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“We
contract with hospitals to open,
develop, and manage advanced wound care
facilities, primarily in the outpatient
setting,” said President and CEO Jeffrey
Nelson. “It’s an underserved market and
typically a new service for a hospital.”
For hospitals with pre-existing wound
care clinics, DCS brings a medical model
with a higher quality, evidence-based
approach that enables the hospitals to
provide better patient care. It also
brings an additional revenue stream to
help the hospital’s bottom line, as
physicians following the clinical
practice guidelines will assess patients
for their underlying wound etiology,
thereby needing ancillary services at
the hospital.
Standing united
The history of DCS dates back to April
2006 when Diversified Therapy, which
managed comprehensive wound care centers
at more than 80 contracted hospitals in
25 states, merged with Praxis Clinical
Services, which provided management
services for the development,
implementation, and operation of wound
care centers. That December, DCS merged
with Wound Care Centers (formerly
Curative), a support services, database,
and wound care specialist company
managing centers established in 1988.
The merger resulted in a combined force
of more than 260 hospital clients in 40
states and 700 employees nationwide.
With Praxis’ strong medical expertise,
Diversified Therapy’s strong field
operations and hyperbaric oxygen therapy
expertise, and WCC’s strong support
services and database history, the
company sets itself apart from others in
the industry.
“This is a complex field. It’s not a
single specific clinical specialty,
unlike cardiology or vascular surgery,”
said Nelson. “Because we are the largest
provider in the marketplace, we can
bring more resources to bear.”
DCS handles the recruiting of each
center’s staff members, including
physicians, and 10 months of the year
trains between 60 and 80 medical
professionals. Although it might seem
simpler to recruit physicians from the
hospital partners themselves, Nelson
believes it’s important to make a
hospital’s transition into a new service
line as easy as possible. “We like to
collaborate with our customers to
effectively open and operate the wound
center to meet their clinical and
financial goals,” he said.
Synergistic benefit
Within each of its 300 centers, DCS has
a standardized continuous improvement
protocol to develop benchmarks for
clinical outcomes, physician
performance, and patient satisfaction.
At the start of the Dash cycle—the
corporate name for the improvement
process—corporate officers go to each
area meeting of about 15 programs,
explain the direction the company wants
to move, and then ask each center’s
program director what issues s/he faces
on a regular basis.
That information goes back up the
management chain to a corporate-level
meeting roughly three or four weeks
later. The executive team then selects
one or two common concerns and creates
corporate initiatives, which are tested
and revised prior to launching, to
address the issues impacting the centers
nationwide.
“When we initiated this process, it
became clear that we were having
challenges providing enough time to
train our program directors, especially
with the level of growth we’ve had,”
Nelson said. “We identified the
difficulty of frequent face-to-face
communication with our customers, which
had been the hallmark of the three
companies that came together.”
Through the first implementation of the
Dash cycle, the company determined that
its field managers’ duties were becoming
too expansive to maintain a high service
level. In March 2008, DCS significantly
expanded its field management team from
10 regions to 20, reducing the span of
controls and putting more focus at the
customer sites.
The implementation of the Dash process
was well received by each of the
individual program directors, as they
are now seeing the synergistic benefits
the merger has on providing hands-on
training from senior management and
access to continuous improvement. “We
can now provide our hospital liaisons
with more contact with the corporate
office and identify their changing needs
as we move forward,” said Nelson.
Complementary service
Prior to the merger, each of the three
companies had proprietary databases. DCS
identified the best practices of each
and created a single set of policies,
procedures, and forms to migrate into
one database called I-Heal. The system
enables each of the centers to benchmark
against one another and allows corporate
governance to intervene for positive and
negative patient outcomes and center
performance.
DCS now has an extremely comprehensive
set of data for roughly 2 million wound
treatments. I-Heal allows the company to
review the data and determine what the
appropriate treatment pathway is for
patient presentations. Moving forward,
the company plans to move to a
point-of-service model, which will set
the stage for a company-wide EMR. The
technological migration is an offshoot
of the issues Nelson wanted to
tackle when he first arrived at DCS July
2007.
“Rather than coming up with a vision of
the future, we were trying to mirror
what the three companies had done in the
past,” he said. “To move away from that
line of thinking, we sat down and asked
who we wanted to be, what we wanted our
point of difference to be, what we
wanted to separate us from the
competition, and what would make us a
more compelling partner for our
customers.”
These discussions led to an area of
growth the company hadn’t previously
dealt with: the lack of payment to
hospitals dealing with hospital-
acquired wounds. Medicare and other
third-party insurers will soon no longer
reimburse for hospital-acquired wounds,
and the change, said Nelson, will
greatly impact most hospitals. To handle
this new challenge, DCS developed a
consulting service that allows its wound
care experts to go into a hospital,
diagnose the challenges, and recommend a
course of action.
“It’s complementary to our existing
outpatient centers, and we incorporate
I-Heal into the process,” said Nelson.
“We use our corporate-level resources to
come in, assess, make recommendations,
and follow through in evaluating the
hospital’s progress. It leverages our
current infrastructure and gives us an
opportunity to further assist our
customers.”
- Amanda Gaines
remi
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