may chose
based patient care center providing special
their health program which can be extended to
exam, treatment, and diagnostic services for
the spouse and other family members. Under
acute and chronically ill patients.
this scenario the profile of the VA patient would
change.
Primary Care services may be provided as
determined on a project basis.
General Trends in Ambulatory Care
Although the majority of Ambulatory Care
The continuing shift of selected diagnostic
patients are outpatients many inpatients may be
examinations and procedures to an out-patient
treated in the ambulatory setting to eliminate
setting has brought about the evolution of the
duplication of services, facilities and staff.
Ambulatory Care Facility.
These "hospitals
without beds" may involve such diverse
VA Trends
activities as surgery, sophisticated imaging
systems, and both invasive and non-invasive
VA budget allocations for hospital based
diagnostic and therapeutic procedures.
ambulatory care may diminish in favor of
primary care centers outside the hospital
Ambulatory Care Facilities may be connected to
setting.
an existing hospital structure or they may be
remotely located as part of the hospital's
VA is evaluating how patients should be served,
outreach program to a targeted population area.
and how they should participate in their own
In either circumstance, ease of access and
care.
circulation for outpatients and their families is a
primary planning objective. It is important to
More accessible and convenient primary care is
remember that patients are often experiencing a
provided by smaller, community based, free-
heightened sense of anxiety with regard to the
standing facilities of less than 930 m2 (10,000
status of their health. Their experiences in
s.f.)
finding their way around an unfamiliar facility
should not contribute to this anxiety. This is
Hospital Based Ambulatory Care is likely to
particularly important for first -time visitors.
consist of highly specialized referral clinics,
technologies, and staff that cannot afford to be
duplicated in off-site Primary Care settings
VA funding is moving from a bed service
orientated operation to an ambulatory care
VA DESIGN GUIDE
AMBULATORY CARE (Hospital Based)
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