CLINIC IN FOCUS - Riverview
If an accredited facility, how has seeking UHMS accreditation affected your clinic?
The accreditation has affected the clinic by raising the bar and meeting the highest standards of care and patient safety set forth for hyperbaric treatment. The clinic is continuously streamlining processes to better help our patients and keep the level of care at its finest.
What are the most common indications treated at your clinic?
crush compartment syndrome, acute traumatic ischemia
diabetic foot ulcer Grade III or greater
healing of other problem wounds
necrotizing soft-tissue infection
delayed radiation injury (soft tissue and bony necrosis)
compromised grafts and flaps
What is the most memorable treatment success story to come out of your clinic?
In July 2016, Sarah Polakoff ’s left leg was crushed just below the knee when a car rolled over her. Sarah was lucky and didn’t suffer any broken bones or open wounds, but she was left with painful swelling. A staff member at her physician’s office recommended Riverview Health Wound Care after Sarah was turned away from an Indianapolis orthopedics practice because they couldn’t treat her.
Jennifer Zyromski, MD, a surgeon with Riverview Health Physicians, performed surgery on Sarah’s leg on Aug. 12, 2016, to begin the process of healing her injury.
“The damage to the tissue in a crush injury can be pretty extensive, even if there isn’t an open wound,” Dr. Zyromski said. “The goal of the surgery was to remove a blood clot under her skin that was disrupting her blood supply and, in turn, killed skin tissue in the area. The surgery relieved the pressure but left a pretty big wound to heal.”
To heal her wound, Sarah used the services of Riverview Health Wound Care. First, Sarah made regular visits to change a special kind of vacuum dressing designed to heal large wounds by applying continuous negative pressure to the wound to drain it. She had weekly visits to monitor the wound, then she completed 30 treatments in a hyperbaric oxygen chamber for two hours a day to help her body heal the large wound.
“Hyperbaric oxygen treatment increases oxygen levels throughout the body to promote healing,” Dr. Zyromski said.
Patients who receive hyperbaric oxygen treatment are required to comply with several safety precautions, because the high-oxygen environment is extremely flammable. In the hyperbaric oxygen chamber, patients are required to wear a 100 percent cotton gown and aren’t allowed to wear makeup or jewelry or bring anything in the chamber that could spark a flame — including books. The hyperbaric oxygen chambers at Riverview Health have televisions for patients to watch shows or movies to pass the time.
"The hardest part was being an avid reader and not being able to take a book in there,” Sarah said.
After 10 weeks, Sarah had much more time on her hands to pursue other hobbies, because her wound care visits dropped down to once a week to check on the healing progress of her wound. On Oct. 15, 2016, she returned to her job as an activities assistant and certified nursing assistant (CNA) at a nursing home. As a CNA, Sarah is accustomed to helping others more often than she helps herself. That defined her experience at Riverview Health Wound Care.
“Caregivers make the worst patients,” Sarah joked. “I had to learn to let people help me while I was healing and while I was in and out of the hospital. The staff understood and let me help myself as long as I could do it.”
Sarah was initially given a timeline of six months to one year to fully recover, yet after three months she had made significant progress and was healing ahead of schedule. Dr. Zyromski credits Sarah’s diligence for her quick healing.
“Sarah came to all of her treatment sessions. She kept her leg elevated and always had her dressings changed appropriately and maintained good nutrition,” Dr. Zyromski said.
After many weeks in the care of Dr. Zyromski and the wound care staff, Sarah is back to her normal life of taking care of her 2-year-old daughter with her husband.
Do you work with a management company? If so, which one?
Riverview Health Wound Care is managed by Outpatient Integrated Strategies (OIS).
If you had to pick one thing to attribute your clinic’s success to, what would it be?
The clinic provides a multidisciplinary approach to the diagnosis and treatment of chronic wounds. In addition, the clinic offers sophisticated treatment technologies to promote wound healing. Our clinic is run by providers.
What is one marketing recommendation that you can make to help clinics increase their patient load?
The one marketing recommendation that has helped increase our patient load is educating the various physicians about the benefits of HBO2 and their prospective fields. The wound clinic wants to partner with other physicians to help heal their patients.
Are there are any additional questions you’d like to answer or any other information about your clinic you’d like to showcase?
We have several nurses who have completed and are HBO2- certified trained operators. In addition, Riverview’s program director has also completed the necessary course.
Riverview Health was the first facility in the state of Indiana to become UHMS certified and provide the Luna technology.
Last, the entire staff was nominated for the Daisy Award. (This award for nurses and nurse-led teams recognizes extraordinary practice by nurses who engage in the transitioning process of patients and their families as they access and migrate through the health-care system. The nominees must show extraordinary compassionate care.)