Wounds

National Stakeholder Round-table

Report of the June 27 2012 Meeting

Wound Care Alliance (WCA) Canada exists to pursue a Canadian wound management innovation agenda in which clinical, academic, industry and government expertise intersect to drive innovation, value and quality in wound care. The groups founding members the Canadian Association of Wound Care (CAWC), Canadian Association for Enterostomal Therapy (CAET), Ontario Woundcare Interest Group (OntWIG), and MEDEC (the national association representing the medical technology industry in Canada) made an initial commitment to (1) plan a wound management innovation meeting of key stakeholders; (2) develop a policy paper based on the outcomes of the meeting and (3) advocate for the adoption of the recommendations. Thank you to the members of the Planning Committee for their expert advice. Laura Teague, President, Ontario Woundcare Interest Group (OntWIG) Cathy Harley, Executive Director, Canadian Association for Enterostomal Therapy (CAET) Peggy Ahearn, Executive Director, Canadian Association of Wound Care (CAWC) Fabien Paquette, Chair, MEDEC Wound Care Committee John Stone, Vice Chair, MEDEC Wound Care Committee Peter Gardner, Member, MEDEC Wound Care Committee Maureen Latocki, Acting Executive Director, Wound Care Alliance Canada

The perfect storm

Timing could not be better for a wound care focused Centre of Excellence
In 2011, the World Health Organization and the United Nations issued a warning that the major global health threat was not communicable but non-communicable disease including diabetes and cardiovascular disease, both of which are linked to chronic wounds. Often overshadowed by higher-profile conditions, wounds are a major and under-recognized health issue. While anyone in hospital, home-care and community-care management recognizes wounds as a big challenge, it comes as a surprise and shock to learn that wounds take an annual economic toll of $3.9 billion in Canada thats 3% of total health costs!2 Governments must take responsibility and lead on these issues. They must adjust their thinking to recognize that spending on health care now is a real and necessary investment that is far less of a burden than the un tallied cost of inaction how their inaction is crippling their health systems and ruining their economic development.1 WHO 2011 http://www.who.int/nmh/events/un_ncd_s

The enormous economic and social impact of wounds in Canada calls for greater attention to this area of health care and more effective allocation of resources to prevent and treat wounds. A Canadian Wound Care Innovation Centre of Excellence (CoE) would make it possible to achieve efficiencies that will transform service delivery and provide value for money. The timing could not be better for a CoE for wounds. Recent developments suggest that the federal government, the Council of the Federation representing the provinces, local health authorities, hospitals, and community/home care agencies are beginning to align around the wound care challenge. A CoE would be a hub for accelerating best practice, measuring outcomes, building knowledge capacity, and fostering innovation. Its a quick and easy win for patients, practitioners and governments. We congratulate Maureen Latocki for her vision and Wound Care Alliance Canada for their support of the concept of a CoE as a mechanism for providing national leadership on wound management in Canada. The June 27, 2012 stakeholder meeting confirmed that there is a powerful consensus to make wounds a national priority. We ask that you share this report with your colleagues and join with us to raise awareness of the wound epidemic and bring evidencebased solutions to policy-makers and decision-takers.

Janet Davidson Co-chair

Tom Closson Co-chair

"This is personal for me. I have suffered with a chronic wound for four years and my experience with the health system has been all over the map. As I speak to more and more people, I see a huge vacuum in knowledge, capacity and awareness. After todays meeting, I have a renewed sense of hope having met so many dedicated people who care deeply about this issue. That goes a long way to keeping hope alive for someone like me." Barbara Turnbull, Patient delegate As a young high school student making pocket money at a convenience store, Barbara Turnbull was gunned down on September 23, 1983 during a robbery at the end of a late-night shift. She was just 18 years old. Today, Barbara lives her life as a high-level quadriplegic.

Table of Contents
Executive Summary Wounds - The Hidden Epidemic The Solution Toward a Centre of Excellence Five Pillars and Six Priorities Future-gazing Call to Action Next Steps References Our Partners and Supporters The Delegates 4 5 6 7 8 9 10 11 1 3

Executive Summary
Wounds are an under-recognized health issue in Canada. While hospital, home and community care managers know that wound care is a major challenge, few are aware that wounds cost the Canadian health system $3.9 billion annually or ~3% of total healthcare expenditures.2 Some estimates suggest this cost may grow by 30% in the next decade3 as a consequence of an aging population and the incidence of chronic diseases including cancer, cardio-vascular disease, dementia and diabetes not to mention the 86,000 Canadians living with spinal cord injuries who are at increased risk for developing pressure ulcers.4 Wounds, increasingly being referred to as the hidden epidemic,5 have serious patient consequences including intractable pain, infectious complications, hospitalization, reduced quality of life, depression, and increased risk of death. On June 27 2012, thirty-five key opinion leaders representing Canadian healthcare met to start a conversation about achieving efficiencies in wound prevention and care that will transform service delivery and improve value for money.

During the day, participants heard from a number of experts and engaged in a series of facilitated discussions. They highlighted the following issues: (1) a lack of local, regional, provincial, national standards of care; (2) fragmented efforts to introduce product, process and program innovation including timeliness of health technology assessments; (3) the need to make more efficient use of resources; and (4) insufficient Canadian data to support development and measurement of key performance indicators of outcomes and quality. The conclusion - Canada can and must do a better job of improving patient outcomes by leveraging our strengths from coast-to-coast.

Effective wound care connects all the big health care agendas value for money, quality, safety, patient-centredness, and evidence-based practice . Ray Racette, CEO, Canadian College of Health Leaders

It is estimated that 30 to 50% of all health care involves wounds

In the community, 50% of nursing visits involve wound care delivery 7

34 to 37% of persons receiving community care have a chronic wound
8 8

24 to 31% of persons in an acute or non-acute setting have a pressure ulcer At $3.9 billion per year, the cost of wound care exceeds that for stroke
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Executive Summary continued

Linking jurisdictions and organizations in pursuit of evidence-based wound management
The 35 delegates unanimously endorsed the concept of a physical or virtual centre dedicated to reducing the burden of wounds through leadership and innovation with the down-stream impact of improving system accountability and sustainability. It was further agreed that researchers, clinicians, and manufacturers need a mechanism for establishing partnerships to drive R&D and raise the standard of clinical practice. As a funnel for wound care initiatives, education, and standards, a Canadian Wound Care Innovation Centre of Excellence would offer an efficient and costeffective solution to the wound care crisis in Canada. More specifically the Centre would enable interprofessional collaboration; be a clearinghouse for process, methodology, models, tools and technology; serve as a subject-matter focal point and singular voice; build and maintain an educated resource pool through training and hands-on experience; act as the liaison between industry, institutional and organizational peers; and be a central repository for data, research and study materials.

Next steps
Over the next 12 months, a number of commitments made at the meeting will be actioned. These include submitting a brief to the Council of the Federations Working Group on Health Innovation and participating in the Federal Government Standing Committee on Finances pre-budget consultation; initiating discussions and establishing links with partners; securing funding; pursuing opportunities to raise awareness with Canadian media; and developing a partnership model that will strengthen our ability to achieve our goal.

The goal
To improve outcomes for persons with a wound or at risk of developing a wound while ensuring value for money.

The proposed mandate

To serve as a concerted voice, act as a bridge between stakeholders, facilitate collaboration, attract resources and be a central repository of data.

The desired impact

To prevent wounds, reduce healing time, reduce recurrence, reduce system costs and reduce patient pain and suffering.

Wounds - The Hidden Epidemic

Sounding the alarm
We are in the midst of a genuine national health epidemic. Wounds have an enormous and underappreciated impact on individual Canadians, Canadian society, and the Canadian healthcare system. Implicated in an estimated 30 to 50% of health care 6, wounds threaten productivity, quality of life, and sometimes life itself. Canada is not alone in grappling with the burden of wound care. The 2010 study Cost of wound treatment to increase significantly in Denmark over the next decade demonstrated that changes in demography, life expectancy and incidence of background diseases The first time I saw a diabet(including type 2 diabetes mellitus) during the period 20092020 will increase ic foot ulcer, I was horrified. their costs by 30%.4 Millions of Canadians suffer the physical and psychological consequences of wounds yet little attention is paid by policy makers and the public. As a result there is a mismatch between the economic burden of wounds and the dollars invested by governments in finding a solution. Delegates to the Round-table identified several systemic barriers to effective wound care: Lack of systematic focus on the needs of the end-users of wound care research and service delivery Lack of accountability in benchmarking and reporting on wound care services and costs Lack of quality measures leading to an inability to assess value for money Lack of equitable access to services and supplies (notably in First Nations, Inuit, northern and rural populations) Lack of focus on wound care as a separate professional specialty Lack of professional and public education. The conclusion was that Canada has the necessary assets to not only provide pan-Canadian leadership on wound management but also to potentially take a global leadership role. Tom Closson, Health Consultant

The personal implications

Patients with wounds experience physical effects that include pain, odour and discomfort. The loss of mobility caused by wounds affects peoples ability to participate in work and leisure activities, which often leads to depression. Wounds take a toll not only on affected individuals, but on the care-givers who provide physical assistance and emotional support.

The clinical implications

Wound healing is complex and takes place across the continuum of care - acute, community and long-term. Transitions between sectors are uncoordinated, often resulting in set backs in a patients condition. Healing is impacted by a combination of factors including co-morbidities; poor tissue perfusion; infection; copious exudate; malnutrition; inappropriate training and unavailability of products, services and programs.

The economic implications

Wounds are estimated to cost Canada's health care system $3.9 billion, which exceeds the $2.5 billion the country spends every year on stroke. 2,9 Not included in this cost estimate are the Indirect costs including (1) mortality costs associated with the loss of economic output as a consequence of premature death and (2) long-term disability costs associated with lost or reduced productivity because of absence from the workforce.

The Solution
Moving toward a Canadian Wound Care Innovation Centre of Excellence
Thankfully, awareness of the wound-care crisis has been growing, and stakeholders have responded with a number of regional and local initiatives. Within its health care portfolio, the Ontario Centres of Excellence (OCE) program is currently supporting several projects in the wound care area. Making wound care a priority has led a Local Health Integration Network in the North Simcoe area in Ontario to realize substantial savings, and a Sherbrooke, Quebec initiative has effectively introduced a tele-medicine initiative to support wound care in rural areas. While promising, these efforts are isolated and do not go far enough to spread improvements broadly for maximum system impact. Canada needs a national wound care strategy that addresses current gaps and needs and embraces the following principles10: Person-centred: a system that integrates a patient and family perspective Accountable: a transparent system that informs stakeholders about costs and performance Efficient: a system that tracks and analyzes results to ensure a good return on investment Equitable: a system that reaches all irrespective of geography, socioeconomic or disease status Sustainable: a system with built-in processes to ensure efficiencies can be maintained over the long term.

Why a Centre of Excellence?

The goal of a Canadian Wound Care Innovation Centre of Excellence (CoE) is both simple and ambitious: to improve patient outcomes and value for money. With an emphasis on innovation, simply defined as anything but business as usual, a CoE would be the hub for exploring all forms of innovation - products, processes and programs. Specifically, a CoE would (1) enable inter-professional collaboration; (2) be a clearinghouse for process, methodology, models, tools and technology; (3) serve as a subject-matter focal point and singular voice; (4) build and maintain an educated resource pool through training and hands-on experience; (5) act as the liaison between industry, institutional and organizational peers and (6) be a central repository for data, research and study materials. Round-table participants unanimously agreed that a CoE would effectively address the gaps and needs they identified, while putting Canada at the leading edge of this evolving area of health care. Most significantly, the CoE would give stakeholders a mechanism for driving R&D, establishing partnerships and improving and sustaining standards of care and educating health professionals and the public.

Building on the success of others

Two presenters at the Round-table described how previous CoE-based initiatives are increasing the effectiveness and efficiency of wound care delivery. Dr. Bettina Klenker, manager of technology transfer at the Ontario Centres of Excellence (OCE) program, outlined the programs contribution to the provinces health innovation ecosystem, including several projects in the wound care area. Dr. Douglas Queen, a Toronto-based consultant, described the creation of a Welsh Wound Innovation Centre and an Australian Wound Management Innovation Cooperative Research Centre. Both Centres are opening up the innovation pipeline with the ultimate aim of improving wound prevention and care. As a potential model for wound care, the Technology Evaluation in the Elderly Network (TECH VALUE NET) is the latest Network of Centres of Excellence (NCE) to receive support from the Government of Canada. With $23.8 million in federal funding, TECH VALUE NET, located in Kingston, Ontario, will coordinate clinician researchers, Canadian universities and hospitals and industry and non-profit partners to improve the care of seriously ill, elderly patients and their families.

Five Pillars and Six Priorities

Defining a Canadian Wound Care Innovation Centre of Excellence
Delegates agreed that the CoE needed to have five pillars that would underpin its raison detre. These are (1) to serve as a concerted voice for the area of wound care; (2) to act as a bridge between industry, academia, health administrators, and policymakers; (3) to facilitate inter-professional collaboration on wound care related projects;(4) to develop and maintain human and educational resources in wound care and (5) to provide a central repository of research data.

A further plenary brainstorming session led to the following six priorities for the CoE - (1) to build a portfolio of innovative initiatives that support partnering between the academic, clinical, research and industry; (2) to create and maintain a national wound registry to standardize data collection; (3) to create and disseminate nationwide standards of wound care; (4) to coordinate research activities so that practice becomes grounded in evidence; (5) to raise professional and public awareness through educational initiatives and (6) to build sustainability and renewal into the Centres agenda.

Personal impact
A CoE dedicated to wounds would ultimately benefit patients by advancing innovation that leads to faster healing and decreased pain and suffering. Many would avoid amputation of their feet and legs as a consequence of advanced vascular disease. Patients would see improvements in their ability to self-care leading to increased motivation and an earlier return to normal activities. Overall their quality of life would improve.

Clinical impact
Clinicians would be better served by a CoE by having access to appropriate training, supports and standards of practice; and to the right products and services at the right time. Wound care providers would benefit from the profile that a CoE would bring to wounds as a national priority issue. The resulting impact would be decreased healing time for wounds; prevention of first-time wounds; reduced hospital readmissions and fewer amputations.

Economic impact
Besides improved value for money, a CoE would realize increased public and private sector investment in wound research and technology. With the creation of high-value healthcare jobs; stimulation of wound care investment; and an international presence in the area of wound care, Canada would be a more attractive business environment for wound technology companies.

Future-gazing
An exercise in imagining REAL possibilities
Delegates were asked to fast-forward seven years and imagine the Canadian Wound Care Innovation Centre of Excellence has matured and is regarded as the gold standard for wound innovation. Youve been asked to present at an international conference on how the CoE works and what has made it successful. Below is a consolidated version of the responses.

Priority

Future State
The Centre has built a portfolio of innovative initiatives that support collaboration between the academic, clinical, research, patient, public policy and industry communities. The CoE has a reputation for providing pan-Canadian leadership and is recognized and respected by all stakeholders. The Centre is a trusted advisor to governments on innovation in wound management and is the go-to source for wound care knowledge in Canada, especially on how to serve the First Nations, Inuit, northern and rural communities. The Centre, in partnership with CIHI and CHI, created and maintains a national wound registry that is linked to international wound registries. The registry is seen as the premier tool for enabling evidence-based wound management research, analysis and evaluation. The CoE facilitates and coordinates the development and dissemination of national standards, guidelines, protocols and performance benchmarks. The Centre is a repository for these guidelines and standards. The Centre is the clearinghouse for research activity in Canada. As an international hub for wound research, the Centre pools home-grown and international expertise to deliver on a ground-breaking agenda. Working with CADTH and the various provincial health technology assessment agencies, the Centre has successfully promoted Canada as a leader in health technology assessment related to wounds including health economic evaluations and quality-of-life studies. Global pharmaceutical, biotech, nutraceutical and device companies have set up R&D offices in Canada as a consequence of the concentration of talent associated with the Centre. Wound management (prevention and care) is now a national and provincial priority issue. Patients, politicians and the public are aware of the magnitude of the problem. Investments in Canadas wound innovation agenda are in alignment with the economic burden of wounds. Health system managers have made wound care a big dot indicator. Canadas research community has spearheaded a record number of studies about the impact of skin breakdown and wound management. Policy makers are now attuned to wounds as an area requiring sustained effort. Media regularly cover stories related to wounds and wound management. The CoE is partnering to provide and accredit wound management education programs including dissemination of evidence-based information about innovation in products, process and programs. Canada is now the global leader for innovation in wound management and we are selling our expertise globally. Canada is a magnet for clinical trials, industry investment and jobs related to wound care. The Centre continually refreshes its agenda to meet the needs and expectations of its stakeholder community and to remain relevant. Having received $25M from the federal NCE program, the CoE is leveraging this investment to ensure the Centres long-term sustainability.

Partnerships

Wound Registry

Guidelines and Standards

Research and Analysis

Awareness and Education

Sustainability

The break-out sessions

During the afternoon, groups of delegates rotated between three discussion stations to explore how a Canadian Wound Care Innovation Centre of Excellence could help meet current needs in three areas - research, practice, and training.

Call to Action
Rallying support

Canada has a national strategy for cancer prevention and control, a strategy for diabetes prevention and care, and the Canadian stroke strategy. These initiatives have demonstrated that investing in a pan-Canadian approach can pay great dividends. For example, in 2000, the federal government provided $78 million to fund the Canadian Stroke Network as a vehicle for reducing the burden of Here are the highstroke through leadership in research innovation. As a lights of these breakresult, we have seen several important advances in how Wound care is all dot the out sessions. Making wound care a big strokes are managed and lives are being saved. The big health be a indicator would care agenmagnitude of the wound care epidemic calls for a das value game-changer. for money, similar approach, centred around a national Centre of quality, safety, paOn research Ray Racette, Canadian ColExcellence (CoE). tient-centredness, and lege of Health LeaderspracWound care is an evidence-based area with the Delegates to the Round-table meeting strongly tice . potential to yield supported the rationale for a CoE and expressed an quick wins in active interest in helping to create it. We urgently call out to the research and innovation. broader healthcare community to join the process. With the collective Many clinical care initiatives die out energy of all stakeholder groups, political will and support, a Canadian prematurely, while others duplicate Wound Care Innovation CoE can become a reality and propel Canada to earlier efforts. A CoE could avoid such wastage by coordinating projects a position of global leadership in wound care.
throughout the country and identifying those worthy of being deployed on a wider scale.

Beyond developing an action plan for a CoE, Round-table participants unanimously agreed that wound prevention and care should become a priority area for the Council of the As a repository of Federation Working Group on Health Innovation. research data and We always end up in the Additionally, WCA Canada will recommend to the practice guidelines, proverbial pilot stage. We need Public Health Agency of Canada that non healing the Centre would be a more permanent approach. wounds be added to its list of major public health in an excellent Nadine Henningsen, Canadian challenges. position to compare Home Care Association products and care models in terms of WCA Canada has an innovation agenda for creating clinical and cost efficiencies to transform service delivery. Solutions effectiveness. include accelerating the development and uptake of best practice, measuring wound prevention and care outcomes, building knowledge The Centre can hold yearly meetings capacity within the provider workforce, and adopting innovation in prowith manufacturers to help them grams, products and processes. Continued and accelerated government identify projected market needs and investment in wound care innovation will help actualize these solutions develop market-aligned products. while mitigating healthcare costs.
The CoEs research mandate have a dissemination component that includes sharing industry tools and showcasing the work of champions to ensure widespread use of the best technologies. should

The Premiers are interested in accountability and sustainability. The federal government is interested in innovation that improves productivity. Combining these objectives in a CoE makes good sense. Keith Denny, Canadian Healthcare Association

Wound care is an area of growing interest to clinicians, researchers, health care executives and medical innovators. The time has come to harness this momentum in the interest of our collective health and healthcare system. With a CoE as the hub of a national wound care strategy, we can mobilize Canada's best talent in the private and public sectors and apply their discoveries to the task of advancing wound care while developing the economy and improving the quality of life of Canadians. As a progressive, health-focused nation, we have the capacity to meet this challenge. We cannot afford to ignore it. 7

Next Steps
Moving forward
Several steps are needed to make a Canadian Wound Care Innovation Centre of Excellence a reality. Round-table delegates suggested prioritizing the following action items for the next 12 months:
Submit a brief to the Council of the Federations Working Group on Health Innovation Make a submission to the Federal Standing Committee on Finances pre-budget consultation Disseminate the Round-table report widely to all stakeholders Develop an innovative partnership model for next steps Initiate discussions with the Canadian Institute for Health Information about publishing a report on wound care in Canada Confirm go-forward commitments from stakeholders Establish links to other national health professional organizations Identify anchor institution(s) and academic lead(s) Explore funding opportunities for the development of a business plan Pursue Canadian media to raise the profile of wound care in Canada

More from the breakout sessions

On practice
There is a need for a common language for measuring the incidence and heal rates of wounds. Patient self-care is a crucial component in the continuum of wound care and should be included in clinical management pathways. A CoE can serve as the clearinghouse for best practice and the first point of contact for stakeholders seeking information about wound care research and outcomes. The CoE needs to have a strong patient focus, including patient experts and wound awareness initiatives. Funding models must support prevention; there is a case to be made for tying reimbursement in wound care to outcomes.

On training
Round-table participants also agreed on the value of reconvening after a year to review progress and develop a sustainable action plan for the longer term. These steps, as well as the other insights and recommendations put forth in this report, represent the beginning of a consultative process that welcomes input at all levels. As we proceed with implementation, new directions and opportunities will arise. The more people and perspectives drawn into the process, the better we can shape and fine-tune the vision for the CoE and beyond. We invite you to join the conversation.
Knowledge transfer is hampered by the lack of a feedback mechanism for evaluating outcomes. The CoE must prioritize core competency programs for both practitioners and educators in wound care; to this end, it could serve as an advisory board for university training in wound care across a range of health disciplines. The development of wound care certification ideally at several levels represents an excellent opportunity for the CoE. The CoE could either create its own certification program or partner with a larger health care body to help wound care achieve recognition as a specialty; along similar lines, the CoE could develop and update CME programs that include credit and study hours. The CoE can play a leading role in developing wound care materials and resources, with a strong emphasis on prevention strategies.

References
1. http://www.who.int/nmh/events/un_ncd_summit2011/3rd_plenary_meeting.pdf
2. 2010 Ideas and Opportunities for Bending the Health Care Cost Curve Report sponsored by the Ontario Hospital Association (OHA), the Ontario Association of Community Care Access Centres (OACCAC) and the Ontario Federation of Community Mental Health and Addiction Programs (OFCMHAP), p14; Ronald J. Shannon, MPH A Cost-utility Evaluation of Best Practice Implementation of Leg and Foot Ulcer Care in the Ontario Community Wound Care Canada Vol. 5, Suppl. 1; Based on 2009 Statistics Canada population data Canada 33,700,000 Ontario 13,100,000 ; CIHI National Health Expenditure Trends, 1975 to 2011; Based on these sources we can conservatively approximate the annual cost of wound care in Ontario at $1.5 billion. By extrapolation using population data, we further estimate that the annual cost of wound care in Canada is $3.9 billion or ~3% of total health expenditures. 3. http://www.rickhanseninstitute.org/en/information-about-sci 4. A. Hjort, MSc, MPP, Chief Financial Officer, Government of Greenland, Properties Agency INI, Sisimiut, Greenland; F. Gottrup, MD, DMSci, Professor of Surgery, Copenhagen Wound Healing Center, Bispebjerg University Hospital, Copenhagen, Denmark. Cost of wound treatment to increase significantly in Denmark over the next decade. Journal of Wound Care Vol 19, No 5, May 2010 5. The Smith & Nephew Foundation, Skin Breakdown - The silent epidemic Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy, Chandan K. Sen, PhD, Gayle M. Gordillo, MD, Sashwati Roy, PhD, Robert Kirsner, MD, Lynn Lambert, CHT, Thomas K. Hunt, MD, Finn Gottrup, MD, Geoffrey C Gurtner, MD, and Michael T. Longaker, MD 6. OHA and OACCAC Report Four Pillars: Recommendation for Achieving a High Performing Health System June 2011, p15 7. Knight L. Personal discussion re: visit volume and characteristics for Care Partners visiting nursing agencies in the province of Ontario. 2004. 8. CAWC website: Prevalence of Chronic Wounds in Canada. GM Woodbury and PE Houghton 9. News Release. JUNE 8, 2010 (Release) Quebec City Cost of caring for stroke patients double that of earlier estimates, study finds 10. These principles were adapted from the CHSRF Provincial and Territorial Health System Priorities: An Environmental Scan Brasset-Latulippe, Anne; Verma, Jennifer; Mulvale, Gillian; Barclay, Kevin 17/12/2011

Our Partners and Supporters

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The Delegates
Dr. Bettina Klenkler Ontario Centres of Excellence Brenda Moodie Mississaugas of the New Credit First Nation Brian Lewis MEDEC Cathy Harley Canadian Association for Enterostomal Therapy Colin Zvaniga Healthoutcomes Worldwide Danielle Gilbert Regroupement Qubcois en Soins de Plaies David Whiteside Hollister Dawn Beaubien 3M Dr. Douglas Queen Canadian Association of Wound Care Elise Rodd Nielsen Health Canada Fabien Paquette ConvaTec Gayle Stuart Health Quality Ontario Harpreet Bassi Ivey International Centre for Health Innovation Western University Janet Davidson Co-chair Jim Bowen McMaster PATH Research Institute Sandra Dudziak Revera LCol Joel Fillion National Defence Canada Dr. John Semple Womens College Hospital John Stone Healthpoint Karen Witkowski Trillium Health Centre Kathryn Kozell Association of Canadian Academic Healthcare Organizations Dr. Keith Denny Canadian Healthcare Association Kimberly Bain Bain Consulting Group Lacey Phillips Accreditation Canada Laura Teague Ontario Woundcare Interest Group Linda Norton Canadian Association of Occupational Therapists Lynn Abraham MUI Scientific Mark Matti Covidien Mary McLean Molnlycke Maureen Latocki Wound Care Alliance Canada Nadine Henningsen Canadian Home Care Association Rosemary Kohr St Elizabeth Patricia McGarr Canadian Nurses Association Peggy Ahearn Canadian Association of Wound Care Peter Gardner Smith & Nephew Peter Pichini Coloplast Ray Racette Canadian College of Health Leaders Rob Stephen Systagenix Rosemary Hannam Rotman Health Sector Strategy Group University of Toronto Roslyn Baird Southern Ontario Aboriginal Diabetes Initiative Shannon Handfield Vancouver Coastal Health Shubie Chetty Health Canada Tom Closson Co-chair Voula Christofilos Dietitians of Canada Gabrielle Bauer Medical writer Barbara Turnbull Patient advocate Support Celine Bryenton, CAWC Diana Seminara, CAWC

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For more information contact: maureenlatocki@gmail.com