OASIS Alert

If your home health agency is all over the board when it comes to wound care, a standardized program could be the key to better outcomes and could mean more money in your pocket.

Establishing an agency-wide wound care program carries many advantages, noted Susan Flow with Denver-based Centura Home Care & Hospice, speaking at a recent conference sponsored by the Home Care Association of Colorado. The program will create a standard of care for all patients with the same diagnosis. When Centura implemented its program, "staff were no longer making personal-experience decisions on how to care for wounds," Flow said. "It put everyone on the same playing field."

Also, a wound care program "establishes a utilization guideline for modality of treatment," Flow said. That is, if your patient has an uncomplicated pressure ulcer, the program will tell you how often you need to visit her. And once you have everyone on the same page as far as treatment modality goes, you can benchmark between care-givers, Flow continued.

Your program also can increase staffing availability, potentially allowing you to take on more patients, Flow explained. For example, if in the process of developing your program you determine that you must send a nurse out only three times a week to care for a non-complicated wound, instead of daily, you've just reduced the amount of time and resources expended per patient.

Implementing a wound care program also "provides greater predictability in your outcomes," Flow noted. And physicians are much more comfortable referring patients to an agency when they know exactly what kind of care the patients will receive, she pointed out.

Flow advocates a four-step approach to developing a wound care program:

1. Examine your patient population. Take a close look at the kinds of patients you care for, and identify the wound types you encounter most often.

2. Develop care paths or protocols for each wound category. Once you determine the categories of wounds you treat most frequently, you should come up with a specific plan to follow for treating each.

Keep three goals in mind when developing these protocols: they should be easy for staff to use, minimize the amount of wound care products you use and allow you to pass the care on to the patient or another caregiver, when it becomes appropriate to do so. (For more information on developing care paths, see related article 7.) You also should standardize your wound care product line.

3. Educate staff and inform physicians. Hold in-services to educate your staff about the new program. This might take several sessions, and each in-service should include a test to ensure staffers grasp the new information.

Once your staffers are up to speed on the program, hold a product fair to give them a chance to practice with any new products you've decided to use. Then send your physician referral sources a letter explaining your program and its benefits.

4. Establish an expert. This person will be the go-to person for wound care-related questions and issues in your agency. Choose someone who is objective, is able to guide utilization and is capable of heading off any resistance to the program from clinicians reluctant to change their ways.

You can either hire an outside specialist to take over this position, or you can find someone within your agency who is motivated and excited about wound care and train her for the job, Flow advises agencies.