Just as wound healing is a richly choreographed dance of healing cells guided by local biochemical signals, clinical wound care often involves interdisciplinary communication among clinical professionals guided by what they learn from patient and wound evaluations. Whether these interdisciplinary interactions occur between members of an institutional wound care team, committee, or through less formal bonds of communication, shared responsibility, and mutual respect; the messages passed among professionals are as powerful in advancing wound progress as those guiding wound healing at the cellular level. Interdisciplinary messages guiding wound care use the language of standardized, valid, reliable patient and wound evaluations or assessments, evidence-based protocols of wound and patient management, and consistently measured wound care outcomes that are clearly communicated to all involved in the patient’s care.¹ This special issue of WOUNDS shows how measuring, analyzing, and reporting outcomes such as wound healing, infection, or pressure ulcer development, can help improve interdisciplinary wound practice across the continuum of care.
       Each contributor to this issue of WOUNDS describes an aspect of how wound care outcome metrics have helped his or her interdisciplinary team identify wound care challenges and successes, and improve their wound care practice by providing feedback about safety or efficacy of individual wound care modalities or practices. Nurses, physical therapists, and physicians of varying specialties from around the world have collaborated to show how they utilize wound care outcomes to improve wound care practice in various settings.
       Ennis and colleagues² build on their prior outcomes research and report on how wound outcomes differ across care settings in their Midwestern US integrated system despite their interdisciplinary team’s rigorous use of consistent patient and wound assessments guiding use of evidence-based care protocols. They suggest that wound care professionals standardize case evaluation and management metrics so that key risk factors for tissue breakdown are consistently measured across the continuum of care as a recognized, reimbursed aspect of wound management.This would encourage proactive management of wound-related risk factors as each patient traverses settings, instead of treating wounds as isolated events within each setting.
       Streed and Loehne illustrate the value of physicians, physical therapists, Certified Wound Specialists, and nurses interacting with epidemiologists and microbiologists in monitoring and preventing infections and pressure ulcers, while improving wound outcomes. They illustrate how epidemiologic methods can help institutions heighten awareness of wound outcomes and establish professional accountability for aspects of practice leading to or preventing wound complications.
       Once deep pressure ulcers occur, Ohura and colleagues³ show that they are more complex than originally thought. By monitoring Japanese pressure ulcer outcomes, these researchers identified patterns of deep tissue necrosis associated with previously unexplained delays of Stage III or IV pressure ulcer healing. This illustrates how observant physicians can use wound outcomes to clarify wound care challenges and help the wound care team anticipate pressure ulcer healing profiles over time, while managing patient, family, and staff expectations accordingly.
       McIsaac⁴ illustrates how outcome measurement is achieving similar goals while helping to improve professional accountability as teams implement these evidence-based wound care protocols and consistent outcomes reporting tools in different regions across Canada. Evidence-based wound management protocols in the Nova Scotia home care setting reduced chronic and acute wound healing time by 70%, and monthly resource use by more than $900 per client.
       Romanelli⁵ provides an overview of outcome prediction and measurement tools currently used to improve venous, diabetic, and pressure ulcer outcomes in their university hospital setting in Italy. This continues in a tradition of outcomes measurement that Dr. Romanelli and his colleagues have helped to establish.
       These initiatives from diverse professionals and specialties in 4 countries on 3 continents underscore the universal value of reporting wound care outcomes to the entire wound care team, including the patient. Much can be learned from one another’s wound care outcomes and the procedures to measure and manage wounds. The outcomes shared with clients, patients, colleagues, supervisors, and reimbursement or regulatory authorities, provide a consistent language that help to unify the wound healing field and prepare the field for recognition as a clinical specialty.