Transforming Patient Care: The Rise of Ambulatory Services and Innovative Workforce Development in Nursing

I began my career around 25 years ago as a bedside nurse in the oncology department. This was when patients were admitted for extended periods, and everything from orders to consultations was handwritten.  Computers were only used to enter labs and radiology orders and to check results.  Fast forward to the current day, patients are being discharged the same day after having procedures that would have been a weeklong hospital stay 20 years ago, and it almost feels impossible to complete our tasks without electronic documentation. While these are huge advancements, coupled with the mandatory expectations of always using evidence-based practice, monitoring quality metrics, and providing safe, quality care to all we serve, this fast-paced environment has caused a shift in how care is delivered to patients. 

Now that hospital stays are shorter, the importance of ambulatory care has skyrocketed because patients need very detailed instructions on how to care for themselves in the home setting while keeping in mind that every patient is unique and requires individualized healthcare plans. Services within ambulatory cover every aspect of the patient, which includes primary care, cardiology, oncology, outpatient surgery, women’s health, and telehealth, just to name a few specialties. Therefore, ambulatory care has become a true specialty in healthcare. Thus, recruiting, retaining, and educating staff in the ambulatory setting has become a priority to effectively care for the steadily increasing number of patients in the ambulatory setting. 

From a nursing leadership view, there has always been a priority in the education, training, and professional development of nurses. However, we cannot forget the need to pay just as much attention to the needs of our support staff, such as medical assistants and licensed practical nurses.  Therefore, one of my contributions to my organization was to create a pipeline to increase the number of medical assistants within ambulatory by working with the Georgia Department of Labor to implement the organization’s first Registered Medical Assistant Apprenticeship Program.  This program allows senior medical assistant students enrolled in an accredited program to work part-time while earning a salary. This allows the medical assistant to get on-the-job training so that by the time they pass their certification exam, they will be orientated and trained to their department and move into a full-time position, thus opening another part-time apprentice position. 

Medical assistants serve a vital role within the ambulatory setting because they are not only trained in patient care duties such as rooming, lab draws, and communicating patient needs/concerns to the nurses and physicians, but they can also perform administrative duties.  These duties include scheduling appointments, gathering pre-visit data from patients to ensure appointments address all the patient’s needs and prior authorizations, and follow-up care to ensure patients have the information and tools to effectively care for themselves in the home setting. 

We are currently interviewing candidates for a projected start date of July 2024.  We are eager and proud to contribute to the development of support staff not only in our organization but also for the state of Georgia. 

Dr. Lenekia Angry-McKnight Bio

I am a mother of two sons and a daughter and have one granddaughter. I began my career as a bedside nurse specializing in oncology in Sumter County, GA.  I have 25 years of nursing experience in the medical setting. I received my Doctoral Degree in Nursing in December 2021 from Capella University. I am certified in Oncology (OCN) and have served as a certified instructor for the ONS Chemotherapy/Biotherapy Course, as well as an item writer for the Oncology Nursing Certification Corporation. I am certified in Lean Six Sigma (Green Belt). I am the Director of Nursing Education for Ambulatory Services for a large education and research healthcare facility in greater Atlanta. I offer a solid foundation in evidenced-based practice research, clinical nursing, support staff education, change management, and sustainability while serving in leadership by staying abreast of current healthcare advancements that collectively support the organization’s mission.