Baylor Scott & White Medical Center – Waxahachie
In FY22, Baylor Scott & White Medical Center–Waxahachie identified a significant quality gap that revolved around the stay of wound care patients which was more than twice as long as non-wound care patients (9.44 vs. 4.51 days). The hospital’s hospital-acquired pressure injury (HAPI) with harm rate stood at 0.25. The extended stays impacted patient recovery, reduced hospital capacity and increased costs. Without a standardized wound care program, bedside nurses lacked confidence to deliver basic wound care, supply availability varied between units and there was no formal process for wound vac use or consult prioritization.
The Baylor Scott & White Medical Center-Waxahachie Wound Care Program goals included:
- Reducing wound care patient length of stay by at least 5%(from 9.44 to 8.96 days) by FY23
- Lowering the HAPI with harm rate by at least 5% (from 0.25 to 0.2375)
- Improving nursing confidence and capability in wound care
- Standardizing wound care processes and supplies across the facility
- Enhancing timely consultations and interdisciplinary care coordination
Prior to implementation of the program, wound vac devices were often delayed, causing care gaps and driving rental costs. Consult requests were nurse-driven and inconsistent, creating backlogs for the wound care nurse. Supplies were not standardized, leading to delays and variable quality. No unit-based wound care champions existed to reinforce best practices.
As the Baylor Scott & White-Waxahachie multidisciplinary team used root cause analysis and gap assessments to prioritize interventions. They were able to:
- Develop a standardized wound vac process, cutting rental costs by 94% and speeding initiation of therapy
- Shift to physician-driven consults and prioritizing new patient evaluations
- Train all bedside nurses through a robust wound care education program, reinforced with annual competencies, orientation training for new hires and monthly “Tip of the Month” updates
- Establish non-surgical skin and wound care guidelines to reduce unnecessary consults
- Standardize wound care supplies across all units for easy, consistent access
- Create unit-based skin champion roles to sustain best practices at the bedside
By the end of FY23, wound care patient length of stay decreased by over 12% to 8.25 days – well beyond the 5% target – and has continued to improve to 8.17 days in FY25 year-to-date. The HAPI with harm rate dropped from 0.25 to 0.18 in FY23, then to 0.02 in FY24 and currently sits at 0.00 for FY25 year-to-date. The program has been sustained for three years, expanded to other Baylor Scott & White Health facilities and earned the System’s Exemplary Improvement Award for FY24.
Please join us in congratulating Baylor Scott & White Health-Waxahachie for receiving the 2025 Bill Aston Award for Quality.
THA Bill Aston Award for Quality
The Texas Hospital Association Bill Aston Award for Quality honors hospitals’ measurable success in improving quality and patient outcomes through the sustained implementation of a national and/or state evidence-based patient care initiative.