How to do it ... Multidisciplinary wound care teams
Research supported by general industry consensus shows successful wound care management in long-term care cannot be achieved by a singular effort. Building highly effective and functional teams means taking a well-designed, multidisciplinary approach, backed by solid leadership and smooth collaboration. Here's how to do it.
1 Recruit broad participation to ensure the best expertise. “The whole institution needs to be on the team with key leaders,” says Robert Crousore, vice president, general manager, Global Wound Solutions, Joerns.
Although they have expertise in the most obviously relevant discipline — wound care — state-tested nursing assistants are often the most overlooked candidates, adds Billie Jo Schwerin, director, Clinical Services for DermaRite Industries.
“They see the residents the most throughout the day, and view them holistically,” she says. “Their input is extremely valuable.”
Adds Jeri Lundgren, director of consulting services for Pathway Health: “The nursing assistant provides 100% of the preventative interventions.”
Lundgren and Schwerin say other key disciplines should include, if possible: medical director/primary care physicians; nursing; registered dietitian; therapy; discharge planners; and housekeeping/maintenance.
2 Creating a quality multi-disciplinary wound care team begins with commitment.
“Identify wound prevention and treatment as a care priority in your facility,” says Julia Melendez, national clinical director for Joerns.
Once a team is in place, establish a mission and objectives for it, and identify some way to rally the team around goals with real measures, Crousore and Melendez say.
The latter emphasizes that it's important to establish and commit to a schedule for wound rounds and team meetings.
Pathway Health's Lundgren suggests developing an effective agenda that protects residents, including topics like wound care, high-risk residents and review of supplies and equipment.
3 Training and continuing education (including certification) can help to ensure the highest quality performance of your wound care team.
“Every team member should be trained on the prevention, assessment and treatment of pressure ulcers, MDS 3.0 Section M coding and F-315 Guidance in order to be effective,” says Lundgren.
Ensuring common goals and that each member is patient-focused also will help eliminate any barriers or setbacks to healing, Schwerin adds.
Team collaboration also is critical, says Melendez, who adds that evidence-based protocols and tracking outcomes are essential.
There should be “real incentives for goal achievement, providing a dedicated team budget and workload relief to enable team participation,” according to Crousore.
In the end, a quality wound care team is one in which each member has “a mutual respect and understanding of each other's role,” Schwerin says.
4 Recruiting and organizing a multidisciplinary wound care team is pointless unless you establish a means to nurture and reward its success, believes Elaine McGowan, vice president of Clinical Affairs for DermaRite Industries.
Success can be realized more easily by having a team leader who is able to commit the time and energy to its efforts, she adds. Additionally, a leader should be spending enought time on both the front and back ends of care.
“Even the simplest initiatives are doomed to fail if there is no process set up to provide meaningful feedback to the participants,” McGowan observes.
Critical to the team's success is wholehearted support from the entire staff, especially administration, experts agree.
Many organizational structures won't survive without support from the top, let alone thrive, and this area is no different.
“It's essential to empower them within the organizational leadership to ensure their recommendations are acted on, and there's a broad buy-in from the whole clinical staff,” Crousore adds.
McGowan puts it another way.
“The team needs to know that their efforts are making a difference. Ultimately, the successful wound care team must demonstrate it is driving real changes in the way care is provided that result in improved resident outcomes.”
Mistakes to avoid
-Failing to secure top management and staff buy-in
-Neglecting to involve direct caregivers, especially aides
-Acting without wound care as an organizational goal/priority