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Reader Reports

Reader Survey: Monitoring the Changing Wound Care Clinic

“If you don’t like something change it; if you can’t change it, change the way you think about it.” -Mary Engelbreit

  Like death and taxes, changes in the way that an outpatient wound clinic codes and charges are an inevitable and predictable event each January and April. Taking the time to gear up, change charge sheets and educate staff can ward off a multitude of time-consuming amendments to charges and bills.

  Consolidation and changes to the OP charging system in the last few years has been particularly challenging though not impossible to incorporate. As an editorial board, we heavily rely on our Reimbursement Guru Kathleen Schaum, to keep us abreast of these changes as they are approaching and when they are implemented. We hear amazing feedback as to the value these articles bring to you as directors, managers, and clinicians. For this issue, we wanted to hear back from you on how your individual clinics may have been impacted. Surveys were sent out to our Today’s Wound Clinic email list and we heard back from 179 readers. To those who were able to answer, we thank you for your willingness to share.

  In the survey, we had some direct, closed-ended questions, which we have analyzed for you. We also had some open-ended questions to find out plans that our readership may have for making changes to their center related to potentially expanding services, as well as potential changes related to how they market their program.


by Dot Weir

  We asked if you were going to be changing or updating any practices for marketing your current or future services to the communities that you serve. Overwhelmingly, the message was clear, to get the message out to the physicians and the community on several common points:
    • Wound care activities and services as well as expanded services planned.
    • Avoidance of emergency room visits and hospital admissions.
    • The level of expertise/certifications of both the staff and the providers in the center.
    • Healing rates and the one on one care that patients receive.
    • Advanced technologies available.
    • The use and benefits of Hyperbaric Oxygen.
    • The centers continued growth, patient satisfaction, and community physician confidence.

  The methods of marketing were also diverse and creative. Some marketing processes both current and planned include:
    • Direct one on one marketing to physicians.
    • Internal marketing to hospital departments.
    • Working closely with case management / discharge planners to facilitate earlier hospital discharges.
    • Media advertising including TV, radio, billboards and brochures in hospital direct mailings.
    • Lectures for the community at the hospital as well as local community organizations.
    • Education via CEU Lunch and Learns to area SNF’s and ACLF’s.
    • Use of the Internet / website.
    • Co-marketing with other vendors to promote projects in the community.
    • Updates to the strategic/business plans with 1/3/5 year plans coordinated with the overall hospital vision statement and strategic plan.
    • Marketing Hyperbaric Oxygen to oncology, urology, and dentists.

  Great ideas all! And since we can always learn from each other these points may give ideas to others. Additionally, any marketing done helps achieve the larger goal of the vital importance of the specialty of wound healing, limb salvage, and comprehensive patient care.

Expanding Practice

by Caroline Fife

  We received nearly sixty different responses regarding ideas facilities had to expand their practices. While they voiced their ideas slightly differently, the ideas could be grouped into six basic themes:

  1) Increase Clinic Volume. Approaches to this included:
    a. Broaden current clinic hours with the same staff. Some clinics do not currently offer 5 day per week services.
    b. Move to a larger facility with more exam rooms.
    c. Improve clinic work flow: “nurse only” visits were mentioned and difficulties with patient flow were discussed as a current limitation to the practice.
    d. Increase clinic staff: both advanced practitioners, physician extenders, and nursing staff were discussed as needed in various clinics in order to provide care to more patients.
    e. Improve marketing and coordinate better with local facilities such as skilled nursing facilities.

  2) Add services not currently provided. These included:
    a. Hyperbaric oxygen therapy.
    b. Orthotics and total contact casting.
    c. A diabetes center.
    d. An infusion center.
    e. Vein ablations.
    f. Lymphedema services.
    g. Ostomy education and care.
    h. Provide “Home Care”.
    i. Provide care to hospital “in-patients”.
    j. Provide “advanced modalities” not currently performed (one respondent mentioned providing the VAC in the clinic and another mentioned teaching their nurses to perform debridements).

  3) Develop new clinic sites linked in some way to the original clinic: in some cases these were referred to as “satellite clinics,” another was a “joint venture with a sister hospital.

  4) Add Physician Specialists to the Clinic, specifically:
    a. Vascular surgery.
    b. Podiatry.
    c. Diabetes management.
    d. Infectious disease.

  5) Increase education, specifically:
    a. Educational opportunities for home health agencies.
    b. More training for the wound center staff.

  6) Contract with a management company

  There were some very interesting specific comments. More than one respondent said that they planned on opening a wound center, and one said that they hoped to “have a dedicated doctor” for their wound center. These comments tell us that our readership is a very broad mix of clinicians, facilities, and practices, some of whom are still developing their expertise and some of whom already have very sophisticated programs and clinicians. They are also working hard to develop programs, which fit into their particular environment with regard to geography, staffing, and patient needs.

Reader Reports
Analyzed by Caroline Fife, MD, FAAFP, CWS and Dot Weir, RN, CWON, CWS
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