Incontinence Trends for 2009: The Link between Quality and Payment

It’s been a busy year for continence and wound care clinicians. There is high demand for consultation from experienced WOC clinicians. Everyone wants to nail down “best practices” and set up a product formulary that both is cost effective and meets standards. The search for outcome measurement methodology is intense. This trend is certainly fueled by the rising number of older citizens, but more importantly, it’s driven by the new regulatory requirements that link quality of health care to reimbursement.

Following reports from the Institute of Medicine (1), Centers for Disease Control and Prevention (2) and the Leapfrog Group (3) that documented the detrimental effects on patients and their loved ones of preventable hospital errors, the Centers for Medicare & Medicaid Services, along with the National Quality Forum, has implemented rules to link payments for health care services to delivery of quality care. Effective October 2008, the Hospital-Acquired Conditions (HAC) initiative identifies certain diagnoses which could be “reasonably preventable following generally accepted guidelines.” “Catheter-associated urinary tract infections” and “pressure ulcers” are top on the list of conditions whose treatment Medicare will no longer cover at a higher rate if they are acquired during the hospital stay.

How does this change affect our practice? Experts in the field of incontinence and skin care will need to design and implement evidence-based protocols for the prevention of catheter-associated UTIs and pressure ulcers. Specific products and devices designed to divert, contain and manage urinary and fecal incontinence need to be readily available to clinicians and patients. Since alteration in skin integrity secondary to incontinence is well established, the availability of products designed to cleanse and protect skin and treat incontinence-associated skin conditions should be developed into sound intervention pathways.

The demand for continence and prevention of nosocomial conditions will spur innovation and bring new products to market. Clinicians in all care settings can rely on IncontinenceSource as an up-to-date resource for acquisition of products and services related to continence and skin care.

A “perfect storm” of aging demographics and regulatory momentum is brewing in the field of continence and skin care. Let’s use our resources to seize the opportunity and improve quality of care for our patients.

Best wishes for best practices!

Editorial Team:
Catherine T. Milne, APRN, BC, MSN, CWOCN, ANP
Lisa Q. Corbett, APRN, BC, MSN, CWOCN
Tracy Houle, APRN, BC, MSN, CWOCN

1. “To Err Is Human: Building a Safer Health System.” Institute of Medicine report. Washington, D.C.: National Academy Press, 1999.

2. “Feeding Back Surveillance Data to Prevent Hospital-Acquired Infections.” Centers for Disease Control and Prevention in Emerging Infectious Diseases, Special Issue, March/April 2001.

3. “Never Events.” The Leapfrog Group fact sheet, March 2008.