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Improved Clinical Efficacy with Wound Support Network Between Hospital and Home Care Service
Tone Kristin Bergersen1, Elisabeth Storheim, Stina Gundersen
1Tone Kristin Bergersen, MD, PhD, is Associate Professor, Institute of Clinical Medicine, University of Oslo, and Consultant Dermatologist, Department of Dermatology, Oslo University Hospital, Oslo, Norway. Elisabeth Storheim, MBA, is Head Nurse, and Stina Gundersen, BScN, is Assistant Head Nurse, Department of Dermatology, Oslo University Hospital, Norway. Linn Kleven, MPhil, is a Researcher, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway. Maria Johnson, MSc, is Innovation Advisor, Clinic of Innovation, Oslo University Hospital, Norway. Leiv Sandvik is a Professor at Oslo Centre of Biostatistics and Epidemiology, Oslo, Norway. Kari Jorunn Kvaerner is Chief, Clinic of Innovation, Oslo University Hospital, Norway. Nils-Otto Ørjasæter is a Professor, BI Norwegian Business School, Oslo, Norway, and is Senior Advisor, Clinic of Innovation, Oslo University Hospital.
Objective:
The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated.
Intervention:
The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21).
Design:
Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks).
Patients:
Patients with chronic wounds (lasting >6 weeks and with wound area >1 cm) in Oslo, Norway.
Main Outcome Measures:
Closure of the observation wound; wound size; total number of wounds; presence of eczema, edema, and pain; number of dressings per week; time spent per dressing; and number of control appointments at the hospital. The economic impact is calculated for the hospital and for the community of Oslo, Norway.
Main Results:
The number of control appointments (t = 3.80, P < .001) was significantly decreased, and the number of completed treatments (P = .02) was significantly increased after 12 weeks in the intervention group compared with the control group. A significant improvement was evident in the intervention group in terms of eczema (P = .02), edema (P = .03), and closing of the observational wound (46.7% cases in the intervention group versus 25.0% in the control group).
Conclusions:
A wound support network between the primary home care service and the hospital is cost-effective, improves clinical efficacy of the home care services' work, and reduces the need for consultations at the hospital.
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