From the Editor: A Checklist for Quality and Progress

  At the recent Ostomy Wound Management Editorial Board meeting, held yearly at the Spring Symposium on Advanced Wound Care, participants were asked to suggest new ongoing print and online columns that would address key issues in health- and wound care. Board members — clinicians, educators, and administrators, all literally with their fingers on the pulse of what is happening in healthcare — made quick and efficient work of providing numerous ideas that reflect both persistent and emerging concerns. With sincere gratitude to the OWM Board and in no particular order:

  Wound products 101. An idea that was both championed as forward-thinking and challenged as too elementary, a column that explains the composition and use of wound care products would provide the basics with an emphasis on dressings as medical devices.

  Electronic medical records. A reality that currently is frustrating the physicians in my local healthcare system, EMRs, according to OWM Board members, are not user-friendly when it comes to entering wound assessment and care information. Suggestions for navigating around and documenting in wound care EMRs would be an important resource.

  Patient (and caregiver) safety. Increasing evidence about the effects of a “culture of safety” on mortality, morbidity, and healthcare costs has led to more legislative and regulatory mandates for improvement. Authors would focus attention on all well- and lesser-known safety issues – especially as they pertain to patients who are at risk for or have impaired skin integrity.

  Innovations in practice. What is new in wound care? New support surface and bandage materials? MRSA-bursting technology? Willingness to improve products and approaches, like chronic wounds, should never be allowed to stagnate.

  Quality initiatives. A simple change in protocol can facilitate faster, more accurate diagnoses and better treatment outcomes. OWM wants to proliferate programs with proven success.

  Patient-centered care. OWM historically has promoted patient-centered care through its feature articles. Now we are establishing venues to hear directly from the patient. In addition to considering a new print column, a section of our website (now under development) will be devoted to patient queries and reader (clinician and patient) responses.

  Outcomes. Sans a formal scientifically rigorous study, a clinician reader claims to heal 80% of his facility’s diabetic foot ulcers in 12 weeks. We ask, “Show us how.”

  Checklists. Overarching all of the suggestions was the idea of checklists — ie, streamlined approaches to safety and being more efficient and effective at what you are doing. Eliot Mostow, MD, took the lead in this discussion, noting that although many clinicians bristle at the idea of following a protocol, many areas of patient care have been dramatically improved by doing just that. He recommended reading/listening to Atul Gawande’s The Checklist Manifesto. “Wound care is complicated by a great deal of product and practice options that are not always supported by high-quality clinical data,” Dr. Mostow noted. “That being said, a well-structured protocol, with measurement of outcomes, can be the beginning of useful information to substantiate successes and identify failures, ultimately improving patient care. Checklists should be viewed as an important first step in the process of quality improvement.”

  Because checklists are relevant to every topic the OWM Board is considering for future columns, we invite interested clinicians to share their specific checklists. We anticipate that checklists with proven track records will incorporate most of the OWM Board considerations — that they will be evidence-based, patient-centered programs that work and that demonstrate what Board members termed accountable care.

  If we have tweaked your interest, please contact the Editor at bzeiger@hmpcommunications.com for encouragement and support — two key components of the OWM publication checklist.