Wound Care Providers: Can You Meet New Provincial Expectations?

Do you work for or act as a decision maker in a home care agency? If so, you probably feel like there’s more expected of you then ever before. And you’re right.

The Ontario government has increased its commitment to home care. Demand has never been higher, and patient expectations are mounting. Delivering services with limited staff and resources can be difficult—especially when it comes to certain areas of specialization. Take wound care, for example.

Chronic wounds present a huge challenge to the home care sector. Specialists provide evidence-informed care, which generally leads to the best outcomes. But there simply aren’t enough of these professionals to meet the growing demand.

There’s only one way to provide province-wide expertise on budget, and that’s through the adoption of carefully-selected digital technologies.

Ontario: expecting more from health care organizations

In health care, patients and their families want high-quality care that’s both quick and convenient. Government organizations only want to work with service providers who can help them deliver it—and deliver it on budget.

This last point is especially important. At a time when chronic and complex disease rates are rising rapidly, solutions need to be affordable. In addition to being the preference of most patients, home care is more cost effective than acute care. Now, health ministry officials are proving that they too are aware of the value of home care.

Recent government investment into home care has the potential to bring about a revolution in care. That said, agencies can’t expect to be successful by providing the same services they always have. If you don’t start offering the more effective solutions the Ontario government needs, some other organization will.

Wound care is one area that’s ripe for change. Chronic wounds represent a growing set of home care challenges, which experts have long had difficulty addressing. But one thing is clear to policymakers: existing solutions just aren’t cutting it.

The home care nurses that provide assessments in many agencies don’t have wound care expertise. As a result, they can’t always produce the outcomes that government agencies are beginning to expect. All too often, wound care patients who don’t receive specialist treatment experience complications. And complications can compound the already-steep costs associated with chronic wounds.

A recent review of Canadian wound care literature found that the prevalence of pressure ulcers was 15.1 per cent. The average cost for healing these wounds was $27,500.

Ideally, there would be enough certified ET nurses to visit those in need. These visits would bring down the costs to the health care system and—more importantly—improve the lives of patients. Unfortunately, specialists are in short supply.

Given these limitations, what can home care agency leaders do to meet government expectations?

Innovation: the only solution

Growing chronic disease rates are increasing the demand for wound care. This is reality. As a result, health care leaders have no choice but to find quicker, more cost-effective solutions.

But it’s not just necessity that’s driving this new approach. The fact is, Ontario’s health care policymakers are becoming aware of the fact that they have options. And thanks to a phenomenon known as digital disruption, those options are expanding rapidly.

What’s digital disruption? Definitions vary, but here’s what you need to know. Wide spread change is coming. New digital technologies and service delivery models are transforming expectations in every sector and industry—including health care.

A recent paper released by the World Economic Forum found that 90% of health care CEOs wanted to change their technology investments, or find better ways of harnessing big data. Tellingly, there was a large gap between what most CEOs wanted their technological capabilities to be, and what they actually were.

What does this mean? Most health care leaders want to transform their organizations through technology. This makes sense, since patients and policymakers are beginning to expect the better outcomes these solutions can provide. But leaders—including leaders in home care agencies—aren’t always quick to act. Those who are willing to take the leap see a major opportunity.

When it comes to wounds, the potential to make things better is huge. About one-third of home care patients in Canada have wound care needs. And there aren’t nearly enough ET nurses to fill this demand. Closing the gap is critical, and innovation is the only way to do it.

Digital communication technologies can bring the expertise of ET nurses into the homes of Ontario’s many wound care patients. All it takes is the right mobile app—and the right attitudes on the part of practitioners.

Better decision-making, better outcomes

How can digital technology extend the reach of wound care nurses—and, by extension, the resources of home care agencies?

For decades, telemedicine has brought physicians into the homes of patients. These solutions are ideal when practitioners can’t travel for appointments. When a simple phone call wouldn’t suffice, videoconferencing enables face-to-face assessments.

That said, traditional telemedicine solutions have become outdated. When they’re communicating with practitioners, patients expect greater convenience. And government health care organizations expect better assessments and wound care outcomes—all within budget.

Digital apps with teleconferencing capacities can meet these criteria. Their availability on mobile devices–including touch-screen tablets—reduces the learning curve that home care staff often face. Practitioner resistance (or “resistive compliance”) can be a major obstacle to adoption, so it’s best to make implementation as simple as possible.

Teleconferencing apps should do more than connect staff members. They should make it easy for ET nurses to coach home care nurses through real-time wound care procedures.

And there are other features that can greatly improve wound care. As apps become more secure, they can be used safely by practitioners who want to document and share patient information—including wound characteristics over time.

There’s no doubt that digital technology will change the face of home wound care, leading to improved decision making and (ultimately) better healing. In order to provide high-quality, cost-effective services to government organizations, home care agency leaders should aim to be ahead of the curve. Adopting apps that improve existing workflows will provide a very real advantage.

Feature image courtesy of thinkpublic

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COPD Education – Onboarding


To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Patient, Educator (Nurse, RT, the Physician could also be the educator)

One 60-90 min session with the Educator

  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
COPD Education – Continuous Maintenance


To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Patient, Educator (Nurse, RT or Physician)

A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
COPD Respiratory Status Follow-up


Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Patient, Educator (Nurse, RT or Physician)

Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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