From the Editor: Focus on Quality

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Volume 7 Issue 1 - January/February 2013
Dot Weir, RN, CWON, CWS, co-editor of Today’s Wound Clinic

  I’m a wound care nurse in a well-run, successful wound center. I’m currently working clinically on a part-time basis, but spend a lot of time traveling to various types of speaking and contractual work. One of my recurring themes for lectures in 2012 (mostly to nurses and physical therapists) dealt with changing the healing trajectory for chronic wound patients — my agenda typically being to remind everyone that we are all critical “influencers” of how care is provided, even if we’re not the ones writing orders.

  In my travels, I meet so many folks from wound centers who work together for the common good of the patient. Every so often, however, I’m saddened to hear someone describe a fellow staff member who doesn’t perform certain functions, such as wrapping, casting, negative pressure, tissue or cell therapies, etc. What can we do about this? In her article “Proving Your Quality of Care Compliance: A Case Study,” M. Darlene Carey, MBA, shows us how enforcing compliance with data entry and documentation (of what is and is not conducted) at the point of care can improve quality in the wound care clinic.

Focus On Quality

  Quality in healthcare, particularly wound care, continues to be a bigger, developing issue. It’s not just about what the US government will monitor and the financial incentives it will put into place — it’s a concept that must be central to what wound care providers do every day — for the good of our patients, for the good of wound care itself, and for the image that we want our fellow practitioners and referral sources within our own communities to have of us and the care we provide. In our first “Facility in Focus” article in this issue, managing editor Joe Darrah profiles a wound clinic based in Washington, PA, that has committed itself to quality care. The staff hopes to serve as a reference to those looking to begin a new center or seeking any advice related to quality assurance and the development of patient “relationships.”

  Additionally, there are many new and exciting technologies that are currently (or soon will be available) that will enhance healing and improve the quality of life for wound patients. Point-of-care protease testing for example, though not available in the US yet, will help us to determine the environment that we are getting ready to place that cell therapy into and impact decision making related to the timing of that. Whether that testing will be covered and paid for is also yet to be determined, but may be an expense that we would gladly take on for the greater benefit of success with another therapy. Another example is the mechanical negative pressure wound therapy device that we have been using for a couple of years for limited patient types now has coding, coverage, and reimbursement. For most, utilizing the device in the wound clinic is a “break even” proposition, though it will replace the need for other dressings that are not reimbursed and can be used in conjunction with same-day debridement, compression, and casting. From that standpoint, it may actually save or improve reimbursement. From a quality-of-life standpoint, however, the ability to work and go through normal daily activities with the device hidden away and out of view has been a huge improvement for so many.

  If we’re going to continue to improve the state of wound care, we need to be thinking about the development of our quality measures and how the continuous furthering of technology enables us to provide higher standards of care. My fellow co-editor Caroline Fife, MD, FAAFP, CWS, takes another look at the industry’s need for measurable quality standards in her article “Measuring Quality in Wound Care.” We welcome and appreciate your thoughts on this evolving subject.

Dot Weir, RN, CWON, CWS, co-editor of Today’s Wound Clinic