Clinical Update TEN TOP TIPS Expert commentary
Expert commentary
Jacqui Fletcher, Fellow, NICE; Clinical Strategy Director, Welsh Wound Innovation Centre, Wales, UK
S
etting up a wound centre is a daunting task for any clinician. The move from the familiar, comfortable way of working (which may
not necessarily be the most efficient or effective) to a streamlined mechanism of service delivery with clear goals and measurable outcomes raises many challenges.
Perhaps the most obvious challenge is being certain that there is a need for the service; all too frequently, new services are developed without thought being given to the population size or density, or the logistics of how the service will be accessed. No wound healing centre can deliver great outcomes if it does not have patients. Therefore, relationship building, advertising, and setting clear referral criteria are crucial, both to success and also to measuring what has been achieved.
Around the globe, healthcare resources are becoming more and more constrained as the population ages and develops increasing levels of disease, such as diabetes, and lifestyle problems, such as obesity, all of which increase the likelihood of developing and living with wounds. Wound healing service delivery needs to reflect that people are developing chronic wounds at a younger age and have to manage their health care around the competing demands of family and work. The care and management of these patients needs to deliver outcomes within short time frames, or – when this is not possible – discuss with the patient and their primary provider (and, if relevant, funder of care) suitable treatment pathways for achieving realistic goals. This becomes much easier when care is focussed and delivered by a single, committed team.
Throughout the world, patients continue to have wounds without ever having a proper assessment or tailored management plan. Wound care may be delivered by well-meaning clinicians who are actually not skilled in wound management. It stands to reason that centralising wound care in a well-resourced, private facility that delivers evidence-based care can improve patient outcomes, reduce costs and resource usage, as well as improve quality of life for patients (and staff who find positive outcomes rewarding!).
Nicola Walker's Ten Top Tips brings a PR industry perspective on establishing a wound care centre that is effective in recruiting patients and sharing its successes. Clinicians working in these centres have an important role to play in this process: their expertise and the positive outcomes they achieve become the core of the message that will draw in new patients and encourage referrals from colleagues in other services. An example of striving for excellence in service delivery from the UK, is the recently published guidelines for practice on Optimising Venous Leg Ulcer Services in a Changing NHS.[1]
This document offers a framework to guide clinicians
who have identified the need to develop a new service or to improve an existing one. Whether delivering care in the public or private sector, high-quality, efficient care – both financially and from a patient perspective – is key.
Fully engaging in the service delivery process can be challenging, and it should be acknowledged that there are many creative, innovative, and knowledgeable clinicians working within systems that constrain their ability to deliver the care they know would be best for their patients as they compete against higher profile diseases, different agendas, cost constraints, red tape, and the need to "tick boxes".
Not all patients want, or are able, to attend a wound healing centre, but for those who do, these centres may offer a beacon of hope. They can provide patients with wounds the chance to work with a team of multidisciplinary clinicians all focused on wound healing, and who have the freedom to do just that! n
REFERENCE 1. Wounds UK (2013) Optimising venous
leg ulcer services in a changing NHS: A UK consensus. Available at: http://bit. ly/1hk0Yjs (accessed 24.02.2014)
" Not all patients want, or are able, to attend a wound healing centre, but for those who do, these centres may offer a beacon of hope. They can provide patients with wounds the chance to work with a team of multidisciplinary clinicians all focused on wound healing, and who have the freedom to do just that!"
Wounds International Vol 5 | Issue 1 | ©Wounds International 2014 |
www.woundsinternational.com
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