Conversion of a Multi-Hospital System to a New Negative Pressure Wound Therapy System

In 1993, Negative Pressure Wound Therapy (NPWT) was approved by the FDA for use in wounds.  NPWT is well established in the management of hard to heal, acute and chronic wounds. A health care system, which includes five hospitals, a long term acute care hospital (LTACH) a home health agency, and several nursing homes, used the original NPWT system for many years.  In 2009 the system Wound and Ostomy Committee trialed a new NPWT product to determine if outcomes were consistent with the current NPWT system.

The committee recommended that the new NPWT system be trialed at the LTACH because of the volume of patients with wounds (up to 20 NPWT patients at a time), and the 21 day average length of stay which would provide a thorough evaluation of the new system.   The Wound Care Team was trained on the new system and provided all of the NPWT dressing changes.  Reported challenges included a learning curve and resistance to change.   After a year long trial, the LTACH recommended the new NPWT system because of the effectiveness of therapy and the reduction in tissue disruption and pain during dressing changes.  The system was easy for the staff to use and was cost effective. The home care agency and an acute care hospital also conducted short term trials with positive results. 

The system-wide Value Analysis Team reviewed the recommendations and decided to use the new NPWT system exclusively throughout the system.   The Wound and Ostomy Committee developed the staff education plan, which included a competency skills validation tool and clinical support from the company.  

Lessons learned from this experience:  conduct the trial in more facilities in a shorter period of time, obtain cost analysis figures earlier in the process, design a formal evaluation tool, and schedule ample time for staff education.