Assessing and comparing the quality of wound centres: a literature review and benchmarking pilot.

Multidisciplinary wound centres are currently facing an increase in both the incidence of wounds and the complexity of care. This has resulted in rising costs and increased interest in the effectiveness of treatments. Little evidence is available regarding optimal wound centre organisation and effectiveness; therefore, measuring the quality of wound centres has become more important. This study aims to assess the evidence concerning quality by describing the state of the art of wound centres and organisational effectiveness by developing indicators of quality and by assessing their suitability in a pilot study. A multi-method approach was used: a literature review performed resulted in the development of an indicator list that was consequently subjected to expert review, and a benchmark study was completed comparing eight wound centres in the Netherlands. We thus provide a description of the relevant state-of-the-art aspects of wound centre organisation, which were multidisciplinary collaborations and standardisation of the organisation of care. In literature, significant patient-related effects were observed in improved healing rates and decreased costs. A total of 48 indicators were selected. The indicator list was tested by a benchmark study pilot. In practice, the outcome indicators were especially difficult to generate. Six indicators regarding structure, three regarding process and five regarding outcome proved feasible to measure and improve quality of wound centres.