Wound Care Articles and Insights
July 1, 2019

Maximizing Value: How Do You Build a Better Wound Care Continuum?

Rylan Smith

In today’s healthcare environment, it’s important to find innovative ways to save on costs while improving patient outcomes and maximizing profits. As any hospital executive knows, it’s not an easy balancing act.

When it comes to maximizing value across the wound care continuum, one of the most compelling areas to consider is the merging of inpatient and outpatient programs. Wound care touches almost every aspect of day-to-day operations, with many admitted patients already suffering from pressure injuries or non-healing wounds caused by chronic conditions like diabetes, heart disease, lymphedema, or vascular insufficiency. Because they require extra care, these patients tend to stay longer and use more hospital resources, and it sometimes puts the hospital at risk of litigation.

The Current Model

Traditional inpatient wound care is conducted by a small team of certified wound care nurses rotating and providing care while also training floor nurses, managing physician wound consults, tracking specialty beds and managing negative pressure wound therapy devices, among other responsibilities. Weekend coverage is often non-existent and the team typically exists separately from outpatient wound care. 

Let’s look at the numbers. Between 2008 and 2012, nearly 700,000 patients with one or more pressure injuries were hospitalized in the U.S. When a pressure injury is present on admission, the three-day average length of stay currently increases to seven days. Inpatient floors are one of the most costly areas of hospital operations, with a national average cost-per-day of about $2,000. Each pressure injury adds an additional $43,180 in costs to a hospital stay.

To add another layer of complexity, if these compromised patients develop additional pressure injuries in-house, you have a non-reimbursable Hospital Acquired Pressure Injury (HAPI). These occur in approximately 4.5% of all admissions and can extend the patient’s length of stay by another 4-10 days. Even if your current wound care nurse(s) are able to keep the number of HAPI’s in check, should litigation occur, patients are favored 87% of the time with an average $250,000 settlement for each pressure injury malpractice lawsuit.

A Better Solution

Within the outpatient wound care department, you have a highly-dedicated, specialized team of experts capable of managing patients with wounds across the continuum. They often have advanced certifications in wound care and/or hyperbaric oxygen therapy, and a unique and diverse knowledge base of chronic wounds. 

With the high cost of increased length of stays and HAPIs, the best way to combat skyrocketing costs or, in the worst case, a lawsuit, is to merge inpatient operations with the outpatient wound care department. With this approach, there is one unified team that oversees the entire wound care continuum, thereby improving patient outcomes and decreasing the length of stay.

This unified wound care team utilizes best practices and analytics to proactively treat patients - especially those with compromising conditions - beginning on admission. This process aligns the wound care team with the hospital and prepares patients for discharge to the outpatient wound care program as soon as they are admitted. There will be a consistent team of nurses and physicians monitoring their progress and working with primary care providers across the continuum. The faster patients can be discharged, the more likely they will have a positive road to recovery, both physically and emotionally. 

Merging inpatient and outpatient wound care programs can reduce both length of stay and the number of HAPIs. For one of our clients, HAPIs reduced from 14% to 0% once the two programs merged and a unified team was managing the continuum. By merging programs, patients are cared for in a more efficient and effective way that translates into better patient outcomes. This can significantly boost your hospital’s bottom line.

If you’d like more information, or if you need help with your hospital’s wound care program, visit our website at or call 888-484-3922.

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