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Managing wounds via EHR has numerous benefits for one SNF

January 21, 2015
by Lois A. Bowers, Senior Editor
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Implementing an electronic health record (EHR) system and integrating an automated wound management solution into it has resulted in numerous administrative and clinical benefits for one nursing and rehabilitation center, according to the center’s CEO and two of its wound nurses.

It all comes down to outcomes—or as Burgess Square Healthcare Center CEO John Vrba put it, “Outcomes, outcomes, outcomes.” He spoke during a Jan. 20 webinar sponsored by PointClickCare and WoundRounds. “Care is everything,”  he said. The 200-bed skilled nursing facility (SNF) in Westmont, Ill., began implementing the technology about five years ago.

Burgess’ EHR contains an entry for each resident that includes his or her medication list, advance directives and progress notes, reports and other information related to his or her care. The wound management solution enables the staff to generate wound assessment reports, treatment reports and copies of physicians’ orders from information they enter into the system. The integrated system helps automate some tasks and eliminates the duplication of work.

Customizable alerts call attention to residents’ wound statuses, sometimes prompting clinical action, and staff can upload photographs into the system to show the progress of treatment to doctors and others. Opinions differ on whether staff should take photographs of wounds, but the Burgess speakers said they are in favor of it. Gia Fite, RN, wound care coordinator, and Michele Balduff, nursing supervisor, said it reduces the amount of “defending and work” needed, and Vrba said that families may take their own photographs anyway.

“A picture is worth a 1,000 words,” he said, adding that photographs revealing improvement show current and potential resident families that staff members care and provide quality treatment. “The other day, we had someone who toured seven facilities. And my admissions director asked, ‘Why did you admit to us?’ And he said, ‘I talked to people in parking lots,’ ” Vrba said. “He talked to our family members in our parking lot. He talked to staff and said, ‘How is this facility?’ And then when he toured here, he was shown an example of a wound, instead of [our] just saying we’re great at it. And he said, ‘My gosh, these people care.’ And we got that admission.”

Using an EHR with wound management software helps document care to prove quality, ensure regulatory compliance, lessen the chance of lawsuits and assist with state surveys, the Burgess speakers said. “Wound care is one of the most litigated-against occurrences,” Vrba said. “You have to be able to provide the care.” The wound management system, he added, “assists us in producing that excellent care and also documenting that care that we give, which reduces our wound risk.”

The increased efficiency that comes from using the technology means that staff members have more time to focus on care delivery, Fite and Balduff said, and empowering of staff members in the decision-making process helps improve morale.

All of these benefits have had marketing and census implications for Burgess, too, the speakers said, increasing referrals from hospitals and recommendations from families as well as enhancing the revenue stream. The technology also helps control ancillary costs via reports of the ordering and use of supplies, and it’s helpful in showing results to potential referring institutions and legislators, the speakers said.

The technology also has financial implications, Vrba said. Using an EHR with a wound management system, Burgess has realized increased revenue of $540,000 from 36 more admissions every year, he said. Use of the wound management system also has resulted in an RN overtime reduction of more than $18,000 per year, Vrba added.

Vrba’s advice to other SNFs:

  • Adopt an EHR if you haven’t done so already.
  • Implement the technology in phases. Burgess implemented a basic EHR, then added bookkeeping and, later, wound care functionality. Next came a point-of-care system, and Burgess hopes to be paperless soon.
  • Ask “super users”—those in the facility who are comfortable and adept at using the technology—to assist in the rollout and ongoing use.