Diversified Clinical Services: Jeff Nelson, CEO

by webadmin on March 29, 2011

Approximately 8 million Americans suffer from chronic wounds and that number is increasing. A wound is considered chronic when it won’t heal on its own, using standard treatment measures, within 30 days. There are several factors that may lead to chronic wounds, but the rising incidence of diabetes in today’s population tops the list. Any vascular condition that affects blood flow might contribute to a patient developing wounds that will not heal. Age and conditions affecting mobility are also common conditions that lead to wounds that do not heal.

Diversified Clinical Services (DCS), based in Jacksonville, Florida, develops and manages outpatient wound care centers for more than 300 hospitals in 48 states. The company has more than 1,000 employees and is affiliated with another 2,500 to 3,000 nurses and physicians who work in conjunction with DCS hospital centers. They are the largest outsourced provider of wound management services in the nation, approximately twice the size of their nearest competitor.

“Wound management is a very complex field that is multi-specialty and inter-disciplinary by nature. There isn’t a particular sub-specialty that we focus on. There isn’t really a wound sub-specialty,” says Jeff Nelson, CEO of DCS. “We enable the hospital to address the unmet needs of the patients in their community with a comprehensive wound care center that is also a profit center for the hospital.”

Partners

DCS views itself as an extension of each hospital.  Employees work as a seamlessly integrated department within the hospital. Employees wear the hospital badge with the hospital name on it. “Our program directors are interfacing with the hospitals daily,” says Nelson.

“One of our interesting challenges is to make sure the hospitals know what we are doing to run the successful wound care centers,” he says. “It isn’t just magic that creates and manages a successful center, but a lot of hard work.”

On a monthly basis, DCS program directors provide the hospitals with an overview of the company’s activity. They report key business agenda items and clinical results; such as where are referrals coming from, how many patients are being treated through the program and what are the results?

Improving Patient Care

“I’d say one of the biggest challenges of wound care in the multi-specialty environment is making sure we are creating the opportunity for improved patient care,” says Nelson. “Our 300 centers are all across the country as independent entities and we have to be able to project our vision and operational influence into all 300 centers.”

One thing that DCS does differently is training all physicians and staff that work in their centers themselves. Since very few physicians have worked in a comprehensive wound care facility before, our  accredited education program trains  40 to 50 physicians per month on our evidence-based clinical practice guidelines based on our unique  scope and size.  DCS offers expert physicians as mentors, access to clinical publications, and regionally based and web-based seminars focused on wound science.

“This is a niche field that is really very specialized,” says Nelson. “To be able to run a clinically and financially successful center, it takes a laser-like focus on wound care. A wound can come from many different underlying causes, and until you address the cause of the wound, you are not going to heal the patient.”

DCS is able to do a better job than a hospital trying to do it on their own because they are able to share the experiences of 300 different centers utilizing a database that accounts for its experience of healing millions of chronic wounds. DCS centers maintain healing rates of approximately 90% and they have consistently rated 95% in patient satisfaction.

Improving Hospital Revenue

DCS services include revenue cycle management. The company has eight dedicated reimbursement and coding experts who help hospitals setup a master overview of wound management charges.  They monitor reimbursement monthly to assure that the hospital is billing and coding correctly, providing the proper documentation, and following up on collection.

“Over the last two years, we have helped hospitals recover millions of dollars in accurate reimbursement payments by ensuring that our hospital partners learn about and apply the latest information on coding rules, managed care contracts, and Medicare updates.

Continually Progressing

A couple of years ago, the organization identified a 7-step methodology for developing the organization. The idea is to identify root causes and develop measurable plans for improvement with 90 day cycles for advancing steps.  “We make sure we are using data to drive communication with our hospitals and continually improve patient outcomes.  For example, our wound care management system provides data so that we can compare physicians’ patient outcomes to like physicians in like environments. We do this so that we can have a conversation about what is really driving improved outcomes versus just hand waving,” says Nelson.

“This is building our foundation of continuous quality improvement,” says Nelson. “We still have a ways to go. I’m not going to sit here and say we are anywhere close to being where I would like us to be on a planning basis, but we have made tremendous progress over the past couple of years and that’s really demonstrated itself in improvement and healing outcomes, and also in our business metrics. This year we will see 15% more patients in each of our centers than we did last year. That’s possible because of well-focused plans based on identifying specific problem areas and then putting together the steps to address them.”

“Chronic wounds are a large and growing problem and getting worse as the instance of diabetes increases, as well as the increase in the age of the population. Addressing these problems is very complex. I think the focus that we have on this area allows us to be the best in the field: best for patients, and best for the hospitals, as well.”

-by T.M. Simmons

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