key: cord-0717113-8y6wbl42
authors: Garry, Daniel J.
title: Successful healthcare delivery using ambulatory hospitals—past, present and future
date: 2020-05-20
journal: Am J Med
DOI: 10.1016/j.amjmed.2020.04.022
sha: 56ac96e04554a6b1527a3d77985bbdd50352245f
doc_id: 717113
cord_uid: 8y6wbl42

nan

and employs more than 7 million people 2 . Our U.S. healthcare system functions well but seasonal influenza outbreaks can provide unique challenges and stresses regional bed capacity of hospitals.

For example, the 2017-2018 flu season was particularly severe in the U.S. accounting for more than 900,000 hospitalizations and 61,099 deaths 2 . Any further challenge during the flu season can prove to be a challenge for the healthcare delivery system. COVID-19 has provided such a global challenge with areas of higher intensity seen around the world including: Milan, Venice, New York, California, Louisiana and others.

As a result of the co-occurrence of the seasonal flu and the COVID-19 pandemic, the bed capacity in hospitals is at a crisis level. A potential solution for this shortage would be to establish mobile ambulatory hospitals that could be staffed for cardiopulmonary support services and could be moved throughout the country to provide the necessary healthcare support. This might utilize units already available through the Department of Defense or in the future be engineered and mobilized by the government for use and deployment. It would also be important to establish a healthcare team composed of nursing staff, technicians and physicians (critical care, pulmonologists, infectious disease specialists, advanced heart failure specialists, etc.) that would be assigned to these mobile, ambulatory hospitals. Such a model would require that the dedicated healthcare team be released from their professional duties in their communities and state licensure allowances would need to be implemented. This special force of healthcare personnel would provide efficient expertise in the treatment of any panepidemic.

In summary, previous healthcare models that have been established during wartime efforts may have utility in the delivery of hospital care for those with COVID-19 or any other future panepidemic.

The Mobile Army Surgical Hospital (MASH): A military and surgical legacy

American Hospital Association

The efforts of Cynthia Faraday regarding the figure illustration is acknowledged.