Continence Coach: Catch the Spirit of Innovation

     One the chief reasons I love working in healthcare is its pace of change and innovation. At the National Association For Continence (NAFC), we encourage consumers to periodically revisit their providers to discuss their bladder and bowel control problems because new solutions or options may be available since their last visit. Innovation is at the heart of the hope all professionals — educators, providers, and product developers — instill in the public.

     According to the Advanced Medical Technology Association (AdvaMed),¹ a trade organization representing more than 1,600 of the world’s leading medical technology innovators and manufacturers of devices, diagnostic products, and medical information systems, the average life cycle for many products is only 18 months. Improvements based on feedback and ideas from clinicians frequently are incorporated to advance a device to its next generation or to create a completely new platform. Useful feedback requires manufacturers to clearly and objectively communicate new product attributes and train clinicians to use advancing technologies safely and effectively (in some cases, such training by manufacturers is required by the FDA). Only then will end users be able to provide valuable input.

     Because I have worked in industry in new product development and launches for nearly two decades, I can assert that company-sponsored education and training are integral parts of marketing activities and on-going technical support. Expert clinicians often serve as consultants and instructors — designers of the hands-on curriculum for their peers and investigators for ongoing market surveillance. Appropriate disclosure of such relationships between companies and clinicians preserves the public trust in innovations and insulates the integrity of the role of clinicians in providing educational support to others and useful feedback to companies. Transparency protects the dignity of all involved. These roles and responsibilities are vital to product evolution, patient safety, and the achievement of intended outcomes.

     It is easy to drift into the rut of repeatedly using the same products without being challenged by innovations. We are all guilty of living in a comfort zone of what works but this is not what is meant by evidence-based healthcare. Despite the heightened attention currently focused on EBH as a mandate, the complete definition of the term often is overlooked or misunderstood. Correctly applied, EBH is a concept of determining a patient’s treatment by balancing scientific evidence, experienced practitioner judgment, and patient needs and preferences.² Published evidence alone is not sufficient criteria for decision-making. Inappropriate application of “evidence” both can restrict patient access to quality care and stifle the innovative spirit that guides change and subsequently facilitates improvements. Only by embracing the complete, comprehensive definition of EBH will practitioners reconcile their engagement in product evolution with adherence to data-supported protocols. Otherwise, we would never move beyond one gold standard to the next and never experience an improvement in choices, outcomes, or standards of care.

     Despite a weakened economy and an especially difficult time for entrepreneurs managing the risks associated with new product development, I am delighted to report that innovation robustly prevails in healthcare. This fall, the NAFC is publishing its fourth edition of DISCOVERIES®. It features new products that include gender-specific disposable absorbents in varying styles, sizes, and levels of absorbency from Kimberly-Clark (Dallas, TX) and SCA’s TENA (Philadelphia, PA); a reusable urine collection system designed to eliminate the need for men to wear a leg bag, developed by Worldwide Technology Development; and a hydrophilic, intermittent catheter designed for the short length of the female urethra from Coloplast Corp. (Minneapolis, MN). New prescription medications and surgical devices also are available.

     The clinician’s role is to ask vendors for new products aimed at enhancing patient quality of life. Compare innovative products to your current “gold standard,” get properly trained in their usage, collect the comparative data, and fairly assess their value. Consider being part of the team that evaluates new products and services and provide peer-to-peer education and objective input to the marketers.

     Also, spend time this fall reviewing the product literature you obtained from exhibitors at the 41st annual Wound, Ostomy, Continence Nurses Society meeting. Request follow-up samples and manufacturer inservices. Be a part of the innovative spirit that brings greater value and safer, more reliable results to the patients you so faithfully serve.

The National Association For Continence is a national, private, non-profit organization dedicated to improving the quality of life of people with incontinence. The NAFC’s purpose is to be the leading source for public education and advocacy about the causes, prevention, diagnosis, treatments, and management alternatives for incontinence.

This article was not subject to the Ostomy Wound Management peer-review process.

1. AdvaMed Statement for the Record: Hearing on Medical Research and Education July 29, 2009. US Senate Special Committee on Aging: Washington, DC. Available at: www.aging.senate.gov/letters/advamedcme.pdf. Accessed September 19, 2009.

2. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn’t. Br J Med. 1996: 312:71–72.