Breakout Session 1: Patient Selection Criteria

Abstract

This summary focuses on findings from the Patient Selection Breakout Session of the Alternate Care Facility (ACF) Symposium. Findings demonstrate that patient selection criteria were primarily shaped by community needs and operational constraints rather than clinical factors alone. Participants described using local population needs as a starting point to define ACF eligibility. Resource availability emerged as the dominant determinant of admission criteria, often superseding traditional clinical thresholds. External pressures from hospital systems frequently drove expansion of criteria to include higher-acuity patients requiring balancing of resources and capabilities. Successful selection criteria were characterized by iterative, multidisciplinary reviews incorporating frontline staff and strong interagency collaboration. Key challenges included clinician hesitancy to transfer patients to the ACF, limited external communication regarding capabilities, and persistent tension between flexible criteria and standardized guidance for dissemination. Additional barriers included staffing limitations, facility design constraints, and unanticipated logistical factors. External influences, including political decision-making, at times disrupted operational alignment with frontline realities. Patient selection represents a dynamic, resource-driven process requiring continuous reassessment. These findings support the need for flexible, resource-informed selection criteria, coordination with hospital partners, incorporation of frontline expertise into decision-making, and integration of discharge planning services to expand appropriate patient populations while maintaining quality care.