Implementing clinical process management of vascular wounds in a tertiary facility: impact evaluation of a performance improvement project

Abstract

Background

Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. Efforts should be oriented toward the achievement of the most effective and efficient clinical management. The Angiology Unit at the University Hospital of Padova, Italy, developed a performance improvement project to enhance the quality of practice for vascular ulcers.

Methods

The project consisted in a multistep process comprising a critical revision of the previous clinical process management, staff education, tightening connections between operators and services, and creation of a position for a wound care nurse. The previous standard of practice was modified according to the results of revision and the current evidence-based practice.

Results

The new standard of practice reached its full application in September 2015. The number of patients treated and the number of visits in 2015 remained almost unvaried from 2014. However, the total annual expenditure for treating vascular ulcers was reduced by ~60% from the previous year.

Conclusion

Standardization of guidelines and practice is effective in creating an efficient clinical management and in reducing the economic burden of vascular ulcers.

Keywords:

• chronic wounds
• clinical process management
• cost-effectiveness
• vascular ulcers

Acknowledgments

The authors would like to thank G Camporese, MD, RC Martini, MD, G Salmistraro, MD, and MA Scomparin, MD, who served as scientific advisors; E Baracco, RN, M Bettella, RN, L Cacco, RN, N Griggio, RN, S Morandin, RN, F Nalin, RN, A Noventa, RN, O Scarpazza, RN, C Tonello, RN, and P Zulian, RN, who provided and cared for the study; C Napoli, L Bissoli, E Farinazzo, and B Rossato, who provided technical administrative support.

Disclosure

The authors report no conflicts of interest in this work.