This short report describes the recent introduction of new models of care in Australia aimed at disseminating the evidence base for leg ulcer care to health professionals. These innovations have contributed to the establishment of a Cooperative Research Centre with researchers, health professionals, health service and industry partners.

Key innovations

Three key innovations have been initiated for people with leg ulcers in Australia:

1. Establishment of the first nurse practitioner-led Wound Healing Community Outreach Service (WHCOS)
2. Implementation of new community nursing models of care based on the Lindsay Leg Club model of care in the UK
3. Establishment of a new Wound Management Innovation Cooperative Research Centre to lead research and development of future innovations in wound care

CHANGING THE APPROACH TO LEG ULCER CARE

Implementation of new models of care has resulted in successful outcomes for both patients and health services and generated significant interest from health service providers and individual health professionals throughout Australia. As a result, new services based on the Lindsay Leg Club model of care have been established in three states of Australia; over 100 health professionals have visited the Wound Healing Community Outreach Service (WHCOS) at Brisbane; and grants were awarded to the WHCOS to provide further outreach education for multidisciplinary health professionals caring for patients with chronic leg ulcers. These initiatives contributed to a successful bid to establish a Wound Management Innovation Cooperative Research Centre – a collaboration of multidisciplinary researchers, clinicians, health service providers and industry partners to lead research and development of future innovations in wound care.

Nurse practitioner-led wound care
Australia's first nurse practitioner-led, community-based wound clinic was opened by Queensland University of Technology's Institute of Health and Biomedical Innovation in January 2008. Outcomes from the WHCOS have been presented at state and national conferences and include improved rates of wound healing and quality of life outcomes [1,2].
 
The service is based on a self-management model of health and combines evidenced-based treatments with peer support, health promotion and prevention strategies.
 
Unlike most wound clinics, individuals do not require referral to attend the service. This helps to improve access and reduce waiting times, especially for the proportion of the population who do not currently access traditional health services, such as the homeless and disadvantaged. Approximately 40% of people attending the service live alone and the majority are more than 70 years of age. Clients are never discharged – they are always welcome to access the service for regular health checks and to participate in social, peer support and health-prevention activities.
 
Analysis of data collected in 2008 and 2009 demonstrated that 90% of leg ulcers healed within 24 weeks of care provided by the WHCOS, encompassing 94% of venous leg ulcers, 72% of mixed venous/arterial leg ulcers and 54% of arterial leg ulcers. Before admission to the service the average duration of ulceration was 26 weeks [1].