Today's Wound Clinic - Winter 2008 - (Page 47) incentive VW: Our center became one of the first wound centers to completely computerize, going “live”in 1998 to allow complete control over every aspect of the patient data. TWC: What is your patient base? VW: Current patient distribution by diagnosis is: 26% diabetic foot ulcers, 25% venous stasis ulcers, 18% surgical complications, 17% pressure ulcers, and 14% arterial ulcers. TWC: How did the addition of lymphedema treatment affect the center? VW: In 1998, the need for post mastectomy lymphedema patient care was identified, necessitating the hiring of specialized staff trained to provide manual lymphatic drainage (MLD).The center’s only marketing strategy was a listing on the National Lymphedema website; within a year, seven MLD therapists were needed to meet patient demand. Today, the volume of lymphedema patients through this clinic, which uses the same space as the wound center, is equal to the volume in the wound center. TWC: You cross train staff. Please describe this technique. VW: With employees of diverse backgrounds and a need to maximize staffing productivity, the center began “cross training.” MLD therapists and hyperbaric technicians were trained in wound care and nurses were trained in advanced bandaging techniques with interesting dividends. Because employees have an in-depth understanding of the challenges faced by their colleagues, team spirit is excellent. An unexpected plus has been improvement in both patient outcome and satisfaction. Many patients require a team of caregivers to meet their needs for both wound care and edema control. From an operational prospective, the three centers (hyperbarics, wound care, and lymphedema) operate in the same location with separate revenue centers, allowing for more accurate cost accounting, improved cost containment, and productivity. TWC: What have been some of your biggest operational challenges? VW: The biggest operational challenge has been coping with dramatic changes in the Medicare reimbursement policy. Changes in coverage policy and reimbursement amounts have affected the type of patients treated with hyperbaric oxygen therapy. Coverage policy also dictates who can perform certain services. Although the hospital recognizes massage therapists as licensed professionals, Medicare does not. Since 2005, Medicare beneficiaries cannot be provided with MLD from the staff.Another operational challenge is the on-going balancing act between the demands of the University that provides physicians and the hospital system, which provides all other staff, space, and supplies. TWC: What sets the center apart from other facilities? VW: The center is unique because it is staffed by three full-time physicians who specialize in wound care, all of whom have CWS certification and subspecialty Board Certification in Undersea and Hyperbaric Medicine. Memorial Hermann Center for Hyperbaric Medicine is among the first 10 hyperbaric facilities in the US to achieve accreditation. The center’s staff continually seek additional certification and continue to strive to be the leaders in the fields of hyperbaric medicine, wound care, and lymphedema management. ■ Today’s Wound Clinic Winter 2008 47
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