by Caroline Fife, M.D. | Apr 29, 2015 | Do the Right Thing: Thoughts on Quality
If you have followed along with Wound Wednesday for the last several weeks, I have shown a progression of treatment for a with an inflammatory leg ulcer. Here are the final results. 1. Theraskin for GT: inflammatory leg ulcer after debridement with maggots and the...
by Caroline Fife, M.D. | Apr 27, 2015 | Do the Right Thing: Thoughts on Quality
Every Monday in April I have been talking about the annual National Quality Forum meeting, healthcare reform and what I think it means to wound care professionals. Why is CMS driving so hard in the direction of quality measurement? The measures CMS really wants to...
by Caroline Fife, M.D. | Apr 23, 2015 | Do the Right Thing: Thoughts on Quality
I think that Velcro devices for edema control are the greatest things since sliced bread. I hardly ever prescribe stockings for my elderly patients since it’s so unlikely they can put them on. I use Farrow wraps and Circaids almost exclusively. However, I get so...
by Caroline Fife, M.D. | Apr 21, 2015 | Do the Right Thing: Thoughts on Quality
It happened again this week that the manufacturer of a cellular product suggested to me that their product was so effective, there should be no problem with the hospital (wound center) purchasing it for an amount equal to, or slightly more than, the total amount...
by Caroline Fife, M.D. | Apr 20, 2015 | Do the Right Thing: Thoughts on Quality
Have you heard of the “Triple Aim”? The Triple Aim is a framework developed by the Institute for Healthcare Improvement (IHI). The concept is that as we reform our healthcare system, we should simultaneously optimize three dimensions: 1) improve the patient experience...
by Caroline Fife, M.D. | Apr 13, 2015 | Do the Right Thing: Thoughts on Quality
Last week I started talking about what I learned at the annual National Quality Forum meeting in Washington, DC. On the final day we heard Patrick Conway, MD, Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS), who is still a practicing...
by Caroline Fife, M.D. | Apr 9, 2015 | Do the Right Thing: Thoughts on Quality
I still think hydrocolloid dressings are one of the best ways to debride a wound with slough. One of my secrets to debride wounds that have a deep defect is to use Duoderm paste down in the “hole” and then cover it with a Duoderm pad. They bond together and when the...
by Caroline Fife, M.D. | Apr 7, 2015 | Do the Right Thing: Thoughts on Quality
The 2014 Margolis paper questioned the effectiveness of hyperbaric oxygen therapy for diabetic foot ulcers. There are a lot of ways that “effectiveness” can be defined. Even if it’s not the best way to think about it, let’s consider “cost-effectiveness” because most...
by Caroline Fife, M.D. | Apr 6, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Do the Right Thing: Thoughts on Quality, Fight the Good Fight
I just got back from the National Quality Forum meeting in Washington, DC. I’ll spend Mondays in April telling you what I learned about the conference, the theme of which was “Tackling Costs: The Quality Solution.” The Kaiser Foundation estimates that the average...
by Caroline Fife, M.D. | Apr 2, 2015 | Do the Right Thing: Thoughts on Quality
I love maggots for debriding inflammatory ulcers. I’ve used them for this purpose since the 1990s and we still don’t have anything better. The problem is the cost. They are so efficient and don’t cause pathergy in inflammatory ulcers. I’ve been able to debride wounds...
