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Measuring Quality for Money in Wound Management

If you work with chronic wounds, you know your skill set is in demand. And due to increasing rates of diseases like diabetes, the need for high-quality wound care is only growing. In home care particularly, there’s never been a greater need for improved wound management processes.

Of course, a big part of improving these processes is making them more cost-efficient. Consider this. According to a recent Wound Care Canada article, the cost of three months of community care for a pressure ulcer is a whopping $27,600.

It goes without saying that cost-efficiency must be balanced with the needs of other stakeholders—especially patients. That said, under extreme budgetary pressure, the health care system can’t provide the best possible outcomes for patients.

New treatments, technologies, and care delivery methods have great potential to improve wound management while reducing costs. But at a time when quick action is required, how can providers decide which solutions are worth using?

Clearly, there’s a need for methods of measuring the value these solutions provide. In this post, we’ll consider how Ontario providers might perform this measurement to make more informed decisions.

Wound Management and the Need for Change

It would be hard to deny that wound care has come a long way in Canada. This relatively new medical field has seen its share of progress in the last couple of decades.

Currently, wound care nurses have their own training programs, professional associations, and conferences. And in Ontario, many government health care agencies are actively encouraging health professionals to turn their attention to the field.

Take, for example, the South West Local Health Integration Network. The LHIN has a thoroughly-considered wound care program, which focuses in part on the development of regional wound care champions.

These are all positive developments. And there’s good reason for them. Demand is driving advancement—in Canada, and across the globe. This demand is huge. According to a recent study, the global wound care market is set to reach 20.4 billion USD by 2021.

Luckily, research in the field is growing. And there’s a myriad of innovative products and treatments for practitioners—from improved dressings to new gene therapy options. When it comes to wound management, Ontario providers have shown a willingness to figure out what works. But in a rapidly-developing area of specialization, how can those involved in wound management keep up? How can they ensure they make the right choices?

New solutions provide new opportunities. But no matter how promising these solutions are, they need to provide high value—without breaking budgets. And that means their outcomes need to be measurable.

Measurement Challenges

How should leaders decide whether a care delivery method is working well enough to justify its cost? What’s the criteria?

And what about balancing the needs of various stakeholders? There’s no doubt that patients should always comes first. But how much of a role should their perceptions play in the selection of wound care solutions? And how much should they be expected to contribute financially when wound care is provided in the home?

Needless to say, assessing cost-effectiveness is no easy task. Even when it comes to a particular product—like dressings—the considerations go well beyond the cost per unit.

For example, if you’re a wound care professional, you’ll probably agree that prevention is important. But just how much can it save?

Selecting the right product or technology can make a huge difference when it comes to preventing costly complications—and even cut down on the need to spend more on future supplies.

In the UK, Smith and Nephew collaborated with Hull City Health Care Partnership on a project to enhance practice efficiency. It included the use of an innovative dressing. A Nursing Times article reports that 97.3% of patients saw reduced dressing changes, and that there was a 50% reduction in wound-related nurse visits.

In such cases, patients benefit from less intrusive treatment. Practitioners benefit because they can use their time more efficiently. And providers benefit because they get to keep costs down.

The problem, of course, is that such specific figures are difficult to come by. It’s true that in Canada, there are many initiatives underway to improve wound management. But there are few studies that provide information on the scope of the problem, which can make addressing it difficult.

That said, there are steps that provider organizations can take to measure the impacts of wound care innovation—and the protocols surrounding them.

Finding Measurement Solutions

Assessment tools can help decision-makers select health care solutions that provide the best possible outcomes. Often, the complete or partial goal of these tools is to evaluate value for money. But unfortunately, when it comes to the wound care context, options are limited.

For example, the Canadian Agency for Drugs and Technology in Health (CADTH) provides a health technology assessment service. While it’s assessments have an economic component, they don’t pertain to things like information technology and program delivery—two areas that require focus in a developing field.

Measuring solutions in order to determine value is a complicated process. On the one hand, there should be more investment into evidence that supports the selection of quality products and delivery methods. On the other, criteria set out in clinical guidelines can limit the time it takes to implement useful innovation.

So how do providers strike a balance? First off, consistency—and especially consistent outcome measurement—is key to finding what works. Therefore, it’s important for service providers to track the results of what they’re already doing.

One way to do this through the use of technology with information sharing and storage capabilities. While it may seem counterintuitive to assess protocols that may include technology by using technology, it actually makes a lot of sense.

Many digital technologies, which are good at capturing large volumes of information, are implemented at a very low cost. And using them to track a patient’s wound-related progress can pay off big time.

As just one example, it’s good to be able to compare and contrast the wound outcomes of patients in similar circumstances who are receiving different treatments. This can help with determining cost-efficiencies (and inefficiencies) within certain solutions. Apps that help practitioners document wound progress can be hugely helpful in this regard.

This is just one example of how digital technology can help practitioners measure and compare outcomes.

Toward More Efficient Wound Management

In wound management, measuring value for money can be a challenge. Many providers don’t know where to start.

With so much wound care information available, Ontario providers need to track what they’re already doing—and the impact it’s having on patients. By comparing the outcomes of particular treatments (and their associated costs) against each other, decision-makers can begin to develop their own protocols for cost-efficient, patient-centred wound care.

Feature image courtesy of 401(K) 2012

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