Doctor Discuss Preventing Hospitalizations for Wound-Related Issues

How to Prevent Hospitalizations for Wound-Related Issues

Author: Dr. Japa Volchok, DO

There is no better time than the present for nursing home facilities to bring wound care directly to their patients’ bedsides. Not only does it provide better quality of care for patients, it is in the best interest of the facilities considering changes in healthcare and pay for performance.

One thing closely monitored is re-hospitalizations, or bounce-backs. If a long-term care facility can prevent hospitalizations, shorten length of stay, and use services and products in a cost-efficient manner, they’re the ones that will show true value and, therefore, receive the most business.

Let’s take a look at each benefit individually.

Quality of Life

Providing services at the bedside is about more than the wound care itself. If a patient is being transported to an outside facility, he or she is missing scheduled activities such as physical therapy, hobbies, even their meals.

When providing care at the bedside, physicians are only seeing them for a brief 15-minute period, then they’re free to go about their other activities. If patients are transported to a wound care center, that process extends dramatically.

Patients have to get themselves ready for the trip, sit through other patient drop-offs and pick-ups as part of the transportation, and then wait an hour at the wound care center itself before being seen. Then they reverse the transportation process. So it ends up being a six hour ordeal instead of a 15 minute check-up.

Quality of Care

One potentially-overlooked benefit of bedside care is communication. If you have a patient seen in the facility with his or her regular nurse present, the time it takes to pinpoint problems with wound progression is lowered drastically.

Let’s say a patient has a venous leg ulcer, for example. If our doctor comes in and sees the wound hasn’t progressed the way it should be, he is able to discuss it with the wound care nurse right then and there. Perhaps the patient hasn’t been compliant using his or her compression bandages as prescribed.

Regardless of the reason, if that patient is sent off to a wound care center, the doctor loses the ability to do that and — since a large number of patients are not able to communicate — the input from the wound care nurse is critical.

Pay for Performance

Patients that have superior outcomes at a lower cost is what really creates value. Let’s look at two scenarios: in the first, the physician is coming to the patient and providing his or her services; the second, the patient is being transported to a facility for those services.

When nursing homes transport patients out to the facility, they have the added cost of the transportation to and from the wound care center, the wound care center fee associated with that, and then the wound care center physician billing for his or her services.

Compare that to the physician coming to the facility to see the patient. Transportation and wound care center facility costs disappear — it’s only the billing from the physician for the actual visit that takes place, not to mention the non-dollar cost of things like the patient’s time, missed activities, and deterioration of the wound that may occur from sitting in a bus for an extended period of time to get to the appointment.

There’s no question: the true value comes by providing the service at the bedside. Considering there is no cost to nursing homes themselves for bringing a physician in-house for wound care services, taking this step should be a no brainer.

Author: Dr. Japa Volchok, DO

Dr. Volchok is the Vice President of Operations at Vohra Wound Physicians. Trained as a vascular and general surgeon he joined Vohra in 2009. Dr. Volchok is currently responsible for Vohra’s telemedicine program, legal and regulatory matters, and physician recruitment. He completed an executive management program at the Harvard Business School.