North East CCAC refines its wound care program

Don Langlois, director of clinical services, North East Community Care Access Centre.

Don Langlois, director of clinical services, North East Community Care Access Centre.

New protocols, education speed healing

The North East Community Care Access Centre (CCAC) has been making considerable improvements to its wound care program. Don Langlois, director of clinical services, notes that wound care accounts for the largest volume of nursing visits in the community.

“It accounts for approximately 50 per cent of our nursing visits, which is why it was relevant to take a closer look at how we could improve the way we provide wound care in the community and how we support our clinicians to maximize patient outcomes,” said Langlois.

The North East CCAC provides care for people coming out of the hospital with complex wounds after surgery, as well as for people who live with chronic diseases such as diabetes.

The wound care program has seen a marked decrease in healing times since last spring, especially for patients with chronic wounds.

According to the Canadian Wound Care Association, the average cost of treating a chronic wound is $10,376, while the average cost of acute wound care with no complications is $11,840 and the average time to closure of acute wound with no complications is 165 days.

The North East CCAC reported that it treated more than 1,600 patients with enhanced care for wounds last year.

Chronic wounds such as venous, arterial and diabetic ulcers often need ongoing care to manage. Eighty-five per cent of all amputations in Canada are the result of non-healing foot ulcers. Diabetes is a prevalent disease in Northern Ontario, particularly in the First Nation population.

Improvements to the wound care program were found in the type of tools and resources clinicians need and how they could standardize to ensure procedures were followed across the region.

With 600 nurses in their catchment area, providing consistent care is challenging, but evidence indicates that they have been able to achieve their goal.

“We wanted to put in process tools that if a patient is not progressing the way we would expect that we would be able to flag and wrap that patient with the right services such as a dietitian or physiotherapist,” said Langlois.

Ken Wallenius is a Sudbury resident who was referred to the wound care program after surgery to remove a tumour caused by melanoma. He had been attending the wound care clinic at Health Science North and was then referred to the North East CCAC.

“I had to have the dressings changed three or four times a day,” said Wallenius. “While I was being treated for the wound I was able to travel to Timmins and continue my treatment there through the CCAC,” he said.

Grateful to not be tethered to his home, he has been able to return to a relatively normal routine and continue treatment. Wallenius is an example of how the improvements allow patients to return to a normal routine.

A large part of the improvements began with extensive education for front line clinicians. Close to 20 clinicians received training.

“They became the master trainers,” said Langlois. “We developed a model that was more sustainable and created local champions that formed wound care teams.”

They delivered the education over several months to build expertise and confidence in their skill sets and knowledge.

Wound care treatment and products to treat wounds have come a long way over the last decade. There is less need for frequent dressings, which results in less discomfort. They also allow patients to resume a more normal level of activity.

Patients can also choose to attend a local clinic or have a clinician visit them in their home. With clinicians not required to make so many visits, they can see more patients with complex needs.

The wound care program also includes the integrated clinical pathways that show the care that will be provided for the various wound types. Physicians are informed about the care that is being provided and, if the wound is not healing as expected, there are ways to escalate the treatment and bring the physician back into the plan of care.

Working with health-care partners in the communities, including hospitals and contract service providers, is an important reason for the success of the program, especially in the rural areas of the region where the North East CCAC would like to ensure that patients have access to the same quality care that is available in urban centres.

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