WHAT YOU CAN EXPECT FROM YOUR MANAGEMENT COMPANY
October 31, 2007
PAT HUDSON, RN, BSN, CWCN;
SHERRILL A. WHITE; TERRY;
BEARD, RN, RRT, CHT, ACHRN
From conception to recognition as centers of excellence, wound care clinics must make education a priority. Management companies understand the importance of a knowledgeable team and have spent years refining and perfecting the education process. Not all managed companies are alike — hospital and wound clinic decision makers must understand what type of knowledge and support will be provided by the management company before partnering with them. Ultimately, the hospital should seek an accredited, comprehensive approach to education that includes all staff involved in the care and support of a wound center patient.The instruction provided should address key areas of clinic operation: wound care and hyperbaric medicine, clinical practice guidelines, advanced wound management, program operations, clinical coordination, safety, database outcomes management, quality improvement and accountability, reimbursement, patient education, marketing, and community education. The following article details what a hospital should expect from a management company in terms of education support of its wound clinic.
Commitment to education. A hospital should be diligent in exploring the management company’s educational resources and commitment to education and ask the following questions:
• Does the management company have a formal infrastructure and department that coordinates all education processes?
• Are the educational offerings comprehensive?
• Is the management company a leader in wound care and hyperbaric education?
• Are processes in place to ensure ongoing education throughout the growing needs of the specialty center and changes in the wound care industry?
• Most of all, does the management company meet our clinic’s educational goals and culture?
Accreditation. A hospital should choose a management company that provides training that is in line with national standards and adheres to requirements necessary to maintain professional accreditation. These accreditations may be provided by the Accreditation Council for Continuing Medical Education (AACME) as a provider for Category 1 AMA credit hours for continuing medical education for physicians and CEU offerings for non-physicians. The authors’ management company has the longest continually running wound care training course for physicians in the US. This course is held monthly at The Woodlands, Texas and provides 53 credit hours in Category 1 of the Physician’s Recognition Award of the AMA, prescribed credit hours from the American Academy of Family Practice, 53 Nursing CEUs by the State of Florida Board of Registered Nursing, and 53 Category A credit hours by the National Board of Diving and Hyperbaric Medical Technology. This course is open to the public; clinicians do not have to be associated with the management company to attend. A hospital also should consider partnering with a management company that supports pursuit of recognition as a center of excellence. Such accreditation can be secured through the Undersea and Hyperbaric Society or JCAHO Disease Specific Care certification.
Association affiliation. A management company’s education program should include national standards as well as knowledge gained within their own centers. The content of that education should be based on recommendations from national and international professional societies and published guidelines. Management companies should strive to develop effective communications and support for participation in professional societies, including membership. Recognized national associations include the American Academy of Wound Management (AAWM), the Association for the Advancement of Wound Care (AAWC), the Wound Healing Society (WHC), the Wound Ostomy and Continence Nursing Society (WOCN), the Undersea Hyperbaric Medical Society (UHMS), Baromedical Nurses Association (BNA), the National Board of Diving and Hyperbaric Medical Technology (NBDHMT), and the National Fire Protection Association (NFPA).
Faculty. Educators should be leaders in the industry. They should be credentialed and certified, sit on national committees, and play an active role in relevant national organizations. Ideally, these individuals are published and regularly speak at national wound care and hyperbaric medicine meetings.
Wound clinic education. A management company should meet the varying education needs of the wound clinic. Introductory, advanced, and ongoing education is needed for the entire team. Management companies provide instruction and training through offsite education courses, mentor site training, onsite education, web-based conferences, and online courses.
Training schedule. Ideally physicians, nurses, and HBO technicians will attend offsite training courses and visit a mentor center within a couple months of center opening. For an established center, newly hired staff are sent to offsite training at the first available opening. The management company should be onsite for staff training during the opening phase as well as when needs are identified.
Clinical practice guidelines. Management companies provide clinicians with evidence-based clinical practice guidelines for wound care and hyperbaric medicine that include conventional and innovative approaches to care utilizing leading edge wound healing technologies. These guidelines should be comprehensive and continually updated based on the latest wound care and hyperbaric medicine literature, along with knowledge gained from the synthesis and analysis of clinical practice and outcomes within the managed company centers.
Wound care education. Clinicians should receive instruction regarding comprehensive patient assessment, normal and abnormal wound healing, common and uncommon wound types, differential diagnosis, debridement, comorbidity management, topical wound care products, ways to ensure offloading, and organized approaches to managing the patient through the continuum of care.
Hyperbaric medicine. A clinician must attend a UHMS-approved course to perform and supervise a hyperbaric treatment. The course curriculum should adhere to the strict guidelines outlined by the UHMS, BNA, and NBDHMT. By attending these courses, physicians and clinicians are introduced and/or familiarized with best practice protocols via didactic and hands-on experience. After the initial course, onsite training should include all aspects of clinical and technical hyperbaric care.
Operational leadership. Education is needed to ensure the Program Directors receive instruction in all facets of program management. Management companies provide ongoing support through regional and national resources. They work with hospital partners to develop and implement cost-effective educational marketing and promotional plans that instruct and engage the medical community and assist centers to cost-effectively secure reimbursement for wound care and hyperbaric services. This information typically is provided during onsite inservicing for hospital and medical providers.
Clinical coordination. A well-managed clinic will need to continuously monitor care as well as clinical outcomes. Training and education support are needed for the clinician responsible for clinical management of the wound center. This person will have responsibility for managing the day-to-day clinical care provided at his/her center and may be responsible for scheduling, monitoring data outcomes, case management, and quality assurance. Clinical managers receive training and information regarding duties needed to fulfill their roles. Management companies maintain clinical oversight and support provided by the many resources available to them through a management company.
Safety director. Every wound care center should have a person designated to coordinate safety. Management companies offer offsite training on pertinent safety considerations surrounding the operation of wound and hyperbaric facilities. This can be integrated with the hospital’s safety plan.
Quality improvement and accountability. Management companies provide initial and ongoing training on quality and data. Our success as clinicians in terms of patient care depends on our ability to measure the outcomes of our comprehensive, interdisciplinary approach to treating patients. We must be able to assess and subsequently adjust our processes to improve healing rates and performance. Management companies provide outcome management and tracking systems that coordinate data. These data can be incorporated into national benchmarking and clinical practice guidelines to ensure patient/clinician goals and corporate standards are met.
CONCLUSION
A wound center must ensure all staff receive needed training in all aspects of clinical and operational support of their center. Having a well-trained team enhances the center’s ability (and may shorten the time frame needed) to achieve successful patient outcomes and become a recognized center of excellence. ■
Employ your time in improving yourself by other people’s writings, so that you shall gain easily what others have laboured hard for. — Socrates
Pat Hudson is Regional Director of Clinical Operations; Sherill White is Director Professional Education; Terry Beard is Associate Director of Hyperbaric Services; and Mary Cook is National Director of Clinical and Development Support, Diversified Clinical Services, Jacksonville, Fla.
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