Part 3 in a series examining the reduction of facility costs and the continuation of quality care
For Part 1, Click Here
For Part 2, Click Here
By Sue Hull MSN, RN, CWOCN
After recognizing that wound care is expensive, North Mississippi Medical Center (NMMC) assessed the situation to discover possible reasons for why advanced wound care was costing so much. Then they standardized processes, education and products. So, the question is, what happened? Did they reduce costs? If so, did patient care suffer?
NMMC looked at four categories of results: Process-related outcomes, Patient/clinical related outcomes, Product-related outcomes, and Cost/fiscal outcomes.
Process related outcomes included reduced number of vendors. Before standardization, they used nine vendors. They reduced that to one primary and two secondary vendors. This change resulted in improved communication between clinicians and those involved in supplies, and it resulted in more efficient product trials. Previously, trials took nine to twelve months. Now they take one to six months.
Patient/clinical outcomes, in my mind, represent the most relevant outcomes. What I mean is, if all other outcomes were stellar, but the patients suffered as a result, the project would be judged a failure.
In this case, though, the patient related outcomes improved significantly. They recorded wound-healing rates for eight months before and eight months after implementing standardization. Healing rates went from 48.4% before standardization to 87.5% after! Patient satisfaction rose by 13% and the clinicians were, of course, more satisfied as well.
Product related outcomes resulting from standardization showed a surprising (to me, anyway) reduction in product usage. Types of wound care products used were decreased from 68 to 34, the number of units of wound care products decreased by more than half, from 113,812 to 55,394.
Cost/fiscal outcomes were dramatic. The $620,000 expense for wound care products was reduced to $320,000. That is a $300,000 reduction! And, that is just the obvious reduction.
Standardizing wound care and decreasing the number of different products used resulted in a decrease in product education hours. That was another cost saving.
Along with that, because they were able to give one vendor 80% of their wound product business, they saw improved pricing on wound care products.
Another interesting result was that wound related infection outcomes improved due to increased usage of advanced antimicrobial dressings. Before standardization, antimicrobial dressing usage was 6.6% of the total dressing volume. After, it was 20.5% which makes me think we should not be so hesitant to use dressings we perceive to be expensive when they are called for.
So, as I asked in the first article of this short series, can we decrease wound care costs and provide excellent patient care at same time?
That is exactly what they did at North Mississippi Medical Center.
McNees, P, Kueven J. (2011) The bottom line on wound care standardization. Healthcare Financial Management. (65.3) 70-74, 76.
About The Author
Sue Hull MSN, RN, CWOCN has been a home health nurse since 1992 and a CWOCN since 2003. She currently works for Peace Health Home Medical Group in Alaska. Sue is an educator and author. In addition to nursing in home health and hospital settings, she is also the editor of two wound care education websites.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.