by Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
With uncertainty over how the Affordable Care Act (ACA) ultimately will affect operations, hospitals and other healthcare facilities are tightening up. In many areas, they’re laying off staff. In May, the healthcare industry lost 9,000 jobs—the worst month for the industry in a decade—and another 4,000 jobs were lost in July.
Medicare, Medicaid, and private insurance companies are reducing reimbursements to care providers, meaning less money is coming in and healthcare facilities have less money to pay out. In my experience, when job cuts are needed, the specialty and subspecialty positions go first. Wound and ostomy care is a subspecialty, so we need to be prepared to protect our jobs—not only for ourselves but for our patients.
At a recent seminar, an attendee candidly admitted she doesn’t use extended-wear wound dressings. She uses b.i.d. or t.i.d. dressing changes instead because, with so many treatments needed, her facility has to keep her around. At first, this strategy might sound like a great way to save a job. But poor outcomes, supply costs, and high labor costs eventually win out. In the end, the job will be lost or absorbed into another position. One of the driving forces behind reimbursement in the future is a focus on quality, not quantity. Just as the ACA focuses on quality outcomes, wound and ostomy specialists need to ensure that their treatments and interventions are providing measurable positive outcomes.
Here are some ways to add security to your wound or ostomy care position:
• Monitor and control wound management costs. Don’t confuse product prices with the cost of care. The real cost of wound care includes dressing costs, labor costs, cost of ancillary supplies (such as gloves and biohazard waste disposal), and cost of the duration of care (for instance, facility charges and travel costs for home care nurses).
• Save money by using effective treatments with appropriate products. Don’t keep using ineffective treatments after 2 weeks of no change.
• Increase your credibility. Serve as a clinical resource who provides support, clinical expertise, and leadership.
• Be an expert, not a know-it-all. Know-it-alls overload others with data dump. Experts share specific information based on the consumer’s or patient’s unique and special needs.
• Track healing rates along with wound incidence and prevalence. Avoid focusing too much on the negative and remember to celebrate the positive.
• Push prevention protocols and programs even more.
• Focus on building relationships with people in your organization and within the community. Become a liaison between your facility and referring sources to enhance communication and improve coordination of care.
• Share your accomplishments. Keep management informed of cost savings, quality outcomes, and treatment successes. Send positive progress reports and updates to your patients’ prescribing clinicians.
• Be enthusiastic. Let your bosses know you’re motivated to work.
• Think like the boss. Show how your job performance benefits other parties. Explaining isn’t enough; demonstrate how it helps.
• Always look for ways to help your employer reduce costs, increase revenues, or reposition a product or service.
Final thought: If doing ABC gives you XYZ and you continue doing ABC, then you will always get XYZ. “When you can’t change the direction of the wind, adjust your sails.” – H. Jackson Brown, Jr.
Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Wound Care Advisor
Cofounder, Wound Care Education Institute