Pressure Ulcers: Interdisciplinary Approach Across the Continuum

At our center, a skin care program in the managed care arena was developed to fit the needs of the spinalcord-injured (SCI) patient across the continuum of care. The aim of the program was to prevent and treat skin complications through an interdisciplinary, interdepartmental, and multifocused approach. Using a continuous quality improvement (CQI) method for program development, under the MAXIM (monitor, analyze, experiment, implement, monitor) performance improvement process, a center-wide skin team was developed to evaluate and improve the management of SCI patients as they progress along the continuum. The team is comprised of the inpatient SCI rehabilitation skin team, the outpatient wound clinic, the inpatient medical-surgical skin team, and research/telemedicine. This holistic approach toward the SCI patient across the continuum has provided for better outcomes, better utilization of resources, and a more unified approach to care, despite the complications resulting from decreased length of stays, inadequate transition into the community, and inconsistent funding resources.