Jones guides UMMC’s wound management program towards statewide flagship goal
By Patrice Sawyer Guilfoyle
Dr. Harriet L. Jones, associate professor of medicine, eagerly awaits the day when she will begin seeing patients in a planned renovation of space in the University Physicians Pavilion that will become the University of Mississippi Medical Center’s first comprehensive wound management clinic.
Jones and Candice Adams, business administrator for general internal medicine and wound care, said a dedicated clinic is necessary to accommodate the patients Jones currently follows, ideally on a weekly basis.
Since returning to UMMC in April 2011, her practice has experienced a series of growing pains. Initially, Jones saw patients during four half-days each week in the UP Pavilion.
“We’re running out of space and available time slots,” Adams said. “We began borrowing rooms anywhere we could find them in the pavilion, as well as locations like the rapid track.”
In June, Jones was able to relocate her clinic completely to University Physicians-Grants Ferry, which is a bit farther for patients to travel but provides consistency and more timely follow-up appointments, she said.
Now plans have been approved to renovate an area in the Pavilion for a comprehensive wound management center, which is expected to open next year. The program also will include TeleWound as a means of providing referring physicians with more timely support.
Jones specializes in the treatment of patients with complicated wounds. They include, but are not limited to, various types of soft-tissue injuries and infections, open orthopedic injuries and osteomyelitis, soft-tissue crush injuries, pressure ulcers, lower-extremity diabetic ulcers, and oftentimes “spider bites.” They are rarely true spider bites, but rather abscesses associated with a germ known as MRSA.
“While there are many reasons a patient’s wound becomes chronic, identifying and treating those variables can be challenging,” Jones said. “Not surprisingly, in Mississippi, diabetes and vascular disease are common culprits.”
The vision of Dr. Shirley Schlessinger, interim chair of the Department of Medicine, enticed Jones to return to the Medical Center after leaving in 2005.
“Shirley convinced me that she shared the same vision as I had to develop a program that would most benefit patients we serve in Mississippi,” Jones said. “Our goal is to be the flagship center.”
Schlessinger said a statewide referral center for wound management is needed and UMMC should provide services that other places around the state don’t necessarily provide. The wound clinic benefits patients and referring physicians.
“Wounds don’t heal overnight,” Schlessinger said. “These patients need regular monitoring. She’s a fantastic physician and patients love her. She has saved at least two legs and three or four feet of patients on the transplant list.”
Jones received the M.D. from the School of Medicine in 1998 and completed residency training in internal medicine at UMMC in 2001. After she completed a fellowship in infectious diseases, she joined that division as an assistant professor of medicine and surgery in 2003 and began the Outpatient Antimicrobial Service in the Division of Infectious Diseases.
Jones’ professional experiences helped her recognize that patients used to be sent home on long-term intravenous antibiotics without appropriate oversight and follow up. This program demonstrated a way to meet that need.
“Wound care is emerging as a specialty on its own,” Jones said. “There is a shift toward providers becoming practicing full-time wound care specialists,”
For the last seven years, Jones worked as a full-time wound specialist, which was a bit unusual as most hospital-based wound care programs are managed by outside contracted groups that use a panel-model of physician staffing. However, Jones said that model limits a patient’s accessibility to care, especially when unexpected urgent issues arise.
“Dr. Schlessinger realized that continuity of care and availability is important because healing a wound is a dynamic process, affected by so many different variables,” Jones said. “Patients do better when the same set of eyes is looking at them and the provider is able to notice what has changed for better or worse between appointments.”
While UMMC has one of the lowest amputation rates in the state for diabetic patients, thanks primarily to the Medical Center’s cardiovascular program, Schlessinger said Mississippi still has a high rate of amputations and Jones’ work is invaluable.
“Her approach is to try to accomplish limb salvage,” Schlessinger said. “A lot of that has to do with improving a patient’s quality of life and some of it is life-saving.”
Adams said the groundwork has been laid for establishing a comprehensive center.
Representatives from most surgical services, along with hospitalists, cardiologists, therapists and inpatient wound care nurses, have been contacted to participate in developing the comprehensive care model for patients with chronic wounds.
“Because a lot of our patients share similar co-morbidities or barriers to healing, they are already being seen by different service lines on campus,” Adams said. “We’re trying to be better stewards of the patient’s and state’s health-care resources, which are sometimes used unnecessarily by duplication of tests or unnecessary admissions to the hospital.“