A Novel Point-of-care Solution to Streamline Development of Local Wound Care Formularies

Background: Local dressing formularies reinforce the use of clinically appropriate and cost-effective products. Despite its significant potential to impact on the bottom line, many institutions postpone decisions to create a local formulary, as the process is frequently regarded as time-consuming. 

Once implemented, formularies are frequently saved as local files that need to be manually updated. The authors aimed to create a solution to overcome obstacles in formulary development, implementation, and management. 

Method: Using the Design Thinking methodology (WoundReference Clinical Decision Support Web-App; Wound Reference, Inc, San Francisco, CA), the solution was developed as a module within a clinical/reimbursement decision support web-application for wound care and hyperbaric clinicians, as follows: 

• Clinician needs/desired features were identified through interviews. 

• The module was developed with robust programming language, library, framework, and APIs. 

• The module was implemented at a hospital-based outpatient wound clinic. 

• Products used by the clinic were selected among ~1000 product profiles stored in the module. Selected products were automatically categorized and listed in groups (eg, alginates, foam). 

• Guided by the web application’s evidence-based content, interactive feature matrices, and virtual advisory panel, clinicians chose products with best fit, eliminating redundancy within each product group. 

• Clinic added custom instructions/educational notes to each product on the digital formulary, to serve as staff quick-reference manual. 

• Clinic shared link to formulary with partnering institutions (eg, home health agencies). 

Results: The module streamlined development of a local wound care formulary through automatic product categorization, immediate access to critical formulary decision-making information, product-specific customized notes, and real-time interdepartmental collaboration. The process resulted in a 36% decrease in the number of products (from 67 to 43 across 22 categories), and an inventory cost savings of 7% ($35 888/year). 

Conclusion: A solution to streamline creation of local wound care formularies was developed. Implementation resulted in inventory cost savings and increased staff efficiency. Its ease of use may significantly increase adoption of cost-effective formularies and maximize health outcomes.

*This poster won 1st place in the Practice Innovations Category at the 2019 Symposium on Advanced Wound Care Fall.

Additional Oral and Poster Abstracts are Available on the Wound Care Learning Network.