Implementing Evidence-Based Research and Standardized Quality Measures in the Management and Prevention of Chronic Ulcers

Chronic wounds are a growing problem in the United States. Based on evidence-based research of relevant quality wound measures and utilizing clinical practice guidelines, the hospital's wound clinic implemented process improvement initiatives to target specific care-based management techniques that are evidence-based and patient-centric. A process redesign and a cultural change were identified as appropriate methods for improvement. Clinic staff were educated prior to implementation.

The initiatives included: ordering vascular screening and ankle-brachial index (ABI) for chronic lower extremity ulcers, unless already completed within one year; addressing and documenting compression for every visit in patients with venous stasis ulcers; and documenting off-loading methods each appointment for patients with open diabetic foot ulcers, unless contraindicated. The goal for each of the initiatives was set at 80 percent, and all of them achieved 100 percent in the wound clinic's 875 visits in 2014 and 306 visits in January through April 2015.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/