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Perspectives on our Patient Care Journey: Past, Present and Future

April 4, 2017 by Nancy Paez, BSN, RN, CWCN, CHRN, CWS, LNC, DAPWCA; Director of Clinical Support for Development

Throughout my career in health care, I have visited over two hundred Wound Care Centers® (WCC) in all corners of the U.S. During that time, I have had the opportunity to learn and grow while witnessing patients' incredible stories of healing. There is little in my career that has afforded me such pride in my work. Today, I’d like to share with you some perspectives on my patient care journey past and present, and my thoughts on the future of wound care.


  In any story, the past plays an important role by setting the stage for what is to come. One recurring theme I have noticed, is some colleagues who have been in our field for an extended period of time saying “that’s how we’ve always done it.” We must beware the pitfall of becoming too comfortable with the status quo. Just because something worked in the past, doesn’t mean it’s the way of the future.
As an inpatient nurse in a hospital in the 1970s, I would call on the wound, ostomy and continence nurse when we had particularly challenging pressure ulcers to treat. She was the expert, so we all listened carefully and followed her instructions to the letter. One such set of instructions included tape, Maalox, Opsite and a heat lamp. I think we can all agree that times have changed!
  Today in wound care, we have international associations and practice guidelines, and we must ensure we are holding ourselves accountable to the highest standards of care of yesterday, today and tomorrow. Applying the knowledge and experience of the past, we must always strive to improve the present and innovate for the future.
  Today will always be the most important day, because today influences tomorrow. The current state of wound care is evolving rapidly, and we have to stay informed, up-to-date and committed to continuous learning.
One word that is going to drive the state of wound care for the foreseeable future is standardization. Standardization is becoming more and more important. Hospital systems across the country want to be able to provide the highest level of care regardless of location. We want patients to know that no matter where they go in the network, they will receive the highest quality care. More importantly, standardization helps us reduce variances in outcomes and create positive reproducible results.
Just because it’s simple, doesn’t mean it’s easy. Many professionals come to wound care from all walks of the health care community. It’s important that those seeking to specialize in wound care remember it’s not a specialty you simply jump into. There is a science to each treatment offered at our Wound Care Centers and it is imperative that clinicians take the time to receive the proper training. Remember: practice doesn’t make perfect, perfect practice makes perfect.
There are many changes on the horizon and we need to prepare for them. We are going to be expected to provide high quality care and deliver exceptional outcomes under increasing payer pressure and in a much more defined timeframe.
  Lucky for us, the future is born of the present. We have the chance to lead the future of our industry.
One of the best ways we can influence the future of wound care is through accurate and appropriate documentation of every patient wound. Uncommon wounds, such as those related to sickle cell disease, are massively important to document thoroughly as they contribute to the limited amount of knowledge that currently exists, helping us to better treat the next patient we encounter with that rare wound type.
As we move into the world of pay for performance, we’ll be focusing more on quality vs. quantity and ensuring that every encounter with our patients is meaningful and productive. The “wait and see what happens next week” attitude is a thing of the past. We will need to be up to date with the most current evidence-based practice for treating wounds and establish our treatment plans accordingly.
Nearly all wound programs are using an Electronic Health Record of some sort: some are wound specific, some are adaptations of the program used for inpatients. It is essential that we collect all pertinent data and understand how to analyze it properly to truly understand the impact of our interventions. It is imperative that we objectively assess care, and understand what our data tells us, so that we are always in position to adjust the sails as necessary, in order to quickly, effectively and responsibly care for our patients.
  As you can see, I have experienced wound care through multiple lenses: from inpatient to outpatient, from staff to management, from clinical to administrative, from student to teacher, and as a consultant. One observation that has transcended time and is almost without exception: patients love their wound care providers. Due to the chronic nature of many wounds, this is one area in health care where relationships have time to develop. Patients generally have regular appointments for weeks, and staff have time and the opportunity to earn the trust of their patients. As wound care professionals, we are passionate about what we do and it shows in the interactions we have with our patients. I am thankful for where we have been and excited about where Healogics is going.