Freederm Project: Pressure Ulcer Prevention Training at VA Hospitals
The Freederm Project is a three-month pilot program designed to eliminate pressure ulcers (decubitus) in hospitalized veterans through staff training and implementation of evidence-based best practices. Certified Nursing Assistants will be trained using the SODOTO (See One, Do One, Teach One) methodology to prevent and manage bedsores in mobility-compromised patients. The project employs the PRINCE project management framework and measures success through staff training numbers, incidence rates of new pressure ulcers, and recovery rates of existing ulcers. With over one million Americans affected by pressure ulcers annually and treatment costs exceeding $55 billion, the project addresses a significant healthcare challenge while establishing a sustainable training model for expansion to other VA facilities.
- Executive Summary: Project overview and scope
- Purpose and Scope: Pressure ulcer prevention and CNA training
- Market and Competitive Analysis: SWOT analysis and organizational change factors
- Target Market and Demand: Veteran population and cost projections
- Project Management Approach: PRINCE framework and performance metrics
- Training Methodology and Key Personnel: SODOTO method and staffing requirements
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What makes this paper effective
- Clearly establishes the business and clinical case for the project by quantifying the health burden (over 1 million affected annually, $55 billion in costs) and connecting it to organizational improvement and competitive advantage.
- Integrates strategic business planning tools (SWOT analysis) with healthcare-specific metrics, demonstrating professional project framing that appeals to hospital administration.
- Provides concrete details about the training methodology (SODOTO) and project management framework (PRINCE), showing how best practices will be implemented and measured rather than simply proposed.
- Acknowledges both internal barriers (staff resistance, funding constraints) and external competition (Red Cross training programs), demonstrating realistic market awareness.
Key academic technique demonstrated
This paper demonstrates the integrated business planning technique of combining evidence-based practice implementation with organizational change management theory. The author cites Rogers' Diffusion of Innovations to explain why administrative endorsement is critical to successful practice change, then structures the entire project to leverage that insight—securing administrative buy-in becomes the key mechanism for overcoming staff resistance. This approach moves beyond proposing a training program to proposing a change management strategy grounded in scholarship.
Structure breakdown
The paper follows a standard healthcare business plan structure: executive summary and purpose establish the clinical problem and project scope; market analysis uses SWOT to position the project competitively; target market analysis expands the growth opportunity; project management and personnel sections detail implementation. The progression moves from "why" (clinical need and market demand) through "how" (management framework and training method) to "who" (staffing and expertise required). This ordering allows readers to understand both the clinical and business rationale before engaging with implementation complexity.
Executive Summary
The Freederm Project is a training and best practices development project designed to eliminate the occurrence of decubitus (pressure ulcers) in patients at Veterans Hospitals. Increased privatization of healthcare services has resulted in a more competitive market and greater demand for contracts with external suppliers. The project is well positioned to establish a business relationship with Veterans Hospitals and to extend the project after a successful pilot year. The scope of the project is a three-month pilot that introduces training and implementation of new evidence-based practices at the hospital, followed by nine months of follow-up support. Certified Nursing Assistants will be trained to implement evidence-based best practices in their workplace using the SODOTO training methodology. Project performance will be measured by the number of staff trained, the incidence rate of new pressure ulcers, and the recovery rate of existing pressure ulcers at the beginning of the pilot project.
Purpose and Scope
The Freederm Project is designed to eliminate the problem of decubitus (bedsores) from hospitalized patients. The project pilot will be launched at a Veterans Hospital. Decubitus is a preventable condition associated with lengthy confinement to bed in people who are unable to manage position changes independently, such as mobility-compromised patients or spinal cord injury patients. The project will provide training to Certified Nursing Assistants on updated best practices to prevent and treat bedsores.
Certified Nursing Assistants are the hospital staff most likely to be available for and assigned to assist patients in changing positions on a schedule and in a manner sufficient to prevent pressure ulcer development. By improving the knowledge and skill of this workforce, the project directly addresses the root cause of preventable pressure ulcers in the hospital setting.
Market and Competitive Analysis
The project is needed to change the culture of care in participating Veterans Hospitals. The changes required of staff are not innovative but instead represent evidence-based best practices that are already well-established in nursing literature. In any medical facility, changing practice and procedures can require longer implementation time than is acceptable. By working with a dedicated project manager, the hospital establishes official endorsement of the recommended practices and can put the full weight of hospital administration and quality groups behind the training and implementation of the new practices.
As Rogers has demonstrated, the strength and speed by which a change or innovation proceeds through an organization and becomes embedded in practice is related to the approval and escalation that officials in the organization provide (Rogers, 1995).
SWOT Analysis
Strengths
Weaknesses
Opportunities
Threats
Effective management of decubitus and eliminating all new instances of this preventable condition will result in substantial savings in the cost of care and valuable contributions to improved quality of life for patients. Over a million people in the United States are affected by pressure ulcers each year, with substantive impact on the general health and morbidity rates in mobility-compromised and hospitalized individuals. Overall costs of treating people with pressure ulcers in hospitals exceed $3.6 billion annually, with all associated costs reaching well over $55 billion (Healthcare Inspection, 2006).
Target Market and Demand
The target market for the pilot project includes all bed-ridden patients in Veterans Hospitals. A successful pilot project will open the way for the project to be expanded into other VA hospitals and, in response to market demand, into other types of hospitals as well. The reputation of the Veterans Hospital will be improved by the addition and success of the new program, and the Freederm Project will experience an increase in market share of this type of Certified Nursing Assistant training program.
The Congressional Budget Office (CBO) estimates that the cost of treating veterans in VA hospitals will increase faster than appropriations designated for that purpose (CBO, 2010). This is primarily because overall healthcare costs per veteran are projected to increase faster than the overall pricing level. The CBO estimates that providing healthcare to all veterans who come to VA hospitals would range from $69 billion to $85 billion in 2020, which represents an increase of roughly 45 percent to 75 percent since 2010 (CBO, 2010). This expanding budget pressure creates both urgency and opportunity for cost-saving initiatives like the Freederm Project.
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