Chart Reviews

Over time, experienced clinicians in every field develop a rationale approach to the evaluation and management of their most common clinical challenges. However, an individual’s experience or beliefs may not be the best basis for clinical practice since they have evolved from the narrow experience of that clinician. Across all medical disciplines there has been an effort to introduce an “evidence based” approach to clinical decision making. Dramatic reductions in mortality from pneumonia, for example, have been realized by utilizing “order sets” specifying antibiotic selection and other aspects of patient care, based on data from clinical trials. Unfortunately, only a fraction of clinical medicine has been subjected to randomized controlled trials (RCTs). Thus, many specialties have introduced “clinical practice guidelines,” (CPGs) developed using the best scientific data as well as experienced clinical judgment. The WOCN has excellent wound care guidelines available now on “guidelines.gov” and some pertinent standards are also available from the National Qualify Forum (NQF). 

While wound centers may have access to the latest technological advances in dressing options and therapeutic interventions, there remains a basic minimum standard of care for each wound category. Problems relating to pressure must be off loaded, edema must be controlled, and patients at risk for ischemia must undergo arterial evaluation. The challenge then becomes how to incorporate “best practices” into the daily lives of physicians. Despite the high quality of care provided by wound centers, delays to implementing even the most basic treatments still occur. This is likely due to the complexity of the patients and their disease processes. This problem of inconsistent care, or quality of care which is dependent on the experience of the practitioner, continues to limit the provision of care despite our technological sophistication.

 How can we help you standardize your care plans?

If you are new to the wound care specialty and wish to have your treatment plans reviewed, one of our services is Medical Oversight of Care Plans by Dr. Fife. Dr. Fife will review the treatment plans from every consultation and send you a personal email regarding its compliance with general guidelines. If there are suggestions for further testing, you will also receive a reminder in the EMR upon which you can act at the patient’s next visit. This correspondence is visible only to the attending physician/nurse practitioner and is not part of the patient’s record, and the clinician can choose to act upon the recommendations or disregard them.