Procurement’s role in reducing the total cost of wound care
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As healthcare managers struggle with rising treatment costs and inconsistent patient outcomes 1 , the concept of value-based healthcare is becoming more important to solving these economic and clinical challenges. In wound care, the total cost of the patient journey — not just clinician time and labour but also complication incidence, length of hospital stay, patient outcomes, staff safety and satisfaction and other measures — is a key factor driving purchase decisions.
Dissecting the costs of wound care
A UK retrospective cohort analysis estimated that GBP £8.3 billion is spent on wound care annually (2017/18). This increased by 48%, relative to the period 2012/13 2 . In another analysis, wound care costs were found to be rising worldwide at a rate of 5-6% per year 3 .
Where do these costs come from? The UK cohort analysis referenced above found that for UK’s National Health Service, only about 6% of the total cost burden of wound care was spent on product. The remaining expense went toward managing treatment including infections, maceration, delayed healing, and the additional nursing and hospital resources needed to address these complications 2 .
Many providers may benefit from building wound care programmes centered around evaluating and addressing the total cost of wound care. In terms of specific goals, procurement managers who participated in a Mölnlycke-sponsored survey identified four key value drivers as their most important priorities:
- patient experience and healing
- clinical outcomes
- operational efficiencies
- staff safety and satisfaction
Let’s walk through the fundamentals of a strong value-driven wound care programme.
Find an experienced partner
A McKinsey & Company survey found that 44% of hospital executives in Europe and the U.S. are working more closely with Medtech as industry partners 4 . McKinsey’s report indicates that healthcare leaders are growing more aware of the supplier’s role in not only containing treatment costs, but also improving quality of care4.
A collaborative approach brings experts to the table who can evaluate, configure and implement a tailored programme focused on your unique challenges and opportunities.
For example, Mölnlycke Health Care demonstrates the strength of 'beyond product' partnerships in the wound care space. One client, the largest rural hospital in the United States, sought Mölnlycke’s help to reduce redundancies that caused less-than-desired clinical outcomes and excessive product usage (an average USD620,000 annual expenditure) 5. Mölnlycke coordinated a wound care standardisation programme that included inventory analysis, protocol assessment and clinical education across the wound care continuum. The results included a near 40% improvement in wound healing rates, $300,000 annual reduction in supply expenses, and increased patient and clinician satisfaction 5 .
A wound care standardisation programme implemented at US hospital achieved
a near 40% improvement
in wound healing rates 5
annual reduction in
supply expences 5
increased patient and
clinician satisfaction 5
In the previously referenced McKinsey survey, healthcare executives ranked the strength of supplier capabilities in several areas. Consumable and device suppliers were most often ranked 'excellent' in the areas of clinical/medical expertise (37% of respondents), technical expertise (37%) and understanding of the hospital business (24%) 4 . This feedback could be used as a starting point for defining the wound care partner’s role and where their capabilities can be best leveraged to assist your teams. For example:
- auditing key data
- determining realistic metrics
- implementing new clinical processes and protocols
- tracking and data gathering on important metrics
- training and educating clinicians for standardised knowledge across teams
Address inconsistencies within the same practise
A systematic review of global literature conducted by a Scottish university in 2018 found consistent shortcomings — as reported by clinicians themselves — in wound education, knowledge of wound care and poor application of knowledge in the clinical setting 6 .
In a separate 2020 study, nurses expressed feelings of uncertainty around wound care decisionmaking 7 . Methods of gathering information were characterised by some of these nurses as 'random' — i.e., relying on previous experience, internet searches or asking colleagues for input. Many in the study group pointed out that practice-based choices were not evidence-based despite the credence of evidence-based approaches 7 .
Another report indicates that variability in practice, protocols and solutions can lead to unpredictable outcomes, compromised care, unpredictable costs, increased staff time and product waste 8 9 . Standardisation, training and educational support rooted in evidence-based practice helps ensure that the most optimal wound care treatment protocols are consistently applied by clinicians at all levels across care settings.
Standardising to a limited set of high-quality products — for example, dressings clinically proven to properly handle fluid management over a longer period — can minimise skin maceration, reduce clinician time for dressing changes and, in turn improve product utilisation 10 11 .
In addition, a seemingly simple metric like the number of changes required for a dressing type can have a significant impact on infection rates. As one study noted, frequent dressing changes are a risk factor for bacterial contamination. It was also observed that wound healing is interrupted for approximately three to four hours after a dressing change 12 .
Your partner can help you find the wound care solutions that are backed by clinical evidence, as there are potentially significant product differences that you’ll need to consider for both efficiency and clinical outcomes.
Solution training and data collection are key to results
Hands-on training support from your partner is essential to ensure solutions are used correctly and aligned to best practice protocols. Supplemental to this training are a number of smartphone based digital bedside tools to assist clinicians with tasks like wound assessment, measurement and dressing selection. These digital apps not only reduce errors in manual wound measurements, but also decrease documentation time 13 .
Aside from treatment, training can also be focused on prevention. Consider the benefits of a value programme aimed at preventing pressure injuries. Training clinicians on how to spot an emerging pressure injury, proper patient repositioning and solutions that help clinicians turn the patient without injuring themselves all go a long way to reducing costs and risks while improving clinical outcomes, patient experience and clinician safety.
Our programme
Our programme is not something we just introduce and hand over for you to implement. It’s a customer-focused process that brings together patient-centric solutions, services and tools that simplify and standardise outcomes delivery and make value easier to calculate. We walk through the journey with you every step of the way. We lead the needs assessment process to clarify the best opportunities for improvement and value creation based on your current state.
Working together, we develop an improvement plan — including ways to collect data — that aligns to your desired outcomes and financial goals. Our clinical experts support your clinical teams directly with education, training and tools that are delivered in both hands-on and digital formats.
We also closely monitor programme success to not only ensure goals are being met, but to also identify where adjustments can be made to maximise results.
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References
- Boston Consulting Group, “How Procurement Unlocks Value-Based Health Care,” 9 January 2020
- Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013. BMJ Open 2020;10:e045253. doi:10.1136/ bmjopen-2020-045253
- Markets and Markets, “Advanced Wounds Care by Product, Wound Type, End User. Global Forecast to 2026.
- McKinsey & Company, “Creating ‘beyond the product’ partnerships between providers and medtech players,” February 2019
- McNees, P and Kueven, JA. The Bottom Line on Wound Care Standardization. Healthcare Financial Management. March 2011
- Welsh L. Wound care evidence, knowledge and education amongst nurses: a semi-systematic literature review. Int Wound J 2018; 15:53–61
- Tayyib, Nahla & Ramaiah, Pushpamala. (2021). Nurses’ Challenges in Wound Care Management- A Qualitative Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. 15. 10.7860/JCDR/2021/47039.14626.
- Kotler Marketing MedTech Analysis, “Hospital Purchasing and Value Analysis Evolve: Implications for Suppliers,” 2018
- Becker’s Hospital Review and Mölnlycke Health Care, “Wound care standardization: How it drives clinical and financial outcomes — and total value,” November 2, 2022
- Joergensen B, Åberg Håkansson M. CHEXU 03, A randomised multi-centre non-inferiority investigation to evaluate the efficacy and safety of Exufiber versus Aquacel Extra in moderately or strongly exuding venous and mixed ulcers of predominantly venous origin; Mölnlycke Clinical Investigation Report. PD-581107 Rev 00. 2020
- Lev-Tov H, Picchietti A. Exufiber Ag+01; A clinical investigation to study the effect of Exufiber Ag+ and other gelling fibre dressings on wound exudate and bioburden in medium to high exuding wounds; Mölnlycke Clinical Investigation Report. PD-573989 Rev 01. 2019.
- Zarghooni K, et al. Is the use of modern versus conventional wound dressings warranted after primary knee and hip arthroplasty? Acta Orthop Belg. 2015;81(4):768-775.
- Mazuz, R. “4 Ways to Integrate Digital Health into the Wound Center Today,” Today’s Wound Clinic, April 2019