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Why Are Wounds Difficult to Manage Across the Care Continuum?

February 21, 2017 by Carol Murdock

The relationship between hospital partners and Skilled Nursing Facilities (SNF) can be a bit of a balancing act. Both are seeking to maintain a mutually-beneficial relationship with the other, while also trying to provide their patients with the best levels of care – both wound care and otherwise. Outside of an ACO or bundled payment, the incentive to support one another is less financially obvious. However, with an aging population, growth in value-based care payment models and a rising incidence of chronic wounds, maintaining the hospital to SNF relationship becomes more important each year.

As the population ages, the number of wound care patients requiring care from either a SNF or a hospital will grow.  Approximately 40 percent of Medicare patients discharged from the hospital are cared for in a post-acute setting with a little over 20 percent going to nursing homes1. With up to 10 percent of nursing home patients are suffering from bedsores at any given time, these statistics should tie the hospital and nursing home community tightly2. Nationally, 19.6 percent of these patients are readmitted within 30 days which creates a significant financial penalty for the hospital and oftentimes a poor outcome for the patient1.

Did you know that four to 13 percent of all hospital admissions for bedsores culminate in the patient dying as a result of complications2? And in the field of wound care, amputations of limbs with wounds do not necessarily extend a patient’s life.  In fact, the mortality rate within five years of an amputation is nearly 50 percent for vascular diseases and between 40 and 80 percent for diabetes-related amputations3. So, for those of us that are passionate about patient care, what are we going to do about this?  It is hard work and the financial benefits often don’t outweigh the cost even though the benefits to the patient are clear. 

As you may know, a wound is typically a symptom of a larger problem, and whether the patient is in a post-acute, clinical or a home setting it is important that they receive the best and most consistent care possible. An appropriate and consistent level of care can only be offered when the health care community comes together to support positive healing outcomes.

This is why I am proud of Healogics Integrated Wound Care Community (IWCC). The IWCC is a network of acute, post-acute and outpatient settings where patients’ care continues to be managed by one care team. Patients receive a consultation, evaluation, and specialized treatment from highly trained Healogics Specialty Providers (HSP) leaders and their teams in the inpatient or outpatient setting.  This model is designed to ensure continuity of care, leading to better healing outcomes. This seamless care will only be possible if all parties involved have the best interest of the patients and community at the forefront of their minds at all times.

Full healing often requires months of care so I believe healthcare is going “back to the future” where caregivers will meet patients wherever they are: hospital, home or post-acute setting.  This patient-centric approach focused on care compliance will yield the positive patient outcome and experience that we in the healthcare community know is possible.

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Sources:
1. http://content.healthaffairs.org/content/29/1/57.full
2. http://www.nursinghomeabuseguide.org/bedsores/bedsore-statistics
3 http://www.amputee-coalition.org/limb-loss-resource-center/resources-by-topic/limb-loss-statistics/limb-loss-statistics,