Wound Care – The Ultimate Hospital Team Sport!

A well put together outpatient wound care center not only provides outstanding care to an all too often underserved and fast growing segment of patients, it also offers significant benefits to the care givers.

In fact, what an opportunity for physicians! What an opportunity for nurses! And, what an opportunity for the hospital!

For nurses, it can be a very specialized career path. This can go well beyond WOCN certification. The Wound Ostomy & Continence Certification Board encourages nurses to validate their commitment to excellence in wound care by becoming a Certified Wound Care Nurse. The American Academy of Wound Management offers certification as a Certified Wound Specialist. And, the National Alliance of Wound Care Certification also offers nurse wound care certification. In addition, learning the clinical and technical aspects of hyperbaric medicine affords the ability to gain hyperbaric certification.

For physicians, it can and should be more than a supplement to their income. It can be a true specialty, as the American Board of Medical Specialists now recognizes the Physician Wound Care Specialist. And, a physician can become certified by the American Board of Preventive Medicine, the American Academy of Wound Management and the American College of Hyperbaric Medicine.

But, equally important, a dedicated wound care physician can significantly increase income potential, particularly with hyperbaric medicine. For physicians in specialties such as emergency medicine and surgery, it can be a transition to a very rewarding, but less physically taxing and career extending specialty. Or, for primary care physicians, it can mean the development of their own specialty niche.

And, yes, the hospital certainly benefits. A well structured and well-managed wound center – including an emphasis on documentation and thorough coding – can turn a department, which has been draining hospital resources into a profit center, especially if hyperbaric medicine becomes an integral part of the therapy. Plus, the high touch / high tech combination of care modalities in an outpatient wound center can be a major public relations benefit and, at the same time, it complements other hospital departments and services.

So, there is a natural basis for a team effort, since all of the players win if the wound center is successful.

Still, the greatest opportunity for a team effort is a clinical one! When hands-on nursing experience and in-depth knowledge of the latest dressings are combined with a physician’s medical understanding of underlying disease states, synergy occurs making the patient outcomes better than they would otherwise have been without the other team member. The writer believes that wound care can be unique in this nurse/physician relationship.

How do you achieve such a highly effective team?
The first step is to make the initial investment of time to recruit and train a solid staff of career oriented wound care nurses and physicians committed to wound care. The second is to establish, and designate a champion for, an on-going mentorship and skills assessment program. Consider a monthly best practices and/or wound care article sharing time, as well as regular “outlier” case group management studies. Plus, there should be rewards for pursuing career goals, taking tests and achieving additional certifications. Sponsoring clinical conference attendance for high performance could be an earned perk. In addition, a system such as room flags and clearly defined nursing roles is critical for both efficiency and optimal medicine.

To further build the physician-nurse team, medium to large volume programs should implement nurse case management. Each physician treating in the center should have a consistent case manager to work directly with her or him – advising, as well as following through on orders ... And asking, “Would this patient be a good candidate for HBO?”
In conclusion, any department reflects the goals and temperament of its leader. It certainly doesn’t hurt if the department director is a great cheerleader – focused on positively reinforcing the connections between all of the team members. (Because we know that she or he is also outside the department strengthening the bridgework with referring and potentially referring physicians to bring them onto the extended team!)

Steve Gardner has worked with hospitals, physicians, nurses and nurse practitioners in wound care since 2004. Steve worked for Medical Multiplex and National Healing Corporation. And, he has helped implement new wound care programs and/or worked with health care professionals in thirteen states.