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A new method for planning an ambulatory care facility

University of British Columbia

The ambulatory care facility is a new phenomenon in the British Columbia health care delivery system. Therefore, not only is its planner faced with the uncertainty of predicting future need, but also the perplexity of not having the very basis for his predictions: past utilization data from existing facilities. Moreover, there is no real agreement on what services should be provided in an ambulatory care facility. This thesis attempts to at least partially allay these uncertainties by setting down a format for planning an ambulatory care facility in and for the community of Delta, B. C. The planning method was divided into four parts: ambulatory care definition, data assemblage, data projection and facility simulation. Delta practitioners and several health care consultants co-operated in the production of an exhaustive list of medical, surgical and dental procedures defining ambulatory care. In accordance with this list, data was assembled regarding the number of ambulatory procedures regularly performed for Delta residents, by Delta practitioners. Medical and surgical data was taken from Provincial Department of Health computer data files; while dental data was gathered by questionnaire. The data trend for each procedure was then projected to the Target Years 1978 and 1982. Following these initial steps, a General Purpose Simulation System (G.P.S.S.) analysis was performed on the data gathered. Other information required for the simulation was gathered through questionnaires to Delta practitioners and private conferences with health care consultants. The results from the simulation were expressed in "work areas" (i.e. examination rooms, stretcher-beds, etc.) required in the major departments or service areas. The simulation analysis could only be completed for the Surgical Day Care Services area, because the data from Provincial computer data files, relevant to other departments or service areas, was found to be insufficient. The main problem encountered was an imprecise identification of patients' geographic origin; which in some instances made it impossible to identify procedures performed for Delta residents. Detailed suggestions for improving the method are presented in the Discussion. However, one should at least do the following: endeavour to use more than two years of data to project the trend in the Provincial computer data files; and explain the questionnaires circulated to practitioners by giving individual person-to-person instructions, rather than group verbal and individual written instructions.

Text

2010-02-08

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http://hdl.handle.net/2429/19822

Health Care and Epidemiology

University of British Columbia

Graduate