PRSB publishes its Wound Care Information Standard to help over 2 million people suffering from chronic wounds

Millions of people suffer from pain, distress and reduced quality of life from chronic wounds, and millions more have wounds that need care following surgery. Treating wounds is costly to the NHS, which spends £5.3 billion a year on these services.1 Better use of evidence-based practice would improve the quality of people’s care and treatment, and release NHS resources.

As part of improving wound care, the Professional Record Standards Body (PRSB) has published a Wound Care Information Standard, which is designed to support the use of evidence-based practice and improve the recording of consistent information which can be shared with professionals involved in the person’s care. The development of the standard was commissioned by the National Wound Care Strategy Programme (NWCSP) and will support the NWCSP’s objectives to prevent the development of new wounds, reduce pain and suffering, improve healing rates, prevent healed wounds from recurring, support self-management of wounds, and improve the efficiency of healthcare services and resources. It covers specifically the assessment, management, maintenance, and prevention of lower limb (leg and foot wounds), pressure ulcers and surgical wounds. There are three domains of information that will be covered: wound assessment and treatment, treatment plan and supported self-management.

To develop it, the PRSB gathered evidence and consulted widely with people, professionals and software vendors including tissue viability nurses, community nurses, podiatrists, and surgeons to find out what they want to record and share to support wound care management and better outcomes.

Dr Una Adderley, Director at the National Wound Care Strategy Programme, said: “The opportunity for improving wound care services lies in the adoption of  best practice on a wide scale – and this is something that the PRSB’s Wound Care Information Standard will support. The collection and use of standardised, high quality clinical information will enable better assessment, management, maintenance, and prevention of wounds for clinicians, and will support system leaders to understand their wound care services.

I was pleased to be involved in the development of the standard, and I look forward to seeing how it will contribute to better outcomes and will make a difference to millions of people suffering from wounds.”

Maureen Baker, PRSB’s Chair, added: “Wound care affects people of all ages, and is a complex area of healthcare. Sharing and recording information consistently with the right professionals is key to ensuring that people receive the best wound care possible and that services are used more efficiently and effectively.”

1A new quality of life wound checklist: the patient voice in wound care, 2018

NOTES TO EDITORS

About the PRSB

The Professional Record Standards Body (PRSB) is a body responsible for the development of standards enabling interoperability for clinical record sharing across health and care. It is a member organisation bringing together 82 members, including royal colleges and social care organisations, and promotes professional and patient engagement to drive uptake of digital solutions in health and care.

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Successful teams have the functional skills to lead a task, benefit from diversity, and are led in a way that creates time and space for reflection; the ability to take stock periodically, of the task and of the way in which the team is engaged in delivering it. Your stakeholder analysis [HYPERLINK] should help you assemble the most appropriate team and identify how the team interacts and relates to other stakeholders like sponsors, services users, etc.

The variation in the size, both in terms of population served and numbers of constituent organisations, and of complexity, between Integrated Care Systems, precludes the possibility of any prescriptive guidance on the way in which this team is assembled.

Engeström’s expansive learning cycle of learning actions explains how there are 7 stages of learning actions;

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”