After 20 years in private practice, Rob Carson, MD, assistant professor of medicine-internal medicine, took on an additional role at the University of Colorado Hospital (UCH). In just one year as medical director of the outpatient wound care program, he has helped transform how the team cares for patients with wounds. (Pictured at right: Rob Carson, MD and Shelley Brake, PA-C.)
“Before Dr. Carson, there were a lot of opportunities for improvement regarding how we were delivering care for our wound care patient population,” explained Michael Torpey, director of ambulatory services for UCH. “Dr. Carson has brought an excitement and passion for wound care that has been transformative for our program and our patients. He has been a great partner to work with and has set a clear vision for patient care.”
Dr. Carson came to the SOM/UCH with a strong track record in wound care—early in his career he played an integral role in one of Denver’s first multidisciplinary wound care clinics at Presbyterian/St. Luke’s.
“The model at UCH was different from where I’d come from,” Dr. Carson said. “I knew that in order to do it right, we needed to think more broadly about who delivered care, and how we delivered it.”
The first step was to recruit the right team. Since the summer of 2016, Dr. Carson has recruited five full-time staff: two certified wound care nurses, two medical assistants and a physician assistant specializing in wound care.
Although Dr. Carson praises every member of the team for their dedication and expertise, he believes the team’s physician assistant—Shelley Brake, PA-C—is a key contributor to the success of the clinic, in particular their improvements in continuity of care.
“Shelley is spectacular—energetic and thoughtful with patients while remaining efficient,” he said. “She takes the time to get to know all of our patients, and she’s really expanded what we can do at the wound clinic … Our patients need people who have energy and passion, and now they’ve got a whole team. It’s an extremely rewarding thing for us all.”
Under Dr. Carson’s leadership, the wound clinic has expanded into a truly multidisciplinary program, including half-day podiatry clinics with Florin Costache, DPM, and a ½ day vascular clinic with members of the vascular surgery department.
From June 2017, the team will also be joined by cardiologist James Carter, MD, who specializes in the treatment of venous wounds. Dr. Carson sees patients 1.5 days each week.
The patients at the wound clinic usually have 2–3 comorbidities that require a broad approach to care. To meet their needs, Dr. Carson has worked to establish a collaborative team environment.
“When I teach residents, their first question is usually about what dressing to use,” he said. “But that’s the least important thing. First we need to understand what is contributing to the non-healing wound … I try to encourage my MAs and nurses to participate in patient care to the fullest extent and work at the top of their scope. I want to make sure everybody feels like their input is appreciated. And it is—our team is very savvy.”
As a result of Dr. Carson’s changes, the wound care clinic has grown exponentially, experiencing more than 200% growth.
Reenie Zaccardi, RN, vice president of ambulatory services at UCH, said Dr. Carson’s quick progress reflects his dedication to caring for patients with wounds. “It’s amazing how quickly Dr. Carson has navigated our organization to accomplish so much,” she said. “I think it’s because everyone he works with really respects his vision.”
Dr. Carson says his passion for wound care comes from the satisfaction of being able to improve quality of life for patients with multiple medical problems. “To do good wound care, you have to look at the patient as a whole,” he said.
After a patient’s initial visit, Dr. Carson and his team aim to help the wound heal within three months. Although they are currently unable to track their outcomes, in the fall of 2017 a wound care platform will be released in Epic that will allow the team to demonstrate their quality outcomes through data.
Dr. Carson may not have been in the academic medicine world for long, but he is committed to an evidence-based approach to care. In the future, he hopes to expand the clinical research and teaching opportunities at the wound clinic.
As for Torpey, Zaccardi and the rest of the ambulatory services leadership team, they are looking forward to seeing how Dr. Carson will continue to improve care for our patients.
“It has been great to see the growth of the wound care program and all the patients that we are now able to care for,” Torpey said. “With Dr. Carson’s vision and multidisciplinary collaboration in care, the future of the program is bright.”
Thousands of people volunteer for clinical trials each year at the School of Medicine. Some offer payment; others give free health exams and follow-up.
View the CU Clinical Trials Website for volunteer opportunities.