Exploring Your Options: Ambulatory and Post-Acute Care

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If you’ve ever longed for a day at work that isn’t packed with one fast-paced crisis after another, then you may want to consider the ambulatory and post-acute care setting. Here therapists work with chronic lung patients to help them manage their conditions and improve their quality of life, often in an offsite facility or the patient’s own home.

The AARC’s Ambulatory and Post-Acute Care Section Chair Adam Mullaly, BSRT, RRT, AE-C, shares his thoughts on the area and what you would need to succeed in it —

How would you describe the ambulatory and post-acute care setting to RTs who have never worked in the area? What types of jobs does the specialty encompass?

Respiratory therapists working in the ambulatory and post-acute care setting traditionally work with patients who have chronic lung conditions such as COPD, ALS, bronchiectasis, pulmonary fibrosis, cystic fibrosis, asthma, etc. The work we do takes place in various environments, including long-term or continuing care facilities, pulmonary rehabilitation programs, and in-patient homes (home care). However, many therapists have carved out progressive roles in physician offices, lung clinics, and virtually in the telehealth space.

These therapists are dedicated to promoting and facilitating a comprehensive range of health services, such as oxygen therapy, invasive and non-invasive chronic mechanical ventilation, airway management (i.e., tracheostomies), patient education, and more. Care evolves with patients over time and focuses on preventing unnecessary hospital admissions and managing and progressing patients after hospital discharge.

What are the educational, credentialing, and experience requirements to grow a successful career in this area of the profession?

There are no advanced education or credentials required to be successful in ambulatory and post-acute care. Courses provided by the AARC, such as the Pulmonary Disease Educator Course and the Asthma Educator Certification Preparation Course, are highly recommended, as facilitating patient education is a key component to most roles.

Additionally, you will benefit from some quality experience at the bedside. Practicing in an acute care hospital setting provides you knowledge and insight into treating, managing, and preventing exacerbations of many chronic lung conditions.

How does working in ambulatory and post-acute care differ from practicing traditional respiratory care in a hospital setting?

The most significant difference working in ambulatory and post-acute care is that your focus is on preventing unnecessary hospital admissions and readmissions. In many ways, your primary goals are to help patients progress their quality of life and better self-manage/control their disease or condition.

What opportunities for career advancement does the setting offer?

I think the biggest opportunities for advancement in ambulatory and post-acute care revolve around innovative interventions/programs that add value to patient care, enhance patient quality of life, and prevent unnecessary hospital admissions. There are respiratory therapists out there who have started whole companies based on this premise/mission.

The Advanced Practice Respiratory Therapist credential and licensing will also lend itself well to ambulatory and post-acute care opportunities, including physician extender roles.

What are the biggest challenges and the biggest rewards of working in ambulatory and post-acute care, and why?

While ambulatory and post-acute care roles are currently adding value to the health care system and remain ripe with the opportunity to have additional positive impacts, the reimbursement and national integration of these roles/programs have a ways to go. The AARC is advocating for and supporting several initiatives that should help propel progress; however, there is still a lot of work to be done to demonstrate and prove the ongoing value of the respiratory therapist in the ambulatory and post-acute care setting.

What are the top 3-4 things you think an RT should consider before making the move into ambulatory and post-acute care, and why?

  • You must enjoy engaging and interacting with patients. Building rapport is often the key to a successful encounter that leads to optimal care management and a positive outcome.
  • Working with chronic disease patients is much different than working with acute/critically ill patients; while both can be fulfilling, in this profession, some prefer one to the other.
  • Ambulatory and post-acute care can be less structured and rigid than other more seasoned and established areas, particularly traditional hospital roles. Therefore, it’s important that you can adapt as needed and think outside the box, evolving with your patients if you’re considering this area of work.

To network with others working in this area of specialization in respiratory care, consider signing up for the AARC’s Ambulatory and Post-Acute Care Specialty Section.

To learn more about AARC courses that can help you build the skills, you’ll need to succeed, visit our Online Respiratory Therapist Courses page. In addition to the two courses Mullaly mentioned here, the Association offers courses on pulmonary rehabilitation, asthma, smoking cessation, and more.