Maintaining wound moisture balance allows for progression of wound healing, which can be achieved through various pathways (Figure 5). Quality measures detailing the types of dressings that provide continued moisture, manage wound exudate, and protect periwound skin are required. Currently, no quality measures exist that focus on wound moisture. As such, additional measures for wound moisture assessment may be warranted, especially in the case of stalled wound healing following intervention (Figure 4, Table 3).
Over the years, patient-centered wound treatment has become a prominent portion of wound care. This holistic approach builds a comprehensive treatment plan that takes the patient’s concerns, support system, and environment into consideration during the development and implementation of the treatment plan, which may lead to improved patient compliance and wound healing.2
Although the CMS prefers to measure outcome of care, it is possible to measure the appropriateness of clinical interventions through “process measures” as long as these processes can be shown to contribute to the desired outcome. Thus, in the field of wound care, improved patient care may need to begin with the reporting of process measures.
The US healthcare system is transitioning to a quality-based system. Wound care, still an emerging specialty, is poorly represented in the current approved quality-based measures. It is clear that the lack of suitable wound care quality measures threatens the survival of wound care provider practitioners and services services and therefore, must be urgently addressed. Quality measures are based upon current evidence, validated guidelines, and best practices; however, patient-centered concerns must be considered when advising diagnostic and treatment protocols. In addition, wound healing should be regularly reevaluated to ensure current treatment plans are promoting healing.
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