Ambulatory Care in the Magnet® Model: What Counts and What Matters

Ambulatory settings continue to play a bigger role in demonstrating nursing excellence across the Magnet^® model. Several empirical outcomes (EOs) and non-EOs require an ambulatory care example, making early identification essential for effective planning in an application. In the Magnet framework, ambulatory care includes any clinical service where patients receive care without inpatient admission, across environments such as:

• Hospital outpatient clinics and diagnostic services
• Ambulatory surgery and procedural centers
• Specialty or community clinics
• Telehealth and care coordination programs
• Home care and home health services

Emergency departments and emergency care settings are also considered ambulatory in Magnet documentation (ANCC 2023 Magnet Application Manual, 184). In short, ambulatory care refers to settings delivering scheduled, episodic, preventive, chronic, or transitional care without inpatient admission. Use our guide to help identify ambulatory examples for your application.

Some common ambulatory care settings in Magnet^® exemplars include the following:

Hospital-Affiliated Outpatient Services

• Outpatient departments or clinics
• Outpatient radiology/imaging
• Post-anesthesia care in ambulatory surgery pathways

Procedural & Treatment Centers

• Ambulatory surgical centers
• Infusion or oncology treatment centers
• Dialysis centers

Specialty & Population-Focused Clinics

• Women’s health clinics
• Rehabilitation therapy clinics
• Behavioral health or psychiatric outpatient programs
• Other specialty clinics (e.g., cardiology, wound care)

Community & Virtual Care

• Urgent care clinics
• Telehealth/virtual care services
• Home care/home health services

Ambulatory Empirical Outcomes: Patient Outcomes vs. Improved Outcomes

When planning ambulatory narratives, it is essential to distinguish between improved patient outcomes and broader improved outcomes, as the Magnet^® framework employs them differently.

Improved Patient Outcomes

These directly reflect changes in patients’ clinical status, health, or lived experience of care. Improved patient outcomes are considered the strongest level of evidence because they demonstrate the impact of nursing practice on patient health or well-being.

Common ambulatory improved patient outcomes include:

• Fall rate (ambulatory clinics, infusion centers, procedural areas)
• Patient-specific readmission rates (e.g., 30-day readmission, surgical follow-up, emergency department)
• Surgical site infections (SSI) (ambulatory surgery, procedural clinics)
• Average length of stay (ALOS) (ambulatory procedures or observation populations)
• Patient experience (e.g., CAHPS ambulatory surveys, specialty-clinic tools)

Typical ambulatory data sources:

• Specialty clinical registries (e.g., cardiology, oncology, wound care)
• Home care/service databases (admissions)
• Population health or partner databases (e.g., Strategic Health Partners)
• Ambulatory quality dashboards or electronic health record (EHR)-derived clinic metrics

Improved Outcomes

These reflect improvements in processes, access, or efficiency rather than direct patient health status. These measures remain valuable and Magnet^®-acceptable, but only for elements that require improved outcomes (not improved patient outcomes).

Common ambulatory examples:

• Door-to-treatment, such as:
• Door-to-scan
• Door-to-medication
• Door-to-provider evaluation
• Door-to-treatment
• Throughput Time
• Revenue (Related to treatment)
• Workplace Violence
• Turnover Rate

Typical ambulatory data sources:

• Finance Department
• Human Resources
• Ambulatory quality dashboards or EHR-derived clinic metrics

Where Ambulatory Examples Are Required in Magnet

Below, you’ll find a consolidated guide to the Magnet elements that require ambulatory care settings.

We hope this guide helps you to identify locations for Magnet examples and outcomes that will work for each source as you start or continue work on your designation journey.