Healthcare providers are currently under significant pressure because of factors like increased demand, aging populations and reduced public funding. This has created an urgent need for the integration of acute and community care, as this can ease the pressure on providers. Creating a more comprehensive and integrated system can help more people get the health and social care they need in a safe and effective way. Below, we define acute and community care, explore the need for bridging the two, and outline some potential ways to achieve this.
Table of Contents
- 1 What is acute care?
- 2 Emergency room services
- 3 Urgent care
- 4 Intensive care
- 5 What is community care?
- 6 Community occupational therapy
- 7 Child health services
- 8 Community physiotherapy
- 9 District nursing
- 10 Community speech and language therapy
- 11 Community palliative care
- 12 Why is there a need to bridge acute and community care?
- 13 Provide acute care in patients’ homes
- 14 Smooth referral processes
- 15 More outbound nursing
- 16 Insufficient resources
- 17 Poor exchange of information
- 18 General challenges in the healthcare industry
- 19 Cyber security threats
- 20 Staffing shortages
- 21 Patient expectations
- 22 Implementation of telehealth services
What is acute care?
Acute care is a type of secondary healthcare that involves treating patients with potentially severe medical issues on a short-term basis. These may be patients suffering from a broken bone, an asthma attack or a heart attack. Patients may receive acute care for injuries, illnesses or when recovering from surgery. Their issues typically have a fast onset and are resolved relatively quickly. This type of care is usually administered from hospitals, such as on an accident and emergency ward or an acute care ward. It can also be administered in settings like ambulatory surgery centers and urgent care centers.
The recent pandemic created a huge uptick in acute care admissions, as COVID-19 and related complications necessitated acute care for many people. There is also psychiatric acute care, which can be more long term due to the nature of treatment and rehabilitation options for these issues. A nurse that has completed an accelerated BSN program can go on to specialize in acute or primary care. These courses equip students with what is required to have fulfilling careers as registered nurses, giving them a Bachelor of Science in Nursing degree in just 16 months. During clinical placements, students can experience the variations of care provision.
Here are some examples of the different kinds of acute care:
Emergency room services
An emergency department (ED), or an accident and emergency department (A&E) is an emergency medical treatment facility in a hospital. These departments treat patients with acute medical problems that do not have prior appointments arranged. Patients arriving to these departments may arrive by ambulance or by their own means. Emergency rooms are equipped to evaluate and provide treatment for a broad range of medical issues, then they filter patients to the appropriate places throughout hospitals. Some patients entering primary care settings through emergency rooms have life-threatening illnesses and require immediate attention.
Urgent care centers, also known as walk-in centers and minor injury units, exist to serve patients with acute care needs that fall outside the remit of accident and emergency departments. These are issues that require urgent medical attention but are not life-threatening. This can include cuts, grazes, burns, broken bones, insect bites and minor infections. Urgent care centers help to reduce pressure on emergency rooms and hospitals by treating walk-in visitors as effectively and efficiently as possible without having to refer them to hospitals. They are not equipped to perform major surgeries but can refer people if necessary.
An intensive care unit (ICU) is a hospital department offering acute care to people with life-threatening illnesses and injuries that necessitate constant care and supervision, life support equipment or medication to enable normal bodily functions. Various medical specialists staff these departments, including physicians, nurses and respiratory experts, all of whom are trained to care for critically ill people. These departments typically contain resources and medical equipment that are not readily available elsewhere in hospitals due to their specialist nature. Patients may arrive at emergency departments and be referred to intensive care units if their condition is serious or rapidly deteriorating.
What is community care?
Community care is medical care based in the community, such as doctor’s offices, clinics and patient’s homes. Community care seeks to cater to the needs of populations within an area and serves as a primary point of contact for medical issues. Doctor’s offices provide community care, dealing with the day-to-day healthcare needs of patients and coordinating specialist care as needed. For example, they may refer patients to hospitals for surgery. Physicians often provide community care, but registered nurses also play an essential role in the community, helping people manage long-term medical issues.
Community care providers often have relationships with their patients, as they may have worked in a community for many years and see them regularly. Community care can also include outpatient healthcare, such as when providers visit patients in their homes. This is typical among patients with complex medical conditions who require ongoing support. Community care involves a wide scope of healthcare, as it covers patients of all ages, from any background, with both chronic and mild conditions. This means community healthcare providers require a broad understanding of medicine so they can treat and refer people appropriately.
Here are some examples of the different kinds of community care:
Community occupational therapy
This community-based activity aims to support people with disabilities so they can complete everyday tasks more easily. This may involve making adaptations to the home or installing equipment to improve the quality of life in patients. It can also involve assessing the housing situations of disabled people and supporting them with rehousing, if appropriate. Occupational therapists and therapy teams help people live more independently and participate in social activities within their communities.
Child health services
Community child health services exist to support the health and wellbeing of children within certain geographical areas. Healthcare professionals working in this capacity promote optimal mental health and deal with children who suffer from minor ailments. Mental health specialists can also support families whose children have behavioral problems. Community child health doctors may also work directly with vulnerable children, such as those with disabilities, developmental disorders and those who are suspected of being abused.
This service exists to support people who require physiotherapy but are unable to leave their homes and require community-based care. Professionals working in this field help people come to terms with disabilities and adjust to new ways of living. They also help people improve their mobility when suffering from balance problems, recovering from a fall or have reduced mobility due to an illness, for example. After conducting assessments and determining goals and daily living requirements, professionals help patients maximize their independence within their community.
These kinds of nurses work directly in the community and lead other community and support workers. They work in primary care settings like local doctor’s offices, care homes, clinics and people’s homes. District nurses help to reduce hospital admissions by supporting patients in their communities. They apply their leadership and clinical skills to support people in managing long-term health problems, which enables them to live as independently as possible.
Community speech and language therapy
Community speech and language therapists work with people with speech, language and communication difficulties, helping them to integrate with and participate in their communities. They assess people’s needs and offer personalized treatment and support to improve these kinds of problems and improve their patients’ quality of life. These healthcare specialists also help those suffering with eating, drinking and swallowing problems.
Community palliative care
Community palliative care workers deal with people who have incurable illnesses and help them maximize their quality of life in their communities. These teams comprise healthcare professionals from multiple disciplines. They apply a medical-social collaboration model to support patients with terminal illnesses and their family members. The type of care administered is a combination of physical, emotional and spiritual care, and it is personalized for each patient. Palliative care also seeks to make patients as comfortable as possible in the final stages of their lives, aiming to manage pain and minimize distressing symptoms.
Why is there a need to bridge acute and community care?
Bridging the gap between acute and community care has become an important issue in recent years. It is crucial for healthcare providers to relieve some of the pressure on hospitals by reducing admissions, which many are hoping to achieve by integrating acute and community care. Public health events like the recent pandemic threaten to stretch hospitals beyond their limits, which could lead to problems in terms of the safety and effectiveness of treatments if a new system is not implemented.
Here are some potential ways to reduce the gap between acute and community care:
Provide acute care in patients’ homes
Delivering acute care within patients’ homes may seem like an unrealistic goal, but it is feasible and already happens occasionally. By coordinating various community care providers, like community nursing staff and physicians, healthcare providers can set up the necessary equipment and resources and provide outbound acute care. This can help to reduce unplanned hospital admissions for a range of acute conditions like respiratory problems due to viral infections. Once everything is set up, patients can benefit from hospital-level service without leaving their homes, with hospital beds and intravenous fluids readily available.
Smooth referral processes
Many patients report negative experiences with referral processes as quite often people are passed to and fro when trying to access the right service for their needs. With a better system for communicating and referring in place, community care providers can work more effectively with acute care practitioners in hospitals. This can help to reduce the number of unnecessary referrals and hospital admissions, and help to ensure that people who need to be admitted can be. Improving the efficiency of referral processes also frees up valuable time that can then be spent on delivering care.
More outbound nursing
Nurses, like palliative care and district nurses, already play an essential role in the community and help to keep unplanned hospital admissions to a minimum. Increasing the funding for these nurses and deploying more staff to target areas can further reduce pressure on hospitals and connect acute and community care. Caring for as many people as possible within the community ensures hospital beds are free for critically ill people who desperately need them.
Here are some of the potential challenges healthcare providers face in the effort to combine acute and community care:
Healthcare providers already face funding issues, and to connect acute and community medical services without negatively impacting efficiency and effectiveness will be challenging. It may be necessary to rethink existing ways of doing things to produce a more integrated system using available resources. By diverting more attention to the community, hospital admissions can be reduced, which frees up valuable time and resources that can then be invested back into the community.
Poor exchange of information
Oftentimes, poor communication between healthcare providers can lead to wasted time and ineffective services. Failures in communication can lead to substandard care being delivered, which can lead to more hospital admissions in the future. Ensuring continuity of care, effective decision making and improved communication can help to better coordinate community and secondary healthcare and improve outcomes for patients. Documentation systems are also crucial aspects of communication in healthcare, so having a highly efficient and accurate record-keeping system is imperative.
General challenges in the healthcare industry
Here are some general challenges affecting the industry, beyond the need for bridging acute and community care:
Cyber security threats
Cyber security is not a topic that comes to mind for most people when contemplating the challenges facing the healthcare sector, but it is, in fact, a major concern. Healthcare providers are privy to some of the most sensitive data of all, as they collect information such as patients’ identifying information, addresses, payment information and medical records. The reputations of healthcare providers and the data of their patients depend on stringent cyber security measures to remain protected, so many healthcare providers are investing in upgraded IT and cyber security systems to protect patient data and maintain rapport with their customers.
Healthcare demands are predicted to steadily outpace the supply of physicians, meaning there will be a huge demand for skilled medical professionals in the near future. This is likely to place immense pressure on providers and the industry as a whole if solutions are not devised soon. Fortunately, technological advances in fields like telehealth can drastically reduce hospital admissions, which can ease the pressure on existing doctors and nurses. However, serving increasingly demanding populations will pose a challenge to physicians until the staffing shortages are overcome.
Ensuring patients have positive experiences is another essential element of delivering healthcare. Because patient experiences are partly subjective, it is important to deliver excellent experiences for everyone. With so many factors adding pressure to the system, this is becoming a significant challenge. Patients are also more likely to follow medical advice and see better outcomes when they have positive interactions with healthcare providers. Dealing with patients quickly and efficiently is one of the most effective ways to exceed patient expectations and drive positive experiences.
Implementation of telehealth services
Telehealth services are medical and health-related services delivered over the internet on video conferencing platforms and other communication platforms. This type of healthcare boomed during the recent pandemic, and it is expected to be rolled out even further in the coming years. Because it allows patients to access healthcare faster and more easily, the popularity of these services is likely to soar, so healthcare providers must make it available to the public to meet this demand. With effective telehealth systems in place, physicians will be able to help many more people in a shorter span of time.