Consulting and Management Services: No One Size Fits All

  Wound Care and Hyperbaric Medicine is a sub-specialty service, clinically and operationally. Many physicians have devoted their careers to this exciting field, yet it is still in its infancy. When it comes to successfully implementing an advanced standard of care practice and at the same time operating an efficient and profitable wound clinic, it can still be misunderstood.

  As hospitals recognized the importance of adding wound care and hyperbaric medicine both as a service and business line within their organizations, they also recognize the need to do it right. Thus the expansion of consultant and management services within our specialty developed. Many of these original management companies not only provide an excellent service, but can be credited with helping wound care become recognized as a sub-specialty. With many years of research, experience, knowledge and practice under our belts, we have become much more cognizant of the ever-changing needs within the healthcare industry, and specifically what it takes to build a “best in class” wound center.

  As a physician, I have devoted my career to the furthering of wound care as a specialty practice, and have personally been involved with the development, implementation and management of various wound programs across the country. Through these experiences, I have learned that there is not a ‘one size fits all’ approach to building a comprehensive model, but many different components that must be coordinated in order to provide a high quality, successful program.

  Nautilus Health Care Group (NHCG) was formed to provide and orchestrate best practices learned and identified through years of experience to help an existing (or new) program achieve greatness within its community.

Wound Care Sub-Specialty Group

  NHCG is a physician-owned and operated wound care and hyperbaric medicine sub-specialty clinical, management and consulting group. As hospital-based wound clinics and management companies have struggled with the development and compliance of their physician panels in the operations of their respective wound clinics, to NHCG it has become increasingly obvious that the best providers are those that practice wound care full-time as a career choice. As with any other medical specialty, the full-time clinician who is passionate about their specialty not only provides the highest quality of care to their patients, but also understands the much needed business applications of the specialty—billing and coding, communication, education, and marketing. These ‘physician champions’ become the central core of the community-based wound care program.

  As a specialty group, NHCG has grown to provide clinical services throughout the continuum of care in the community. In today’s age of liability, diminished reimbursement, and lack of communication our goal is to enhance quality by providing a physician-driven inpatient and outpatient wound care program in the acute care setting as well as provide wound care and dermatology services in LTACs and skilled nursing facilities. These are the groups of patients that need specialty wound care services, but are not eligible to come to the outpatient wound center where the service is available—so the group goes to them. In essence, the group penetrates the community by providing high quality care and facilitating cost-effective care through diminished transportation costs, liability, and lengths of stay.

Physician Practice Management

  As there are a number of physicians that are changing their career path to explore wound care and hyperbaric medicine as an alternative to their current practice, many are wary of the practice management components and the risks associated with the change. NHCG helps to provide practice management solutions to these physicians. Whether a single physician looking for a change or an established wound care group looking to expand, NHCG provides many levels of consultation and strategies—business development and strategic planning, billing, coding and documentation, direct employment and relocation opportunities, consulting and on-going practice management. Wound care can be a very rewarding lifestyle and NHCG strives to allow the clinicians to focus on what they do best—treat patients.

Physician Recruitment, Training and Management

  Wound care has evolved into a physician-driven specialty—some programs have a single physician model while others are successful with a panel of physicians—usually determined by the ‘personality’ of the medical community. Through our expertise, Nautilus is able to assess the characteristics of the hospital, its medical staff and the community needs to help determine how to best set-up the community-based continuity of care model. With wound care necessitating a multidisciplinary approach and a broad referral base, it is very important to make sure the physicians enjoy learning about wound care, educating the staff and feel comfortable implementing programs and disciplining other involved physicians when necessary. NHCG is a leader in professional recruitment, training and professional development. Whether independent, hospital-employed or part of NHCG, physician recruitment, management, and training can often be the most important—but also most difficult—component to a successful program.

Long-Term Care

  Geriatric residents are more susceptible to wounds and dermatological conditions compared with the majority of the population. Age, decreased circulation, and immobility, combined with underlying causes like diabetes, incontinence, and vascular issues, can make treating chronic wounds extremely difficult and frustrating for the patient, facility, and family. Nearly 12—15% of all high-risk patients in nursing homes, rehabilitation centers, long-term acute care or assisted living centers deal with chronic non-healing wounds, which can be time-consuming for the staff and costly for everyone. NHCG provides the staff, equipment, and advanced wound healing supplies to long-term patients at the bedside –at no additional cost to the facility. Our comprehensive dermatology and wound prevention and treatment program includes detailed clinical documentation that also proves very valuable during regulatory inspections.

Acute Care Wound Care

  Similar to the long-term care resources, the goal of the continuity-based model is to incorporate wound care physician consulting to the inpatient setting. In addition to providing care, the goal is to facilitate communication and discharge of the patient to the appropriate setting in order to impact length of stay as well as decreasing liability to the hospital. The key to a successful inpatient wound care program is communication and orchestration of all of the involved components—physicians, physical therapy, wound care nurses, case management, etc.

Pressure Ulcer Program

  For all settings where wound care is practiced, whether inpatient, outpatient, LTAC or SNF, implementation of appropriate pressure ulcer prevention, treatment and documentation strategies is a must. There are many regulatory requirements that require full compliance or there will be stiff penalties, including the F-314 Tag and the CMS ‘Never Events’ implementation. NHCG is a leader in documentation, formulary development, support surface assessment and utilization and prevention of operating room-acquired pressure ulcers in these settings. Unfortunately, it has been found that many hospitals are not functioning at an appropriate level of care despite the fact that many of these needs are easily attainable.

  In summary, NHCG is a full-service wound care and hyperbaric physician, management and consulting group which strives to partner with a local hospital to de­­velop a Wound Care Center of Excellence. NHCG claims to be the only wound care sub-specialty group providing a continuity of care model for hospitals and nursing homes to aid in the most difficult part of developing a center of excellence – physician recruitment and training. Our goal is to provide the necessary elements—clinical, financial and operational—to make the program as successful as possible for each given scenario.

Christopher A. Morrison, MD, FACHM, CWS is the President and Founder of Nautilus Health Care Group, specialists in wound center management, hyper­baric medicine, wound care and dermatology community outreach services and health care provider education and training. Dr. Morrison also serves as Medical Director, at numerous hospitals. He is a nationally recognized speaker and educator on the subjects of wound care and hyperbaric medicine. He is triple board-certified: Diplomate, American Board of Family Practice; Diplomate, American Board of Preventive Medicine, Subspecialty Undersea and Hyperbaric Medicine; and Diplomate (UHM), American Academy of Wound Management, Certified Wound Specialist.