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HMC unveils tips to beat pressure ulcers

NEEDHAM, MASS. –  April 20, 2010 – The Healthcare Management Council, Inc. (HMC) has compiled a cutting-edge white paper of best practices to address the expensive and widely prevalent problem of decubitus ulcers.

Research from HMC has indicated that decubitus ulcers cost around $575,000 for an average hospital annually. A patient acquiring a pressure ulcer requires an average of $9,200 in extra care. This cost is not reimbursed by Medicare or Medicaid and in the future probably won’t be reimbursed by private insurers, either. What’s worse is that this is a preventable off-quality condition, according to Shelley Burns, HMC’s director of knowledge management.

There are solutions, however, says Burns. “Being able to readily discern patterns in your ulcer incidence increases the likelihood that you can fix your decubitus ulcer issues quickly and effectively,” says Burns in a recently released white paper. The first step required is to identify the prevalent patterns of the ulcers in a hospital with the HMC Cost of Off-Quality online cascade. Other types of data analysis are available in the HMC tool set. For instance, the HMC Clinical Analyzer can present many types of rich data around decubitus ulcer incidences, including diagnosis-related groups (DRGs), Physician of Record, Length of Stay (LOS), and cost.

What to look for

Using this data, wound care coordinators and skin teams can identify patterns and begin to take action, says Burns. Administrators should look for these common patterns:

Nursing unit and diagnosis-related group clusters. Ulcers tend to appear most in particular nursing units and DRG clusters. Because of this, administrators can target remedial action through specific training programs. This approach costs less time and money than implementing a facility-wide educational initiative.

Long LOS. Typically, patients with longer stays are more likely to develop ulcers. If the ulcer incidence is clustered in patients with a longer LOS, wound care coordinators can ensure there are special measures applied, such as more frequent skin assessments. Or they can initiate preventive care protocols for these patients.

Admitting Physician. Sometimes there is a correlation between the admitting physician and the occurrence of pressure ulcers in their patients. Wound care coordinators can take action to see if the pressure ulcer assessments are effective and if the physicians are showing due diligence in their documentation.

Random occurrences still happen, too

Of course, there are also facilities that will face ulcers that appear outside these categories, seemingly at random. Clinicians in facilities with random ulcer patterns should then consider common patient characteristics, such as nutrition. If they can’t find a common factor, they should assess the house-wide skin protocols, procedures, and education.