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Special Tree's Wound Care Program Takes a Big Leap


What started out as an in-service for an advanced wound care device in December 2018 turned into an epic journey to rethink how we do wound care at Special Tree.   After attending the in-service, CEO Joe Richert was so intrigued by the technology, he asked Chief Nursing Officer Lela Hickonbottom how it could help our clients.  “His inquiry really inspired us to rethink our common approaches to wound care and to look for opportunities for innovation,” she said.  It was shortly after the in-service that Lela, Director of Nursing Della Little, and NCC Asst. Administrator Lisa Bray joined forces with Chief Quality Officer Mark Mac Aleese and his team to form a quality task force to evaluate our wound care program and to implement changes to take it to the next level.   

Process Improvements Focus on Interdisciplinary Collaboration and Wound Care Compentency
Special Tree’s goal for wound care has always been about prevention and for those wounds that are open, healing them as quickly as possible.  Although the current wound care program had a fundamental process in place for how to approach skin care and maintenance, the task force needed to learn why the program wasn’t achieving its targets more consistently within that structure. 

When the task force evaluated Special Tree’s current model of having one nurse, specialized in wound care, to handle all wound assessments and treatment plans, they realized it didn’t allow wound care competency to build in direct care and nursing staff.  “We now have a new model that still has a wound care specialist to manage the program but one that also creates ways to educate and better equip support staff so everyone is engaged and invested in maintaining skin integrity or knows what to do if the skin is compromised,” said Lela.

The task force also looked at the role of an interdisciplinary team in wound care management.  “We really didn’t have a unified focus on wound care from an interdisciplinary team perspective, where the entire team knew who had wounds, knew what the progress was, and were equally invested in the treatment plan,” said Lela.

To build more interdisciplinary collaboration and wound care competency, the task force created a group of interdisciplinary team members whose sole purpose was to aggressively manage, treat, and heal wounds.  “We now have a core team across disciplines that includes nurses, RSTs, therapists, case managers, dieticians, psychologists, and physician assistants who meet every two weeks to do rounds and talk about wounds,” said Lela.

New Wound Care Physician Helping Team to Build Skills and Confidence
To help Special Tree get even better at wound care, the task force teamed up with Dr. Dean Fior, D.O., who joined Special Tree as a Wound Care Specialist this past December. In his new role, Dr. Fior does monthly rounds at the NeuroCare Center and works with the interdisciplinary wound care team to provide education and hands-on instruction.  “Dr. Fior’s support makes us feel more confident in our assessments and treatment plans,” said Lela.  “He’s also very focused on expediting and accelerating wound healing and has helped us close a number of wounds.”  (Learn more about Dr. Fior here).

New Technology is Enhancing Wound Care Management at Special Tree
Finding innovative ways to use technology in our care and treatment is one of the ways we continue to improve our programs, and wound care is no exception.  Last year, the task force introduced a new wound care management app that uses digital photography and planimetry to assess, track, and measure the healing process of wounds over time.  The app gives the wound care team quick access to data about every client with an active wound, which is a great improvement says Lela.  “It’s really intuitive, has great reporting mechanisms, and any questions about wounds or progress we can get with a click.”

In addition to the app, the team is gaining competence on cutting-edge treatment like Special Tree’s Negative Pressure Wound Therapy device (the advance wound care equipment that CEO Joe Richert was so impressed with at the in-service) and is also reaching out to medical suppliers that specialize in wound care to stay in the know about new products and advanced treatments.

Program Wants to Build Reputation for Excellence in Wound
While prevention of chronic wounds is key, the long term goal of the wound care program is to gain a reputation in the industry for our expertise in managing chronic wounds.  “We want to develop the type of reputation that our Respiratory Therapists have,” said Lela. “We’re building towards that reputation, but there’s more work to do.  2019 was all about fundamentally working on our own internal improvement and to gain more competency.  This year is about really refining the content to have a best-in-class wound care program.”