Managing the Gap Consensus Process
Chronic wounds affect over 150 million people each year. Wound care costs in the UK are estimated to be more than £5 billion annually and in the United States expenditures exceed $25 billion every year. Evidence shows that chronic wound care patients often become ‘house-bound’ due to their wounds. They stop working and stop socializing. Research shows that at least 30% of wound care patients suffer from depressive symptoms or anxiety. Decreasing the number of days a patient lives with a wound was the project goal. The consensus and best practice guidance developed through this project will help meet that goal.
Key results achieved were:
1. Engage participants. More than 80% of the identified wound care specialists participated in the process over four months. Eight-three per cent of participants said creating the global consensus will impact their daily practice and 77% said it was clinically valuable.
2. Expand knowledge in chronic wound care. New evidence on how to best prevent and treat chronic wounds and to decrease healing time was developed and accepted for publication by the medical community.
3. Motivate new publications and evidence collection. A peer review article has been accepted for publication in the September issue of Wounds International. A series of 3 other articles are currently being written for publication based on specific topics from the data created through this project. A second research project and consensus process has received funding to develop further evidence and to publish a quick reference guide for clinicians.
4. Create global ambassadors. Several participants were approached to present the consensus results at national and international conferences and to be involved in article writing for journal publications. Every wound care specialist asked agreed to champion the consensus results. In addition, anecdotal evidence suggests that many other specialists who participated in the project have taken on unofficial ambassador roles in their regions.
5. Create momentum to improve patient outcomes. 100% of participants agreed that practice guidance for non-specialists, based on the consensus results, will decrease the number of days with wounds. Coloplast has embarked on a phase II of the project to advance the consensus results beyond wound care specialist to generalist health care practitioners worldwide. In addition, with the publication of 4 research articles and the publication of the bed-side reference guide we are expanding the reach of the new research and treatment guidance exponentially. The social media reach for the consensus results has exceeded 100,000.
The Coloplast Global Expert Panel agreed that the:
- process was highly effective in meeting the objectives
- consensus was reached in a short period of time
- product was significantly better than what could have been achieved without the use of a facilitator to design and facilitate the process.
Context and challenges
Coloplast develops products and services that make life easier for people with very personal and private medical conditions. Working closely with the people who use our products, we create solutions that are sensitive to their special needs. Our business includes Ostomy Care, Continence Care, Wound and Skin Care and Urology Care. We operate globally and our organisation is more than 10,000 people strong.
It is estimated that more than 156 million people globally will experience a chronic wound in their lifetime. Chronic wounds present a substantial economic burden to healthcare systems world-wide and significantly reduce the quality of life for those affected; often leading to serious health complications, amputation and even death. Chronic wounds are defined as wounds that have not healed within 4-6 weeks and often are infected and painful. A detailed literature search concluded that accessible practice guidelines were needed to assist health care providers to reduce the burden of chronic wounds around the world.
The ultimate goals were to increase patients’ quality of life and decrease the economic burden on international health systems by developing a plan to stop routine or ritualistic care and encourage holistic planned wound care focused on wound healing rather than wound treatment.
The project goal was to develop an international consensus on how to assess and treat chronic wounds to decrease the burden on both patients and health care systems. The project’s mantra was “moving towards fewer days with wounds”. The specific objectives were to:
- Engage participants.
- Expand knowledge in chronic would care.
- Motivate new publications and evidence collection.
- Create global ambassadors.
- Create momentum to improve patient outcomes.
The Modified Delphi Process was used for this project that combined the scientific rigor of the traditional Delphi and the RAND Nominal Group Technique, with virtual and face2face facilitated dialogues using Solution Focused, ToP, Focused Conversation and group critical thinking methodologies. The project was led by an IAF CertifiedTM Professional Facilitator from beginning to end, with process facilitation guiding and being used at every step of the project and for every decision.
Entrance visual participants walked over on entry
The road to consensus room set-up
The road to consensus in action – a facilitated event