March is here, and for most of us in the United States, spring cannot come soon enough. But no matter where you live here, we are all facing a storm of undetermined and unprecedented proportion.
I am not talking about the weather. Instead, I am referring to “The Sequester,” the self-inflicted wound that will affect all of us because a Federal budget agreement could not be reached.
My purpose here is not to get into a political argument or to place blame—although there is certainly enough to go around. Rather, I want to look at it in the perspective of healthcare—because what I have discovered is that no one can say exactly how this will affect health care…and specifically long-term care (LTC).
Wound care practices can be a challenge in any healthcare setting, but LTC is particularly vulnerable.
It is critical to utilize evidence-based practice, adhere to standards of care, and promote positive patient outcomes—all while maintaining cost-effective care of your residents.
Utilize the wealth of resources that are available to you. Cutting back on skin and wound care products and protocols, and going back to the days of cost-per-unit rather than cost-effectiveness might be tempting during “The Sequester” but is an error best avoided. Shortcuts such as these will inevitably have a negative effect on patient outcomes, increase potential for litigation, violation of regulations and increase costs ultimately.
Take an interdisciplinary approach to examine and streamline your care and services. What are your prevention protocols? Are they being followed? Do they need updated or revised? Are there advanced wound care dressings available that meet the same clinical standards that may be less costly? Are you using the products appropriately? What about your documentation policies? When and how do you refer your residents to wound care specialists? Is there potential for your staff’s input and collaboration with the wound care specialist?
It is vital to keep egos and territory out of the discussion. The best interests of the residents should always be the focus of clinical decision-making, however there is often a degree of latitude in which topical wound therapy to select. That can only be accomplished by presenting objective data to clinicians.
I have found when the staff informs an outside wound clinician, “We cannot get that product; we have to substitute product XYZ.” That usually causes the person on the other end of line to hit the ceiling. It is not so much as what is said, but rather how it is said.
Present your rationale in a calm manner, using evidence-based rationale. Most wound clinics have their own set formularies, and clinicians have their favorite products. There is generally a great deal of room for compromise that will keep you on budget and your resident on the right track to healing.
How is the sequester affecting you—or how do anticipate that it might? What actions are taking or considering?
Tags: LTC, Long-Term Care, Advanced Wound Care Dressings