Treating wounds is one of the most fundamental undertakings in healthcare. Much of it relies on basic medical approaches that have been around for decades. In the case of pressure ulcers, it’s estimated that 2.5 million U.S. patients annually will develop one, with more than 1 million being affected in acute or long-term care settings.
Complications of pressure ulcers can lead to pain, infection and in some cases death: 60,000 people die each year in the U.S. due to complications from hospital-acquired pressure ulcers. Because most pressure ulcers are considered avoidable, Medicare and private insurers won’t pay the added cost of treating these wounds in patients.
Technologies offer more accurate and efficient ways to prevent, monitor, treat, document and report on patients’ wounds.
Managing Wounds With Mobile Devices
Today’s wound-management technologies make use of mobile devices that are easily brought to the patient’s bedside. Digital cameras on the mobile devices can help clinicians document a patient’s wounds and track their progress over time.
Wound-management systems also automate clinical tools such as the Braden Scale for Predicting Pressure Ulcer Risk and the Pressure Ulcer Scale for Healing (PUSH), making it faster and easier for caregivers to assess a patient’s condition. Based on the results, the systems can then prompt clinicians with best-practice care strategies.
And because data is collected at the point of care, wound-management systems make it possible to share images, reports and other documentation in real time. They also can reduce time spent on entering data and creating reports for quality, reimbursement and inspection purposes. Depending on the systems and vendors involved, it may also be possible to integrate wound-management data into existing EHRs.
Perhaps most important, wound-management systems can improve patient care and comfort. By enhancing the consistency of documentation and supporting communication between care team members, these systems can ensure staff take the recommended steps at the right times to help heal pressure ulcers and prevent new ones from occurring.
Can Technology Take the Pressure Off?
Presence Heritage Village, a skilled nursing facility outside of Chicago, implemented a wound-management system and was able to decrease the incidence of facility-acquired pressure ulcers by over 80%. According to their study, this significant and sustained decrease may be attributable to improved documentation and communication among the care team using their wound management solution.
AMG Integrated Healthcare Management is a privately owned provider of 19 long-term acute care hospitals (LTACHs) and inpatient rehabilitation facilities. CEO Jennifer Wallace of the AMG Greenwood facility conducted a time study showing 65% greater efficiency in wound care nursing time after implementation of their wound management systems. She attributes the time savings to greater efficiencies in documentation and reporting.
Acadia St. Landry Guest Home, a four-star skilled nursing and rehabilitation facility in Louisiana, wanted to grow, and administrator Brian Hensgens knew the right answer meant more than simply adding staff and patients. His strategy was to improve the efficiency and reputation of a key referral area: wound care.
However, Hensgens knew his facility was turning down wound care referrals because the treatment staff couldn’t take on more patients. So Hensgens implemented a wound-management system that streamlined wound care and freed up nursing staff. He then pursued additional higher-acuity patients from referral sources and increased the average daily census by 14%, with the same number of treatment nurses. Hensgens calculates that leveraging his wound management solution increased revenue by nearly $700,000 from additional patients, and profit by $297,000.
As with any new technology, implementing a dedicated wound-management system requires financial resources, technological guidance, planning, communication and training. But it’s worth considering based on the potential benefits, which can be significant:
Better patient experience and outcomes;
Improved quality and satisfaction survey results;
Reduced legal risk;
Reduced staff time and costs;
More consistent and accurate documentation;
Better coordination among caregivers.
Florczak B, Scheurich A, Kleinert J, et al. “Retrospective Study of an Electronic Wound Documentation and Reporting System on Facility-Acquired Pressure Ulcers in a Long Term Care Setting.” Symposium on Advanced Wound Care (SAWC) poster session, Fall 2012.
Kurtz D. Simplify wound care through HIT. Long-Term Living, http://www.ltlmagazine.com/article/simplify-wound-care-through-hit.
Sullivan N. Preventing In-Facility Pressure Ulcers as a Patient Safety Strategy: A Systematic Review. Ann Intern Med, 2013; 158: 410–6.
AHRQ. Preventing Pressure Ulcers in Hospitals, http://www.ahrq.gov/professionals/systems/hospital/pressureulcertoolkit/index.html.
Debra Kurtz is founder and president of Kurtz Consulting Inc.