A new source of funds for pressure ulcer care

Abstract

Why does it so often take external pressure to produce change in tissue viability? On page 137, Isabel Bales and Anne Padwojski describe how a pressure ulcer (PU) prevention programme in one US hospital resulted in the much sought after but rarely achieved zero prevalence for hospital-acquired PUs. A key stimulus, no doubt, was the decision by the US Federal Center for Medicare and Medicaid Services not to reimburse hospitals for these ulcers. But this remarkable result also owed much to the hospital's enlightened management approach in which strong leadership coexists with devolved decision-making, allowing staff and managers to work together to become a driving force for change. Moreover, this took place in a culture that puts quality first and expects all professionals and disciplines to treat each other with respect. The end result — in terms of prevalence figures at least — was perfection.