Ambulatory Settings

Ambulatory care settings provide healthcare on an outpatient basis. That is, patients do not stay overnight in the facility. The term "ambulatory care" encompasses a large variety of healthcare settings that include but are not limited to physician offices, urgent care centers, dialysis facilities, ambulatory surgical centers, cancer clinics, imaging centers, endoscopy clinics, public health clinics, and other types of outpatient clinics.

Special considerations for infection prevention in these settings

• This category covers a wide range of facilities, providing a variety of different medical care services and having a range of licensing requirements, staff training needs, and surveillance procedures.
  • More information on licensure and certification
• The degree to which the infection prevention program is formalized may differ, but for each setting, infection prevention is a high priority. The infection prevention programs range, depending on the type of setting and licensing requirements, from policies established by the facility to accountability defined by the Centers for Medicare and Medicaid Services or another certifying organization.
• Patients play an important role in preventing infections and in identifying any that might be associated with outpatient care. It is important to know the signs and symptoms of infection and contact your provider for follow up if any symptoms develop.
  • This is especially true for ambulatory care settings because the signs of an infection may not present until after the patient leaves the facility.

Reporting requirements

• [UPDATED] Virginia Reportable Disease List
  • Outlines diseases and conditions (including outbreaks) that are reportable to the local health department by physicians, directors of medical care facilities, and directors of laboratories.
  • Part of the Regulations for Disease Reporting and Control.
  • And Regulations to Disease Reporting Portal
• In January 2012, the Centers for Medicare and Medicaid Services (CMS) began requiring dialysis facilities participating in the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) to report certain infection events to the National Healthcare Safety Network (NHSN), including positive blood culture, I.V. antimicrobial start, and signs of vascular access infection. In January 2015, CMS added summary-level healthcare personnel influenza vaccination coverage rates to the ESRD reporting requirements.
• In October 2014, CMS began requiring ambulatory surgery centers participating in the Ambulatory Surgery Centers Quality Reporting program to report summary-level influenza vaccination data for all healthcare personnel via NHSN.

Resources