Developing a Formal Out-patient Ostomy Clinic

Many WOC nurses in the acute setting do not have a formal process for assisting persons with an ostomy who seek assistance due to pouch leakage and peristomal skin complications.  Such patients do not require an inpatient stay, do not fall under a billable code and therefore are limited as to what the WOC nurse can do informally to help assist them with these problems.  Such an informal approach is less than ideal to meet the needs of these patients. Furthermore, without a formal approach, facilities are not able to track ostomy demographics and data related to the incidence and prevalence of stomal and peristomal skin complications which would otherwise be gathered during a reimbursable clinic visit with a WOC nurse.   Following the process outlined in the WOCN Professional Fact Sheet, “Establishment of Wound, Ostomy, and Continence Clinics”, we successfully opened an out-patient ostomy clinic within our wound center in August, 2010, and are now billing for our services.  Developing the ostomy clinic within the wound center allowed our hospital to avoid incurring any increased costs for space utilization, and also provided us with the opportunity to borrow many processes and documentation forms which we modified to meet ostomy documentation requirements. Within our ostomy documentation forms, we have integrated an instrument with established content validity for assessing and classifying peristomal skin lesions. We are currently in the process of developing a data base that will allow us to track ostomy demographics, stomal and peristomal skin complications, and data from the peristomal skin lesion classification instrument.  This poster will provide an overview of the step by step processes used to develop our ostomy clinic, examples of the ostomy documentation forms used at the clinic to meet documentation and billing requirements, and our data base currently in development.