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Special to OWM: Measuring the Value of Wound Care Certification in a Quality-based Health Care System
This is an excerpt from the original article published in the October 2016 issue of Today’s Wound Clinic. Be sure to join the discussion on accreditation and the status of wound care as a specialty on Facebook and Twitter.
As the United States health care system migrates to a value-based reimbursement structure, the idea of what it means to provide quality health care (and the monetary worth of such care) is now primarily judged not only by patient satisfaction scores, but also by the correlation between care rendered and an aging patient population’s ability to remain out of the hospital. Health care providers and their employers will continue to face more incentivized levels of accountability as determined by the government’s ever-scrupulous assessment of measurable clinical outcomes.
What place does education hold in delivering quality health care? Is the current state of education within academic institutions one that properly prepares clinicians to meet the standards of care for wound prevention, diagnosis, assessment, and treatment when most nursing and medical programs don’t offer a robust wound education curriculum? At the same time, how does a licensed clinician determine which continuing education programs will give a level of education that meets current best practices and positions them to meet financial and quality care benchmarks?
It’s confounding to consider what the scope of possessing a specialty certification in wound care means for those within a cohort that is well known to not be officially recognized as a medical “specialty” by such organizations as the American Medical Association and the American Board of Medical Specialties compared to, just to name a few, the fields of cardiology, oncology, and dermatology. However, achievable nationally accredited credentials are available that designate individuals as specialists in wound care. These include Certified Wound Specialist® (CWS®), which is available to any licensed health care professional possessing a bachelor’s, master’s, or doctoral degree with 3 or more years of clinical wound care experience through the American Board of Wound Management (ABWM); and the Certified Wound Ostomy Nurse (CWOCN®), which is offered exclusively to registered nurses (RNs) through the Wound, Ostomy and Continence Nursing Certification Board. Additionally, and similarly exclusive to nurses, the American Nurses Association, the largest nursing organization in the United States formally recognizes wound ostomy continence (WOC) nursing as an actual specialty.
Additionally, Pamela Scarborough, PT, DPT, MS, CDE, CWS, CEEAA, director of public policy and education at American Medical Technologies, Irvine, CA, notes, “The American Physical Therapy Association (APTA) recognizes wound care within the organization as a special interest group, which is moving us in the right direction. On the other hand, as things stand today, anybody can hang up a piece of paper in their office and say they’re a wound care specialist. But there’s no credibility with that.”
Understanding the difference between specialty certification and a certificate are not the only factors that clinicians should weigh when choosing routes to furthering their education. A clinician of more than 30 years who has practiced in a variety of settings, including acute, outpatient, home health, and long-term care, Scarborough claims the level of research required for finding appropriate certification should be as rigorous as researching for the purposes of writing a scientific paper. “We encourage people to do their homework related to the board certification they want to take,” she says. “You want to look at the outline of the content being offered as well as the knowledge that you must have to pass board certification — whether you’re going for several certifications or just one. Look at the faculty. What is their basic health care license? Are they certified? If so, what type of certification do they have? Also, are there practice tests and other study tools available? A viable board certification should have valuable support materials accessible to help clinicians prepare for the exam. Clinicians need to be educated about how to appropriately assess the type of continued education that is best for them, given their clinical background, and whether it is going to give them the best credibility and recognition within their area of health care. Clinicians need to seek out courses and education that is evidence-based and that’s going to discuss the basics of wound care as well as what is current evidence and treatment.”
As patients live longer with more difficult-to-treat chronic wounds and comorbid conditions, clinicians need to acquire and maintain an intimate knowledge of the medical advancements within this specialized field. In choosing a certification venue, clinicians should consider its clinical viability as well as its suitability for their individual professional needs.
