As healthcare managers struggle with rising treatment costs and inconsistent patient outcomes1 , the concept of value-based healthcare is becoming more important to solving these economic and clinical challenges. In wound care, the total cost of the patient journey — not just clinician time and labour but also the incidents of complications, length of hospital stay, patient outcomes, staff safety and satisfaction and other measures — is a key factor driving purchasing decisions.
Dissecting the costs of wound care
A UK retrospective cohort analysis estimated that GBP £8.3 billion is spent on wound care annually (2017/18). This increased by 48%, relative to the period 2012/132 . In another analysis, wound care costs were found to be rising worldwide at a rate of 5-6% per year3 .
In Australia, the direct cost of chronic wounds to the healthcare system is estimated at around AU$3-3.5 billion annually, with patients often facing out-of-pocket costs of approximately $4,000 or more per year for supplies and care 4. Although New Zealand data is not mentioned in this document, the overall burden and cost structure are likely similar, with wound care contributing substantially to healthcare expenditures.
Where do these costs come from? The UK cohort analysis referenced above found that for UK’s National Health Service, only about 6% of the total cost burden of wound care was spent on product. The remaining expense went toward managing treatment including infections, maceration, delayed healing, and the additional nursing and hospital resources needed to address these complications2.
The Australian data similarly indicates that the largest costs are in treatment management and not in dressings and states that, using low quality or inappropriate dressings increases the time required to heal chronic wounds, which leads to poorer patient outcomes 4.
Many providers may benefit from building wound care programmes centered around evaluating and addressing the total cost of wound care. In terms of specific goals, procurement managers who participated in a Mölnlycke®-sponsored survey identified four key value drivers as their most important priorities:
- patient experience and healing
- clinical outcomes
- operational efficiencies
- staff safety and satisfaction
Let’s walk through the fundamentals of a strong value-driven wound care programme.
Find an experienced partner
A McKinsey & Company survey found that 44% of hospital executives in Europe and the U.S. are working more closely with Medtech as industry partners5. McKinsey’s report indicates that healthcare leaders are growing more aware of the supplier’s role in not only containing treatment costs, but also improving quality of care5.
A collaborative approach brings experts to the table who can evaluate, configure and implement a tailored programme focused on your unique challenges and opportunities.
For example, Mölnlycke Health Care demonstrates the strength of 'beyond product' partnerships in the wound care space. One client, the largest rural hospital in the United States, sought help from Mölnlycke to help reduce redundancies that caused less-than-desired clinical outcomes and excessive product usage (an average USD620,000 annual expenditure)6. Mölnlycke coordinated a wound care standardisation programme that included inventory analysis, protocol assessment and clinical education across the wound care continuum. The results included a near 40% improvement in wound healing rates, $300,000 annual reduction in supply expenses, and increased patient and clinician satisfaction6.
A wound care standardisation programme implemented at US hospital achieved
-
a near 40% improvement
in wound healing rates 5 -
annual reduction in
supply expences 5 -
increased patient and
clinician satisfaction 5
In the previously referenced McKinsey survey, healthcare executives ranked the strength of supplier capabilities in several areas. Consumable and device suppliers were most often ranked 'excellent' in the areas of clinical/medical expertise (37% of respondents), technical expertise (37%) and understanding of the hospital business (24%)5. This feedback could be used as a starting point for defining the role of the wound care partner and where their capabilities can be best leveraged to assist your teams. For example:
- auditing key data
- determining realistic metrics
- implementing new clinical processes and protocols
- tracking and data gathering on important metrics
- training and educating clinicians for standardised knowledge across teams
Address inconsistencies within the same practice
A systematic review of global literature conducted by a Scottish university in 2018 found consistent shortcomings — as reported by clinicians themselves — in wound education, knowledge of wound care and poor application of knowledge in the clinical setting7.
In a separate 2020 study, nurses expressed feelings of uncertainty around wound care decision making8. Methods of gathering information were characterised by some of these nurses as 'random' — i.e., relying on previous experience, internet searches or asking colleagues for input. Many in the study group pointed out that practice-based choices were not evidence-based despite the credence of evidence-based approaches8.
Another report indicates that variability in practice, protocols and solutions can lead to unpredictable outcomes, compromised care, unpredictable costs, increased staff time and product waste9,10. Standardisation, training and educational support rooted in evidence-based practice helps ensure that the most optimal wound care treatment protocols are consistently applied by clinicians at all levels across care settings.
Standardising to a limited set of high-quality products — for example, dressings clinically proven to handle wound fluid effectively over a longer period — can minimise skin maceration, reduce clinician time for dressing changes and, in turn, improve product utilisation11,12.
In addition, a seemingly simple metric like the number of changes required for a dressing type can have a significant impact on infection rates. As one study noted, frequent dressing changes are a risk factor for bacterial contamination. It was also observed that wound healing is interrupted for approximately three to four hours after a dressing change13.
Mölnlycke can help you find the wound care solutions that are backed by clinical evidence, as there are potentially significant product differences that you’ll need to consider for both efficiency and clinical outcomes.
Solution training and data collection are key to results
Hands-on training support from your wound care partner is essential to ensure solutions are used correctly and aligned to best practice protocols. Supplemental to this training are a number of smartphone based digital bedside tools to assist clinicians with tasks like wound assessment, measurement and dressing selection. These digital apps not only reduce errors in manual wound measurements, but also decrease documentation time14.
Aside from treatment, training can also be focused on prevention. Consider the benefits of a value programme aimed at preventing pressure injuries. Training clinicians on how to spot an emerging pressure injury, proper patient repositioning and solutions that help clinicians turn the patient without injuring themselves all go a long way to reducing costs and risks while improving clinical outcomes, patient experience and clinician safety.
