TY - JOUR T1 - Leg-ulcer care in the community, before and after implementation of an evidence-based service JF - Canadian Medical Association Journal JO - CMAJ SP - 1447 LP - 1452 DO - 10.1503/cmaj.1041441 VL - 172 IS - 11 AU - Margaret B. Harrison AU - Ian D. Graham AU - Karen Lorimer AU - Elaine Friedberg AU - Tadeusz Pierscianowski AU - Tim Brandys Y1 - 2005/05/24 UR - http://www.cmaj.ca/content/172/11/1447.abstract N2 - Background: Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly integrated services in multiple settings. We report the results of a prospective study of a community-based care strategy for leg ulcers. Methods: International practice recommendations and guidelines were adapted to make a new clinical protocol. The new model, for a dedicated service staffed by specially trained registered nurses, established initial and ongoing assessment time frames and provided enhanced linkages to medical specialists. Data were collected for 1 year before and after implementation; outcome measures included 3-month healing rates, quality of life and resource usage. Results: Three-month healing rates more than doubled between the year before implementation (23% [18/78]) and the year afterward (56% [100/180]). The number of nursing visits per case declined, from a median of 37 to 25 (p = 0.041); the median supply cost per case was reduced from $1923 to $406 (p = 0.005). Interpretation: Reorganization of care for people with leg ulcers was associated with improved healing and a more efficient use of nursing visits. ER -