The Importance of Interdisciplinary Teamwork in Wound Rounds and Assessment
Wound healing is a multi-step, ever-changing process that requires ongoing care and attention by a variety of care providers. Two critical components of wound healthcare are wound rounds and assessments, which typically occur each week. During rounds, care providers observe and discuss each patient’s condition and strategize continuing care. Providers also conduct wound assessments, which involve classifying wounds based on criteria such as size and tissue type in order to evaluate the healing process. Rounds and assessment are essential components of effective wound care and their effectiveness is dependent upon interdisciplinary teamwork.
When conducting rounds and completing wound assessments, providers must continuously communicate with one another to prevent lapses in care. This collaboration involves taking diligent notes, comprehensively documenting treatment changes, and keeping the patient and their care team informed of the treatment plan. Communication failures can have significant consequences: an estimated 70-80% of serious medical errors result from ineffective teamwork. Since wound care patients interact with many care providers, effective communication and collaboration must be practiced during wound rounds and assessments so that all pertinent information is taken into account.
According to Vohra Wound Physicians, the nation’s most trusted wound care solution, teamwork is a critical aspect of the wound healing process. The Vohra Wound Care Certification program emphasizes the importance of teamwork and encourages wound care providers to practice ongoing teamwork and communication during patient care.
The Interdisciplinary Team
Due to the complicated and often lengthy nature of wound healing, wound care requires an interdisciplinary team composed of care providers with different expertise that collaborate to improve patient outcomes. Here is a breakdown of a typical interdisciplinary wound care team:
Certified Nursing Assistants (CNAs) and Medical Assistants see patients frequently – they are the “frontline.” They provide ongoing care such as patient bathing and repositioning, so they may notice small changes in condition and behavior.
Wound Care Nurses are responsible for the day-to-day treatment of wound patients. They change dressings, observe patient status, and ensure that everything is organized in order for rounds to proceed smoothly.
Unit/Floor Nurses are responsible for the basic care of all patients in their unit or on their floor. In facilities without Wound Care Nurses, Unit or Floor Nurses are responsible for doing dressing changes and other regular wound treatments. In these circumstances, Wound Care Physicians must develop relationships with these nurses to ensure open lines of communication about patient care.
Rehabilitation Therapists may be required by some patients depending on the nature of their wound(s). Physical therapists treat injuries and help patients increase mobility and resume normal function as their wounds heal. Occupational therapists help patients fully engage in daily activities, both physically and mentally. Whenever therapists are needed for wound healing, they should regularly communicate with wound physicians during rounds.
Dieticians are an important part of the care team because appropriate nutrition is critical to effective wound healing.
The Director of Nursing (DON) is responsible for all of the nursing care within their facility, so it is important that they remain informed of the effectiveness of nursing intervention. Their continued communication with physicians helps ensure that the nursing staff is successful.
The Primary Care Physician (PCP) for each patient is ultimately responsible for the patient, so it is vital that the PCP is informed of patient status by the care team and is updated on the wound care specialist’s recommendations.
Supporting Workers such as maintenance or dining staff, activities directors, etc., can be the members of the facility staff that patients feel most comfortable talking to. As a result, these staff members can have valuable insight into the condition of a patient and the patient’s perspective on their care and the facility as a whole.
The Administrator has impactful oversight of the finances and operations of the facility. Collaborating with the Administrator is important so that there is mutual understanding if exceptions to normal operations arise.
The exact nature of this team can differ depending on the treatment facility and the patient in question, but each team member plays a distinct role and thus has a slightly different understanding of a patient’s circumstance. Only by combining this knowledge can optimal patient care be achieved. Comprehensive data and collaborative decision making also prevents wound care litigation.
The importance of teamwork has been particularly emphasized for the treatment of the diabetic foot, which occurs in approximately 15% of diabetics. In diabetic foot ulcer treatment, interdisciplinary teamwork ensures that wound etiology, medical treatment, and the need for surgical intervention is continuously assessed, leading to improved patient outcomes.
Teamwork in Wound Care Rounds
During wound treatment, weekly rounds are an important way that care providers assess patient status and determine treatment. Since rounds and assessments can be completed by different members of the interdisciplinary team, there must be effective communication and clear standards for assessment and care.
As wound rounds are completed, continuous dialogue enables care providers to identify problems as they arise and quickly adapt treatment. Wound nurses play an important role in this discourse, as they have the most consistent insight into the status of patient wounds and can quickly identify disruptions in the healing process, such as those caused by mechanical exertion or improper moisture.
One of the most common effects of improper communication on wound care teams is the development of pressure ulcers, commonly known as bed sores, which are localized areas of tissue damage that are often preventable and frequently arise when wound patients are immobile during recovery. Regular assessment of patient risk and discussion between providers can prevent pressure ulcer development. This improves patient outcomes and precludes wound care litigation or noncompliance with insurance coverage policies.
How Does Interdisciplinary Teamwork Support QAPI?
Interdisciplinary teamwork in wound healing – and in healthcare as a whole – plays an essential role in facilitating care assessment and Quality Assurance Performance Improvement (QAPI). QAPI is the practice of making evidence-based improvements in order to improve patient care, optimize the use of resources, and reduce the incidence of pressure ulcers, which are a common and costly complication of wound healing. Interdisciplinary teamwork enables continuous feedback regarding care so that QAPI goals can be set and met.
Teamwork in Physician and Patient Communication
As patients come in with new or healing wounds, care providers must be attentive to patient care changes, healing progress, and potential disruptions to healing. This improves patient recovery and shortens healing time, which limits the risk of infection or further injury. Interdisciplinary teamwork and effective collaboration are crucial aspects of this process.
Vohra has several resources for both bedside and telemedicine post-acute wound care treatment that can help interdisciplinary healthcare teams optimize teamwork. Learn more about wound care management and how Vohra is setting the standard in wound care here.