After a three-month reassesment process, Abbott Northwestern Hospital has decided to reopen the Wound Clinic which they had closed December 31st, 2000. The Wound Clinic, housed in the Minimally Invasive Care Center (MICC), plans to reopen on June 1, 2001, at which time patients with complex, chronic, or non-healing wounds may return and receive care.
As reported in the January 10th ACCESS PRESS, the financial struggles that caused the clinic’s closing were rooted in four major areas which had to be addressed before the clinic could operate on stable terms: an inconsistent standard model for care; no database to track client’s wound history and care history; poor reimbursement levels, and the high cost of real estate.
Since the closing of the clinic was announced, a restructuring group has been working to develop a plan to address
all of these issues. ACCESS PRESS was informed in mid-March that the group has come up with a satisfactory plan. Members of the program development group included Wound Clinicians Jan Chevrette and Jennifer Todd, Wound Clinic Doctors Peter Alden and Eric Irwin, Director Pat Boeckman (formerly Hartwig), and Abbott Northwestern office coordinator Linda Ruiz.
The clinic will reopen with new systems and guidelines in place to standardize methods of care for patients and will also include clear methods for tracking a person’s progress while receiving care at the clinic.
These changes will reduce confusion and stress for patients and clinicians. They will also improve the clinic’s ability to accurately file reimbursement claims, another change necessary for the clinic’s survival. Walt Kune, Director of Ambulatory Services for Abbott Northwestern Hospital, said that “clinicians will now be able to file exact documentation that assures proper reimbursement for services from both Medicare and private insurers.”
Clinician Jennifer Todd pointed to another improvement in the clinic’s reimbursement system. Due to certain changes outside of the clinic, Todd says “we can bill for some things now that we weren’t able to before, like the actual application of a unnaboot. Before the clinic closed, we could only bill an insurer for the supplies, but now we can bill for the actual procedure.” Educating a patient about their wound is another service “that will be newly reimbursable when the clinic reopens,” says clinician Jan Chevrette.
For financial reasons, the clinic has decided to cut some services which previously garnered low reimbursement rates from insurers. Kune notes that services like bandaging, for example, “require minimal care and can be easily treated at a primary physician’s office or even at a patient’s home.” The clinic expects to communicate with primary physicians for the on-going care of these chronic wounds and admits that “for a patient to come in time after time for re-bandaging just isn’t a good use of our resources if the clinic is to stay open.”
The team confronted the problem of high-cost real estate at the Abbott Northwestern hospital by relocating the clinic to a building directly across the street from the main hospital, at 2800 Chicago Avenue. As a tenant of this office building, the clinic will drastically reduce the overhead costs that came with its previous home in the hospital.
Patients who return to the wound clinic will benefit from this new location, as it is housed next to a diabetes clinic. This site will facilitate coordination of care between the two clinics, which consistently care for similar patient populations.
How had patients coped with the three-month interim so far? As Chevrette says, “It was a difficult process for everyone. We did set patients up with transition programs before the close and, as far as we know, patients met with their primary physicians and everybody did fine.”
She continues, “Even though the process of closing the clinic was difficult, we were able to commit 100% of our time to this process and therefore were able to move forward more quickly than we probably would have if we had only been working on it part-time.”
With the new changes in place, everybody involved in the development project is eager for the clinic’s reopening and hoping for long-term continuity. Kune hopes that “patients who had seen us and need to come back again will see that we still have a strong, very qualified program and we’ll continue that standard in the future. Senior management did not make this decision lightly, and then made the decision unanimously. They felt confident with the plan to reopen the clinic. If we do our jobs right on the business and clinical end, than we should be able to sustain the program and make it a really valuable resource to the community that needs this care.” Kune also commends the thorough work of the team who created this possibility “All of them really worked hard. People were very impressed with their caliber of work.”
Chevrette and Todd, both of whom will guide the clinic through its reopening, anticipate caring for patients again at the clinic. “It has great potential. We are going to be very efficient and provide excellent patient care. There will be no compromises in that area.”