Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-3 - HOSPITAL LICENSURE › Section 59A-3.244 - Ambulatory, Obstetrical, and Special Care Units

Current through Reg. 50, No. 138; July 16, 2024
(1) Ambulatory Care Services. Each hospital
				offering ambulatory care services under its hospital license shall establish
				policies and procedures to ensure that quality care based on the needs of the
				patient will be delivered at all times.
(a)
				Ambulatory care services shall be under the direction of a licensed
				physician(s) responsible for the clinical direction of patient care and
				treatment services, and whose qualifications, authority, and responsibilities
				are defined in writing as approved by the governing board.
(b) Ambulatory care services shall be staffed
				with appropriately trained and qualified individuals to provide the scope of
				services anticipated to meet the needs of the patients.
(c) Each patient's general medical condition
				shall be managed by a member of the organized medical staff with appropriate
				clinical privileges, as determined by medical staff bylaws.
(d) When any ambulatory care services are
				provided by non-hospital employees, the provider shall meet all safety
				requirements, abide by all pertinent rules and regulations of the hospital and
				medical staff, and document the quality improvement measures to be
				implemented.
(e) The provisions of
				ambulatory nursing care shall be supervised by a registered nurse who is
				qualified by relevant training and experience in ambulatory care.
(f) Sufficient personnel shall be on duty to
				provide efficient and effective patient care services.
(g) The scope of services offered, and the
				relationship of the ambulatory services program to other hospital units, as
				well as all supervisory relationships within the program, shall be defined in
				writing, and must be provided in accordance with the standards set by the
				governing board's bylaws and the rules and regulations of the medical
				staff.
(h) Written policies and
				procedures to guide the operation of the ambulatory services program shall be
				developed, reviewed, and revised as necessary, dated to indicate the time of
				last revision, and enforced.
(i) A
				medical record must be maintained on every patient who receives ambulatory care
				services. Medical records shall be managed and maintained in accordance with
				acceptable professional standards and practices. Confidentiality and disclosure
				of patient information contained in the medical record must be maintained in
				accordance with hospital policy and state and federal law. Each patient's
				medical record must include the following information, and be updated as
				necessary:
1. Patient
				identification;
2. Relevant history
				of the illness or injury and of physical findings;
3. Diagnostic and therapeutic
				orders;
4. Clinical observations,
				including the results of treatment;
5. Reports of procedures and tests, and their
				results;
6. Diagnosis or
				impression;
7. Allergies;
8. Referrals to practitioners or providers of
				services internal or external to the hospital;
9. Communications to and from practitioners
				or providers of service external to the hospital;
10. Growth charts for children and
				adolescents as needed when the service is the source of primary care;
				and
11. Immunization status of
				children and adolescents and others as determined by law and/or hospital
				policy.
(j) To facilitate
				the ongoing provision of care, a problem list of known significant diagnoses,
				conditions, procedures, drug allergies and medications shall be maintained for
				each patient who receives ambulatory services. The problem list shall be
				initiated no later than the third visit and include items based on any initial
				medical history and physical examination, and updated on subsequent visits with
				additional information as necessary. The problem list shall include the
				following items:
1. Known significant medical
				diagnoses and conditions;
2. Known
				significant surgical and invasive procedures;
3. Known adverse and allergic reactions to
				drugs; and
4. Medications known to
				be prescribed for and/or used by the patient.