Ambulatory services are an important aspect of the continuum of palliative care. Ambulatory palliative care programs are available on a consultation basis to ambulatory patient with serious, complex, or life-threatening illness. These practices can offer a range of services from ongoing symptom management to follow-up for patients discharged from inpatient services. They can also address the various needs of patients and families through a multilevel, interdisciplinary practice. In general, patients seen in such clinics are seen earlier in the course of their illness, and they may be receiving palliative care in conjunction with active, disease-modifying therapy.
Ambulatory palliative care may be provided as a stand-alone service, or it may be incorporated into another clinic such as oncology, infectious disease, geriatrics, or general internal medicine. Programs are staffed by physicians and nurses with specialized skills in palliative care. Therefore, this model allows for assessment and management of symptom control problems; provision of psychosocial support, information, counseling, and bereavement services; continuity of care and contact with the medical system; triage of patients to other specialty services offered by the institution or community; and 24-hour access to care providers on call via telephone. When appropriate, patients seen by the ambulatory palliative care practice can be admitted directly to an inpatient palliative care unit if hospitalization is required to manage intractable symptoms or complex medical situations.