Assessing and comparing the quality of wound centres: a literature review and benchmarking pilot

Abstract

Multidisciplinary wound centres are currently facing an increase in both the incidence of wounds and the complexity of care. This has resulted in rising costs and increased interest in the effectiveness of treatments. Little evidence is available regarding optimal wound centre organisation and effectiveness; therefore, measuring the quality of wound centres has become more important. This study aims to assess the evidence concerning quality by describing the state of the art of wound centres and organisational effectiveness by developing indicators of quality and by assessing their suitability in a pilot study. A multi-method approach was used: a literature review performed resulted in the development of an indicator list that was consequently subjected to expert review, and a benchmark study was completed comparing eight wound centres in the Netherlands. We thus provide a description of the relevant state-of-the-art aspects of wound centre organisation, which were multidisciplinary collaborations and standardisation of the organisation of care. In literature, significant patient-related effects were observed in improved healing rates and decreased costs. A total of 48 indicators were selected. The indicator list was tested by a benchmark study pilot. In practice, the outcome indicators were especially difficult to generate. Six indicators regarding structure, three regarding process and five regarding outcome proved feasible to measure and improve quality of wound centres.

Quality indicators for a community‐based wound care centre: An integrative review

“…As presented in Tables and , the 18 included studies represent a wide range of research designs that included reports and descriptive articles, ranging in levels of research evidence from Level 1 experimental designs (such as randomized controlled trials), to Level 4, observational descriptive studies . Of the primary studies, three were randomized controlled trials; three were observational studies; two were descriptive designs; two others were a mixed method evaluations; one was a case study; and one was an economic evaluation . Further evidence was provided in three recent reviews of literature …”

“…Wound care centres are established and operational across the range of health care services for ambulatory care; from hospital outpatient clinics, to community‐based primary care and home nursing services, to independent free‐standing clinics . Almost all studies concurred with the ideal that patients be managed by a multi‐disciplinary team.…”

“…Although the prevalence of chronic wounds has escalated with an increasing demand for wound care owing to aging populations, patient health care outcomes have improved. The establishment of wound care centres with multidisciplinary care have led this change …”

“…A substantial amount of evidence‐based guidance for wound treatment has developed as an outcome of research. For example, in 2017, Pruim et al cite clinical guidelines from six countries in Europe. A recent review of systematic reviews of interventions to treat complex wounds reported that numerous interventions were found valuable for treating various types of complex wounds, yet few treatments were found universally successful, suggesting that further high‐quality trials are needed to rank the effectiveness of all treatments …”

“…Established wound centres deliver care in many industrialised countries including, for example, the UK, the USA, The Netherlands, Canada, and Australia . Wound care is a costly business, however, with snowballing costs reported in the UK, the USA, Singapore, and Australia .…”