Dr. Stone completed a retrospective, random review in which 147 patients in 10 nursing homes were followed for two and a half years. “Our goal was to raise the bar on wound care by providing additional education and assistance to the nursing staff who provide patient care. Prior to this intervention, some of the facilities had received reports of quality care deficiencies related to the prevention and healing of pressure sores. Most study patients (47%) had Stage 2 wounds, while 22 percent had Stage 3 and 25 percent had Stage 4 wounds. Patients were treated for an average of 60 days. A fourth of the patients studied received conservative care consisting of palliative care and minimal debridement, while 66 percent received moderate/aggressive care consisting of the regimen outlined in the algorithm. Major interventions included offloading, adjunctive anabolic therapy, and debridement. Nutritional support and education played significant roles. Of the patients studied, 78 percent improved or healed.” In light of the changing health care climate, Dr. Stone saw the need to provide point-of-service care to nursing home patients, and is committed to a program of nutrition and wound care education, teaching ways to provide the best possible care environment for the nursing home patient. “Even small changes make a big difference in improving care and outcomes.” he points out.