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MSH Value Based Chronic Wound Care

Project Status: 

The Value-Based Chronic Wound Care Project aimed to deliver the following objectives:

  1. Development of a model of care to guide implementation of the service
  2. Development of clear referral pathways for wound resources across Metro South Health (MSH), to ensure patients are referred to the right service in a timely manner, rather than multiple presentations to multiple services.
  3. Development of MSH-wide policies and procedures, to ensure uniform documentation, digital photography, follow-up of chronic wound and discharge planning.
  4. Implementation of demand management and workforce capacity strategies that would ideally include potential for telehealth use (as currently demonstrated by the MSH Teledermatology Clinic) and e-consultation store and forward pathways for wound follow up
  5. Development of an education strategy for chronic wound management for: MSH staff; staff of contracted organisations; for wound care delivery; and Residential Aged Care Facilities (RACF)
  6. Development of a work-force capabilities growth plan including: growth of a nurse practitioner work force and skill sharing with community partners
  7. Optimise existing service level agreements with Mater Health Services and Blue Care to encompass wound management services
  8. Requirements for a central point of referral for initial assessment, wound care implementation, clinical support, triaging of internal and external referral and knowledge transfer.
Aims & Goals: 

The main goal of the Value-Based Wound Care project is to ensure that wound care services are optimally configured to:

  • Develop an efficient interface between general practice (GP), community-based wound care providers and acute services
  • To embed a connected and enhanced model of care to improve the patient journey and to build capacity through improved system efficiencies to appropriately manage wounds across MSH
  • To decrease clinical variation and align with the Clinical Prioritisation Criteria (CPC)
  • To develop a clear understanding of the current service provision, identify changes required and opportunities to improve
Evaluation/outcomes: 

The project developed a framework to guide implementation of the wound service, including:

  1. Development of MSHHS wide policies and procedures to ensure uniform documentation, digital photography, follow-up of chronic wounds and discharge planning
  2. Implementation of demand management and workforce capacity strategies that would ideally include the potential for telehealth and e-consultation store and forward pathways for wound follow up
  3. Development of an education strategy for chronic wound management targetting: MSHHS staff; staff of organisations MSHHS contracts for delivery of wound care, residential aged care facilities (RACF)
  4. Workforce capabilities growth plan including plan for growth of a nurse practitioner workforce and skill sharing with community partners
  5. Optimisation of existing service level agreements with Mater Health Services and Blue Care to encompass wound management services
  6. Requirements for a central point of referral for initial assessment, wound care implementation, clinical support, triaging of internal and external referral and knowledge transfer.

The following actions have been recommended to support Value-Based Wound Care Chronic Venous Ulcers:

  • Continuation of a project officer to ensure a patient flow solution is implemented across all streams.
  • Development of a transparent, integrated, streamlined wound care management solution to enhance patient flow and improve equity of access to wound care services at Metro South Health, through the Primary Care Partnership Unit.
  • Service map the implications of a General Medicine Clinical Prioritisation Criteria (CPC) Wounds of Uncertain Cause or Non-healing Ulcers
  • Development of a secure app or web-portal designed to receive and respond to referrals and images requesting advice. This would then:
    • negate the need for clinical images to be sent via email
    • allow the images to be stored for future reference
    • allow for a “clinical conversation” to happen between clinicians to support patient care
    • allow non-MSHHS clinicians to submit images and requests for advice to MSHHS clinicians
    • allow all interactions into and out of MSHHS (regarding wound care) to meet all MSHHS guidelines around email and image transfer
    • empower patients to become more involved in their care and enhance ability for self-management
  • MSHHS executive support for the development of a Wound Committee to ensure governance, compliance and continual quality improvement. 
  • MSHHS to liaise with the Brisbane South Primary Health Network (BSPHN) and Non Government Organisation (NGO) partners to ensure the consistent provision of education across MSHHS.
  • MSHHS to liaise with the BSPHN and NGO partners to continue to inform the Commonwealth about the need to address the cost of wound consumables
  • Development of a governance structure to ensure consistency and compliance of practice across all wounds and all streams within MSHHS.
Lead Service / Stream: 
Keywords: 
Chronic Wound, Venous Ulcer, Value-based
Last updated 5 September 2018