The Wound Care Center is a hospital-based outpatient clinic located within Astria Sunnyside Hospital at 1016 Tacoma Ave, Sunnyside, WA. The clinic operates Monday through Friday and includes two treatment bays (one chair, one stretcher) and a dedicated hyperbaric oxygen treatment room with a Seacrest monoplace chamber. The provider works alongside a charge nurse, a floor RN, and a medical office assistant.
The program operates under a Healogics contract, which provides clinical support infrastructure, wound care EMR (iHeal), and access to the 40-hour HBO certification program required for chamber supervision. All clinical revenue runs through Cerner, which is the hospital's primary EMR. Providers will need to be comfortable navigating both systems, as iHeal is used for wound care charting and Cerner is used for patient history, medication lists, orders, and billing.
The patient panel is predominantly Hispanic and Native American, reflecting the broader Lower Yakima Valley community. The majority of patients are on Medicaid or are uninsured, and social determinants of health are a significant factor in clinical management. Transportation barriers, limited health literacy, medication compliance challenges, and financial constraints around supplies and insulin are common. The team has developed protocols for relentless follow-up, patient education, and working within resource limitations to keep patients engaged in care.
The most common presentations include:
Ostomy management is not a primary focus of this program. The clinic does see complex patients who have been followed for extended periods, including some who have been in the program for several years due to the chronic and multifactorial nature of their conditions.
The incoming provider is expected to independently manage the full scope of outpatient wound care, including:
Skin substitutes are available through the Healogics contract. The previous provider utilized skin substitutes heavily, which led to an overutilization review by the organization. The incoming provider is expected to apply skin substitutes judiciously, with clear clinical justification tied to wound healing trajectory. The Healogics framework uses a 14-week interval standard: a wound should reduce in size by 50% within the first 4 weeks; if it does not, the provider has a 10-week window to reassess, apply advanced modalities, and determine whether the patient should be reclassified as a complex case.
Wound VACs (negative pressure wound therapy devices) are in frequent use and have demonstrated strong healing outcomes. The team is currently stocking MEDLINE-based supplies and has the ability to request additional products through the hospital's materials review committee.
The Seacrest monoplace chamber has been in operation since approximately 2019 and is currently underutilized. At its prior peak, the program ran two to three treatments per day. Competitors in the region, including the adjacent critical access hospital in Prosser, are not currently running active HBO programs, representing a clear opportunity to build regional volume.
HBO is appropriate for several of the clinic's primary diagnoses, including diabetic foot ulcers, radiation wounds, and chronic non-healing wounds. The Healogics team has provided resources and support for HBO program development, and the organization is actively seeking a provider who is motivated to grow chamber utilization.
The 40-hour HBO certification course is required through the Healogics contract and will be supported by the organization. Providers coming in without existing HBO certification can complete this training after hire.
The incoming provider will be expected to respond to wound care consults from the inpatient medical-surgical unit, ICU, and emergency department. Consult volume is not daily but averages several times per week, depending on census and acuity. Common inpatient consult triggers include:
The consult relationship between the outpatient wound care clinic and the inpatient teams has historically been inconsistent. Inpatient and ED nursing staff have not always contacted wound care in a timely manner, and follow-through on dressing protocols between consult visits has been variable. Leadership has identified building this collaborative relationship as a priority for the next permanent provider. A provider who is proactive, visible on the units, and willing to work with nursing leadership on education and protocols will have significant opportunity to improve this dynamic.
The hospital uses a separate consult pool structure for internal referrals. Because the wound care EMR (iHeal) operates independently of Cerner, inpatient consults are currently communicated by phone rather than through an electronic order pool. The clinic team monitors voicemails throughout the day to capture after-hours consult requests.
The wound care provider works most closely with the following clinical partners:
The clinic currently draws patients primarily from its internal panel. Leadership has identified referral development as a significant opportunity for growth. The 20 Astria Health outpatient facilities across the Lower Yakima Valley represent internal referral sources, and the organization does not require patients to have an Astria primary care provider to access specialty services such as wound care.
External referral sources include community health centers, FQHCs, and the broader Lower Yakima Valley region, including patients who have traveled from as far as Goldendale to access the program. The organization is open to provider-led outreach efforts, including community health fairs, foot screening events, and provider networking dinners. Astria Health has a dedicated marketing team that produces bilingual materials, runs digital and print advertising, and supports service-line promotion.