InternationalSkinTearAdvisoryPanel(ISTAP)

StrategicPlan:2016-2020

November19,2016

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InternationalSkinTearAdvisoryPanel(ISTAP)StrategicPlan:2016-2020

TableofContentsInternationalSkinTearAdvisoryPanel(ISTAP).......................................................................................................................................1

StrategicPlan:2016-2020.........................................................................................................................................................................1

Draftsubmitted:September21,2016.....................................................................................................................................................1

InternationalSkinTearAdvisoryPanel(ISTAP).......................................................................................................................................2

StrategicPlan:2016-2020.........................................................................................................................................................................2

ExecutiveSummary..................................................................................................................................................................................3

Introduction..............................................................................................................................................................................................5

ISTAPMandate.........................................................................................................................................................................................6

ISTAP.........................................................................................................................................................................................................6

WHY?.........................................................................................................................................................................................................9

WHAT?....................................................................................................................................................................................................10

StrategicAreasofFocus................................................................................................................................................................10

FutureOralPresentationopportunities.........................................................................................................................................62

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ExecutiveSummary

Skintearshavebeenanunderappreciatedwoundwithverylittleattentionorresearchdirected toward this particular wound etiology. The International Skin Tear AdvisoryPanel (ISTAP) defines a skin tear as ‘‘awound caused by shear, friction, and/or bluntforce resulting in separation of skin layers. A skin tear can be partial-thickness(separationoftheepidermisfromthedermis)orfull-thickness(separationofboththeepidermisanddermisfromunderlyingstructures).’’2,8

Skintearsareuniqueinthattheyarecommonacutewoundsinolderadults.However,neonate and pediatric populations are also at risk for skin tears. Skin tears arefrequentlyunderreportedandhavebeenreportedintheliteraturetohaveprevalenceratesequaltoorgreaterthanthoseofpressureulcers.roleofidentifyingskintearswithacomprehensiveskinassessmentneedsfurtherstudy.2,8

Individualssufferingfromskintearscomplainofincreasedpainanddecreasedqualityoflife.Populationsatthehighestriskforskintearsincludetheelderlyandthecriticallyorchronically ill. These individuals are at a higher risk for developing secondary woundinfectionsandhavecomorbidities.In2013,theInternationalSkinTearAdvisoryPanel

(ISTAP) was formed to develop the components of the tool kit pertaining to theassessment,prediction,prevention,andtreatmentofskintears.Thepanelconsistedof

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11keyopinionleadersinthefieldofwoundcarefromtheUnitedStates,Canada,andtheUnitedKingdom.2,8

ISTAP must maintain relevant throughout the global healthcare systems. Through avariety of means, ISTAP must be able to affect policy, organizations, front line careproviders,patientsandfamiliesatvariouslevels.Whilepressureulcersareontheradarof many healthcare professionals, skin tears are often not identified or assessedproperlyleadingtoineffectivemanagement.Patient’satriskforskintearsarealsonotbeing identifiedearly enough inorder forpreventative strategies tobe implemented.Thischallengecanimpactsafeandeffectivepatientcareandcanalsoaddcoststothehealthcare system.Wemust be continuously aware of competing prioritieswith skinandwoundissuesandmustworktomakeskintearsattheforefrontoftheagendasofthe influential bodies and top of mind for patient care providers. Through research,education,advocacyandcollaborationISTAPwillworktosupportthevisionofaworldwithoutskintears.

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Introduction

THISSTRATEGICPLANIDENTIFIESISTAP’SVISION,MISSION,VALUESANDSTRATEGICAREASOFFOCUSFOR2016-2020

It also identifies the specific strategies that the International SkinTearAdvisoryPanelwilldeliverontogetherover thenext fiveyears. ISTAPPanelMemberscontributedtothecreationofthisStrategicPlanwhichwillbuildISTAPoverthenextfiveyears-2016-2020.ThestrategicplanningprocessincludedtheISTAPPanelmembersparticipatinginastrategicplanningmeetingheld inChicagoAugust2016.TheyprovidedfeedbackviaemailandengagedinconversationsaboutISTAP’sfuture.

The Strategic Plan sets the ISTAP direction for the future, and will guide the ISTAPbudget for 2016-2019. It is through themulti-year process that ISTAP’s Strategic Planwill be put into action,with an annual operational plan adding further detail to eachstrategyabouttactics,accountability,timingandresourcing.

Onanannualbasis,ISTAPwillreporttoCanadianAssociationforEnterostomalTherapyBoardofDirectorson the implementationof the StrategicPlan, anddemonstrate theprogressbeingmadeeachyearandhowthisworkismakingadifferenceinthewoundpreventionandcarecommunity.

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ISTAPMandate

ISTAP is mandated to provide leadership andcoordinate the work necessary to facilitate andenable thebuilding ofa culturethat willimprovepatientoutcomesforpeopleatriskfordevelopingskintears-andforthosewhohavealready

MISSION:ISTAPisaninter-professionalcollaborationdedicatedtoimprovingoutcomesfor

individualsatriskand/orexperiencingskintearsacrossthecontinuumofcarethrougheducation,research&advocacy.

VISION:AWORLDWITHOUTSKINTEARS

COREVALUES:Collaborative Innovative Transparent Passion

ResearchbasedCreative Leadership Respect Inspiring

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haveaskintear.ISTAPwillpromoteleadingideassupportedbyresearch,bestpractices,raiseawarenessandprovideeducationandadviceoneffectivestrategiestopreventandmanageskintears.Infulfillingthismandate,ISTAPiscommittedtocollaboratewithInternationalSkinandWoundCareorganizationswhohavenationalnetworksandexpertise.Someofthekeyprinciple’softhe ISTAPmandatearetooperate independentlyasan interestgroupofthe Canadian Association for Enterostomal Therapy ( CAET), have fully transparentoperationsandaccountabilityto individual’satriskoforwhohaveaskintear,andallpeoplewhocare for them.Wewillwork tosupportaworldwithnoskin tearswherepatients,carers,governmentandothersworktogethertoprovideasafeandeffectivehealthcare environment for people at risk for and who have skin tears. Healthcareproviderswillbeconfident in theirability todeliversafeandeffectivepreventionandmanagementofskintears.

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ISTAPStrategicDirectionWhy: What: How:Purpose AreasofFocus CoreProcesses

Research Education

Advocacy Collaboration

Prevent&reduceskintearstoimprovepatient

outcomes

UnderstandissuesEngagestakeholdersBuildCapacityDeveloptools/programsCommunicateImplementationMeasure&EvaluateKnowledgetranslationmanagementInfluencechange

K

Aworldwithoutskintears

Informing

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WHY?2016-2020:ISTAPCommitment

ISTAPwilladvanceskintearpreventionandmanagementby:

1. Providing“bestinclass”evidencebasededucationonthepreventionandmanagementofskintears.

2. Enablingbestpracticesinthepreventionandmanagementofskintears.3. Focusonresearchtoimprovepatientcare.4. Supportthedevelopmentofeffectiveinter-professionalteamsandadvocacyplatforms.

Thedesiredoutcomeswillbe:1. Skintearpreventionandmanagementpracticewillbeperformedatahighstandard.

2. Patientswillbenefitfromsafeandeffectivecare.

ContinuousImprovement

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3. ISTAPwillleadthedevelopmentofintegratingskintearpreventionandmanagementtosupporteffectiveInter-professionalteamsandadvocateforbetterpatientcare

WHAT?StrategicAreasofFocus

Research

Advocacy Education

Collaboration

VISION:AWORLDWITHOUTSKINTEARS

KnowledgeTranslation&Management

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StrategicAreasofFocus

ISTAPhasfourmajorareasoffocus:1. Research2. Education3. Advocacy4. Collaboration

Theareas are supported through thedevelopmentof tools andprogramswhichbackeach area and provide the transfer of knowledge to the key ISTAP stakeholders. Thefollowing information explains each area of focus including role statements, whichdescribethegeneralapproachandemphasistoguideISTAPactionsandpriorities,whichinclude high level goal statements and key strategieswith each goal. Achieving thesegoals is largely determined by the strength of partnerships and engagement of keystakeholdersthattogetherwithISTAPsupporttheseeffortstopreventandreduceskintearsglobally.

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1. Research:Thediscoveryofnew informationand thegatheringofexistingknowledge is thebasis fromwhichwewillchampionraisingawarenessaboutskintearprevention,assessmentandmanagement.Researchwillprovideimportantinformationtohelpusunderstandthemagnitudeofthecurrentglobalissueofskintears,knowwhatisachievable,and identify ideasthatwillworktowards improvingpatientoutcomesinrelationtoskintears.ISTAP will work collaboratively with other research funding organizations toincrease the scope and scale of skin tear research. ISTAP research funding willtargetinitiativeswithuniqueandinnovativeapplicationsthatdonotduplicatethework of other funding agencies. ISTAP sources funds, brokers and facilitatesresearch and knowledge transfer activities related to skin tears globally. Keyprinciples that inform thiswork include adapting best practices for initiating andawarding research to avoid duplication and to ensure credibility, participation injoint planning to ensure relevancy and pursue funding partnerships to optimizereach.

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ISTAPResearchPrioritiesGoals KeyStrategiesBuildcapacity&processestoconducthighqualitypatientskintearresearch

1. Consultwithskin&woundcareglobalexpertstoidentifyemergingissueswithskintearsthatrequireresearch.

2. Buildpartnershipswithinternationalresearchfundingorganizationsaswellasorganizationswithresearchunitsfocusedonimprovingpatientoutcomes.

3. Implementbestpracticesintheprioritysettingforresearchdirections,securinganddisseminatingfundingandthesharingofresearchresults.

4. EvaluateISTAPprocessesandoutcomesandidentifyimprovements.

Facilitatetheuptakeofknowledgecreatedfromskintearresearchfindingsinto

5. Initiateinnovativeknowledgetransferstrategiesofthefindingsfromfunded&othersignificantandrelevantresearch.

6. Explorerelationshipswithotherinternationalorganizationstoimproveknowledgedissemination

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healthcarepolicyandprocedures

activities(ieWUWHS,NPUAP,EPUAP).

2.Education:

Education alone cannot change healthcare systems, or healthcare provider orpublic behaviours within and outside healthcare systems. When combined withother strategies, a foundation of knowledge, skills and attitudes can form.Healthcare provider and patient/ public education should occur in parallel.Educationshouldoccurinaninter-professionalenvironment.Educationalprogramsshould be based on adult learning principleswith content based on the learningneedsofthelearnerandframedbyarobustevaluationstrategy.

ISTAPwillworkwithpartnerstoensuretheintegrationofevidenceinformedskintearpreventionandmanagementpracticesintoeducationandtrainingsystemsforhealthcare professionals across the continuum of care. ISTAPwill be involved inidentifying leading practices, development of competencies, and promotingintegrationintoskinteareducationandtrainingprograms.Opportunitiestoengagepatients/Public in educational campaigns and knowledge transfer should beactivelypursued.

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ISTAPEducationPrioritiesGoals KeyStrategiesPromotetheadoptionofskintearpreventionandmanagementfocusinprofessionaleducationandtraining

1. Inpartnershipwithuniversities,governments,andhealthservicedeliveryorganizations,ISTAPwillsupportthedevelopmentofdiscipline-specificandinter-professionalskinteareducation.

Facilitatethedevelopmentandpromotepatientskintearcompetencieswithpartners

1. Develop,disseminateandencouragetheincorporationofskintearcompetenciesinuniversitiesandpostgraduationeducationalprograms.

2. Educatehealthcareprofessionalsregardingpracticesandtoolsknowntoimproveskintearreductionandmanagement.

3. Promotethedevelopmentof“Communitiesof

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Practice”aroundleadingskintearpractices.PromoteacommunityofpracticethroughtheISTAPwebsite.

Increaseknowledgeandawarenessofskintears

1. Adoptandpromoteskintearbestpracticestothegeneralpublic,patientsandtheirfamilies/significantothers,andhealthcareproviders,throughengagementineducationalcampaigns,knowledgetransferevents,andstakeholdernetworks.

2. Engagethemediatoraiseawarenessofskintearsandtheneedtoimprovepatientoutcomeswithskintearswithinthehealthsystem.

7. AdvocacyAdvocacy combines social networking and mobilization, interpersonalcommunicationandnegotiation,aswellastheuseofmediaforgeneratingpublicpressure.Advocacy involves engaging others, exercising voice and mobilizing evidence toinfluencepolicyandpractice.Itmeansspeakingoutagainstinequityandinequality.It involves participating directly and indirectly in political processes and

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acknowledges the important roles of evidence, power and politics in advancingpolicyoptions.(sourceC.N.A2016)ISTAP is uniquely positioned to assist inter-professional healthcare providers andorganizations to access the latest evidence, change concepts, and will worktowards developing evaluation strategies at an international level. ISTAP willprovide International leadership incoordinatingandsupporting thekeyadvocacymessages with evidence informed interventions and educational programs andensure relevant research evidence to support this message moving into actionacrossthehealthcontinuum.

ISTAPAdvocacyPrioritiesGoals KeyStrategiesEnableasocialscientificapproachtopublichealthasasocialconstructandthesocialdeterminantsof

1. Involveinterestedgroupsandalliancesestablishedforreachingacommonunderstandingofthescopeoftheproblem,thesolutionandtheimpactonsocietyinordertomobilizesocietalforces.

2. ProvideresearchandpositionISTAP’sunique

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healthwithstrongeremphasisonhealthpoliciesandmanagementsuchasgovernance,accountabilityandleadership

positiontoproviderelevantinformationonskintears,inordertoprovideevidenceinformedinformationtopolicymakers.

3. ActivationofmediatobuildPublicsupportandanupwardpressureforpolicydecisions.

Developabroaderunderstandingoftheroleofcommunicationtopromoteandsustainhealthbehaviour

1. Gainanunderstandingofthepatientperspectiveinordertodevelopkeymessagesthatwillresonatetopatient’s,publicandhealthcareproviders.

2. Facilitatedevelopment,coordination,disseminationandevaluationofISTAPInternationalinterventionsandprograms.

3. GeneratePublicdemandandactivatepatient’smovementinordertoevokearesponsefromInternationalHealthcareLeaders.

Addresspolicyperspectivesrelatedtoskintearsthat

1. ISTAPwilldevelopobjectivesandprioritiesalignedwiththecountrygovernmenthealthcareplatforminordertobeconsistentandrelevant.

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dealwithresourceallocation,humanresourcesandcapacitybuilding,enablingenvironmentsforhealthcommunication,andrecognitionofthevalueandcontributionofhealthcommunicationtopublichealth.

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8. Collaboration

Collaboration is an intricate concept with multiple attributes. It is defined in avarietyofways,manyofthemexplicitlyreferringtointerdisciplinarycollaboration(Henneman, Lee, & Cohen, 1995). Attributes identified by several nurse authorsinclude sharing of planning, making decisions, solving problems, setting goals,assuming responsibility, working together cooperatively, communicating, andcoordinating openly (Baggs & Schmitt, 1988). Related concepts, such ascooperation,jointpractice,andcollegiality,areoftenusedassubstitutes.Collaborationisbothaprocessandanoutcomeinwhichsharedinterestorconflictthatcannotbeaddressedbyanysingleindividualisaddressedbykeystakeholders.A key stakeholder is any party directly influenced by the actions others take tosolve a complex problem. The collaborative process involves a synthesis ofdifferent perspectives to better understand complex problems. A collaborativeoutcomeisthedevelopmentof integrativesolutionsthatgobeyondanindividualvision to a productive resolution that could not be accomplished by any singlepersonororganization.(Gray,1989)&(Follet,Mary,1940).In relation to skin tears, ISTAP can identify aligned key stakeholder groups todevelop partnershipswith. They can provide a shared definition of the skin tear

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scope of problem, strategies to address the problem and solutions which areimportant in relation to collaboration. The complexity of collaboration and theskillsrequiredtofacilitatetheprocessareformidable.

ISTAPCollaborationPrioritiesGoals KeyStrategiesEstablishkeypartnersinwhichcollaborationcanoccur

1. IdentifyandprioritizekeypartnerswhoarealignedwiththeISTAPmission,visionandvalues.

2. Leveragemultidisciplinaryforumstoincreasecollaboration.

3. Allocatetimeandfocustoengagewithpartnersandbuildcollaborativerelationships.

Establishasharedmentalmodel

1. Identifysharedvaluesandgoalswhichareafoundationalpartoftheoverarchingmentalstructurethatdrivescollaborativeefforts.

2. Worktogethertoformasharedvision.

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3. Focusonbothtasksandrelationshipbuilding.Visiontogetherwhatwouldbepossibleforskintearpreventionandmanagementglobally

1. UseappreciativeInquiry(Cooperrider,D.L.,&Srivastva,S.(1987)totofocusonthepositivestrengthsoftheorganizationsandthepossibilitiesratherthantheproblems.

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• DawnChristensen

• Kim LeBlancCathyHarley

• KarenCampbellMaryGloeknerDawnChristensenKarenEdwardAnn

• Co-ChairKevinWooCo-ChairDimitriBeakermanKimLeBlancDiane Legermo

Research Education

CollaborationMarketingAdvcoacy

ISTAPWorkStreamsFour ISTAP work streams have been established in order to provide leadership andcoordinationofworkrelatingtothekeyareasofthestrategic initiativeswhichinclude:research, education, advocacy and marketing/communications. ISTAP has broughttogether, experts from the ISTAP panel to form thesework streams to reflect clinical,academic,andprofessionaldevelopmentpractitioners.•

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HOW?ISTAPwillsupportthisStrategicPlanthroughthefollowing:1)BuildCapacityThewill, thecapabilityand resources to implementarewhatwemeanbycapacity.ThefollowingareasarewhereISTAPneedstobuildcapacity:• Patients must advocate for safe and effective skin tear prevention andmanagement

• Healthcare providersmust initiate new skin tear information/knowledgewhilecontinuingtoexpandexistingwoundcarepracticeswithintheirorganizations.

• Educatorsandresearchersneedtodiscoveranddisseminatepatientsafetybestpractices.

ISTAP will assist in providing research opportunities and creating and deliveringeducation and tools. ISTAPwill work towards enhancing the ability of the healthcareproviderororganizationtoaddressskintearsandconcernsrelatedtoskintears.ISTAPwill build capacity on many different levels such as education, research, advocacy,knowledge, leadership, and other initiatives. ISTASP will need to evaluate theeffectivenessofcapacitybuildingandensurethatitismaintained.

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2)EngagingStakeholdersSkintearpreventionandmanagementmustbemulti-faceted,inter-professionalandcommunicated broadly. Better understanding stakeholder needs and developing ashared understanding and aligned vision are key to collaboration. ISTAP mustestablishrelationshipsamongawiderangeofhealthcareprofessional,organizations,patients and their families and governments. Solutionsmust bedeveloped throughcollaborationbetweenprofessionals,organizations,thepublicandpatientsandtheirfamilies to capture important experience, perspectives and expertise. ISTAP iscommitted to engaging stakeholders, in innovative ways, to develop a sharedunderstandingandmutuallyacceptablesolutionsinallofISTAP’swork.Itisimportantto align and use every means possible through formal and informal partnershipswhichwillinvolve:• Engaging and communicating with key stakeholders in promoting andimplementingbestpracticeinskintearpreventionandmanagementand

• Building upon and leveraging partnerships within the healthcare continuuminternationallywithproviderorganizations,agencies,associations,government,andothers.

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3)UnderstandingtheIssuesItisimperativethatISTAPtakesthetimetoidentifyandcomprehendtheissuesrelatedtoskin tears in theirvariousdimensionsandcomplexitiesbefore reachingconclusionsaboutsolutions.In all of their work, ISTAPwill seek to identify core problems andwill work towardsdevelopingasharedunderstandingamonginterestedstakeholdersregardingthedepthandbreadthofskintearissuesathand.4)CommunicatingCommunicationwillbe thedriving force ineffectiveknowledgetransfer.Bestpracticeevidenceandleadingpracticesmustbebroadlydisseminatedandimplementedinorderto achieve improvement in patient outcomes in the area of skin tear prevention andmanagementglobally.ISTAPwillworkincollaborationwithalignedstakeholdergroupsinordertoidentifyanddevelopskintearimprovementinitiativesandtocommunicatethe ISTAP keymessages to the right target audiences. ISTAP and its partners will berecognized as credible sources of information by skin and wound care providerstakeholders,patientsandthePublic.Communicationstrategiesmustbedevelopedand

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integratedintoallISTAPinitiativesandprograms.ISTAPmustsetupawebsitethatwillbecompellingtostakeholdersandthatwillhouseISTAPinformationcommunicatingkeymessages. Successful implementation of communication strategies will involveaddressing language barriers, cultural sensitivity and any other barriers that areidentified.EnglishwillbethecorebusinesslanguageofISTAP.ISTAPmustcommunicateclear,conciseandconsistentmessagestohealthcareproviders,patients,andthePublic.ISTAPwillincludethatpatientinsightareincludedinordertoimprovetheircarewhenat riskorexperiencinga skin tear. ISTAPwill identifycommunicationconduits suchasmedia in order to increase awareness of skin tear issues, and best practices tohealthcareproviders,patientsandtheirfamiliesandthePublic.5)InfluencingChange

ISTAPneeds to enablehealthpolicy changes influencingdecisionmaking towards thecreationofmethods to reduceandmanageskin tears.Significantchanges include theway skin tears are assessed, the way that patients at risk are identified and theapproach to skin tear treatment. There needs to be a clear message arounddifferentiationof skin tears andpressureulcers. ISTAPwill be strategically focused to

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identifywhere and how these changes can bewithin by prioritizingwithin the globalhealthcaresystem.6)MeasuringandEvaluatingEvaluating how ISTAP efforts are making a difference in skin tear prevention andmanagement globally to assess process changes, outcomes and impact. Throughevaluatingprogress,ISTAPcanassesswhetherornotgoalsarebeingachievedandtheoverall mission is being implemented. ISTAP can set up an environment wheremeasurementandevaluationisvaluedandfacilitated.Acomponentofthisprocesswillbe through collaboration with stakeholders to create openness and networkingenvironmentsthatenabledatasharing.Itisimportanttosharesuccessesandfailurestosupport the learning process from experiences of each other and to ensure thatstakeholdersworkingwithskintearsareabletoconnectandintegratetheirwork.ISTAPwillhavetodetermineaformalevaluationprocessandimplementthisprocessaspartofthelaunchofthisstrategicplan.

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EnvironmentalScan

Anenvironmentalscanisaprocessofcollecting,analyzinganddistributinginformationfortacticalandstrategicpurposes.Thepurposeofanenvironmentalscanistoprovidestrategic intelligence by evaluating potential significant environmental trends andchanges. It gathers factual and subjective information from internal and externalsources to enable adaptive planning before trends are fully developed. Informationgathered may be in terms of issues, expectations, events, organization abilities,infrastructure,humanresources,structure,systemsandimpact.

ISTAPStrategicPlanningEnvironmentScan• Globalhealthcareenvironmentiscostconstrainedwithlowresourcesavailabletodevelopandimplementnewprograms

• Workingtowardsdefiningthepercentageofpopulationatriskofskintearsinthefollowingareas:o Agingpopulationgloballyo Acute/criticallyillindividual’so Neonateo Chronicallyillindividual’s

• Thereisaneedforresearchdataonskintearriskfactors

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• Theglobalcostimpactofskintearsneedstobedetermined• Peopleneedtobeawareofskintearpreventionandmanagementinordertoreduceandimprovecare(patientenablerrequired)

• NeedWHOICD-11codeforskintears• Thereisnostandardizedwayofreporting/documentingskintears-skintearsbeingreportedwheninfact-itisastage2pressureulcer

• Thereisaneedforacommonlanguagetodescribeskintears• STARversusPayneMartinversusISTAP-howiseachdifferentiated?• SkinTearResearchhasbeencompletedinJapan,AustraliaandNewZealand• Thereisaneedtobundleskintearswithotherskinandwoundtypesinordertoraiseawareness

• ISTAPgeographicalrepresentationischallengingwithdifferentlanguagesspokenandgeographicaldistance-thereisaneedtomeetthroughelectronicmeans

• ISTAPdoesnothaveafundingmodeltosupportlongtermsustainability

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StrategicInquiryandtheSOARApproach

Appreciative inquiry was used in the ISTAP strategic planning process. The SOARapproach(Strengths,Opportunities,AspirationsandResults)toenvironmentalscanningwas used as a part of the ISTAP Strategic Planning Session. SOAR analysis is derivedfromappreciative inquiry,which involves thediscoveryofwhat gives life to a systemwhenitismosteffectiveandconstructivelycapableineconomic,ecologicalandhumanterms.

Itisalsoaprovenapproachforgeneratingnewenergyandideasfororganizations.

WhenconductingaSOARanalysis,thebasicquestionstobeansweredare:

Whatareourgreateststrengths?Whatareourbestopportunitiesgoingforward?Whatisourpreferredfuturethatweaspireto?Whatarethemeasurableresultsthatwilltelluswe’veachievedthatvisionofthefuture?

Cooperrider,D;Whitney,D;andStavros,J.(2003).AppreciativeInquiryHandbook:TheFirstinaSeriesofAIWorkbooksforLeadersofChange,LakeshoreCommunications,Cleveland,OH.

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ISTAP“SOAR”

Strengths Opportunities Aspirations Results

• Committedpanelmembers

• Internationalstrategyforskintears

• CompletionofISTAPToolkit

• RecognitionbyWUWHSasaglobaladvisorypanel

• Completedresearchstudies

• Educationprogramimplementationtoraiseawareness

• Formpartnershipforbusinessmanagement

• Formalizegovernancestructure,rolesandaccountability

• HavecentrallylocatedexpertiseinskintearsthroughISTAP

• Diversifyrevenuestreams

• Positionskintearsasa

• BecomeaformalglobalInterestGroupwithbusinessmanagement

• Expandtheglobalvoice&brandofISTAP

• Continueresearch&educationtocreateaworldwithoutskintears

• Expansionofbestpracticerecommendationsforskintearsglobally

• Advocateforbetterskintearprevention&management

• AstrongeconomicbasethroughsoundpracticesinsupportofISTAPgoals.

• SuccessionplanningfortheISTAPPanel

• Buildhighqualityprograms&toolstomeettheneedsofhealthcareprovidersglobally

• Ensurebridgebetweenresearch&clinicalpractice

• GlobalrecognitionofISTAP&SkinTearawareness

• Buildcapacitytosuccessfully

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pandemic–showwherethisfitsin-NPUAPgettingattention

• Collaborationthroughbuildingpartnershipsthroughinter-professionalpractice

• Bundleeffectivelywithotherwoundtypes

• WHOICD-11codeforskintears

• Standardizedskintearreporting

implementsolutions

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OutcomeofSOARAnalysis

Theanalysisof informationgathered includingtheSOARanalysis ledtothe identificationofFourStrategic Pillars. The pillars which were used as guidelines in the Board Strategy Session were:

ShapingtheISTAPagenda

Formalizegovernance&

strengthenISTAP

Potentialkeyinitiatives,

programs&tools

FocusonCollaboration

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ShapingTheISTAPAgenda

ISTAPDIRECTION:Themissionandvisionof ISTAPwere revisited toensure relevanceandroleclarity.EffortsshouldbeundertakentomakeISTAPandtheroleoftheISTAPPanel well known to all wound care providers, academics, researchers, patients andfamilies as well as to the general public. This is a significant strategy andcommunicationspieceforISTAP.

INTERNATIONALVOICE:Advocacy initiativesof ISTAP should include takingapositiononvariousaspectsofskintearsandinfluencingadministrators,researchers,politiciansandotherdecisionmakers.ThevoiceofISTAPisneededat importanttables–quality,health equity, research, education, work environment, patient advocacy and leadingsystemchange.

HEALTHSCIENCETRENDS:Skin tearsarean internationalpandemicwhichcan lead topatientsuffering,co-morbiditiesandincreasedcoststothehealthsystem.Strategiesforpreventing and or managing skin tears are challenges that ISTAP can contribute tosignificantly. For ISTAP, this should lead to accelerating the development of evidenceinformedbest practice recommendations, and education aswell as partnershipswithalignedgroups.

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PARTNERSHIPS:Collaboration isvital for ISTAPtohavefull impact. ISTAPshouldfocusattentionondetermining organizations thatwould provide themost synergy.Naturalallianceswouldbewithwoundcareexperts,alliedhealthprofessionalsandeducationalinstitutionsaswellasspecificfocusorganizationslikeWUWHS,NPUAP,EPUAP.

INCLUSIVENESS: ISTAP is changing and the delivery of care to patients at risk for orexperiencing skin tears. ISTAP can find ways to work with these groups in thedevelopmentofbestpractice recommendations thatcomplement theirareas. Itcouldalso consider inviting key organization leaders to become members of ISTAP in thefuture.

FormalizeGovernanceandStrengthenISTAP

LAUNCH A FORMAL GOVERNANCE STRUCTURE: ISTAP needs to work together todevelop the rightgovernancestructure to support Internationalefforts.This structureneeds to identify the panel positions – the number of panelmembers and executivepositionsrequiredandwhichgeographicalareasshouldberepresented.

SUCCESSION PLANNING: Part of an overall leadership development strategy shouldinclude an approach for attracting members to serve on the ISTAP Panel. It should

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createasuccessionplanforISTAPpanelandcommitteeswithappropriatetrainingandsupport.

ONGOING ENGAGEMENT:Clearly define the role of the past president and outgoingpanelmembersiftheystillhaveaninterestinparticipatinginISTAPinanongoingbasis.

SUPPORTPROJECTS: Identify resources to support projects and initiatives in order tomaximizevaluetostakeholders.Thismayinvolvetheincreaseduseoftechnology.

CONFERENCE: ISTAP needs to determine the best approach to an educationalconferenceasasignificantareaof success thatengagespeople, informsandbrings inrevenue.ThereneedstobemorediscussionandplanningastothebestapproachtoanISTAPConferenceandwhatthiswouldlikelikeforthefuture.

POLICYDEVELOPMENTCAPACITYBUILDING:Toensurethat ISTAPcantakeaplaceatinfluential tables, initiatives should be undertaken to increase the capacity of ISTAPPanelmemberstoengageinpolicyanalysisanddevelopment.

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PotentialKeyInitiatives,ProgramsandTools

BESTPRACTICERECOMMENDATIONS:DevelopmentofbestpracticerecommendationsforskintearsisanareathatISTAPneedstopursueonanInternationalbasis.Inordertosupport safe andeffectivepatient care, best practice recommendations for skin tearsneed to be available to healthcare professionals Internationally. Evaluation planningand protocols should be developed for the implementation of Best PracticeRecommendationstoensureclinicalrelevancegoingforward.

EXPANDING PRACTICE LEADERSHIP: ISTAP Best Practice Recommendations will belooked upon favourably by many countries around the world. This provides anopportunity for future partnerships, goodwill and global influence in skin tearprevention and management that should be explored. It could also be a source ofrevenuethroughpublications,educationalworkshopsandrelatedmaterials.

EDUCATION:Theeducationalsessionsthathavebeenprovidedby ISTAPtodatehavebeen well Internationally and should be expanded. Also, partnerships with alignedhealthcareeducationprograms, forexample,nursing/medicalprograms inUniversitiesshouldbepursuedespeciallywhentheirscopeexpandsInternationally.

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CERTIFICATION: ISTAPshouldexplore theopportunity tohavequestionsonskin tearsaddedtoexistingcertification/CEUprogramsfornursesinternationally.ISTAPeducationcouldhelptosupportpreparationforwritingtheexaminthefuture.

EVALUATION & RESEARCH: A component of education should include training forhealthcare professionals in evaluation and research that is clinically relevant.Researchersneedtoconnectstronglywithhealthcareprofessionalsworking inclinicalareasinordertochangepractice.

PROGRAMSANDTOOLS:ISTAPneedstoidentifyandprioritizetheprogramsandtoolsrequired to translate knowledge from research into the clinical areas to impact thepreventionandmanagementofskintears.ISTAPhasdevelopedanassessmenttoolthatneedstobeexpandedinternationallythroughafocusedimplementationstrategy.

FocusonCollaboration

PARTNERSHIP GROWTH: While there has been a good foundation built in ISTAPpartnerships,thereneedstobeafocusonexpandingandbuildingstrongpartnershipswithalignedorganizations.Thereisaneedtodemonstratetherealbenefitsandvalue

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of partnering with ISTAP. Special efforts should continue to attract inter-professionalhealthcareproviderswhocanbenefitwithskintearknowledgeinordertoreduceandorimprovethemanagementofskintears.

MENTORING: There is an opportunity for an International ISTAP Panel membermentoringinitiativewhichneedstoincludedecisionmakingprocessesandgovernance.ThiswillrequireleadershipfromtheISTAPExecutive.

INTERPROFESSIONALCARE: ISTAPneeds to influence inter-professional strategiesandpracticesinsupportofallhealthcareproviderscaringforpatientsatriskfororwhoareexperiencingskintears.ISTAPmustemphasizetheirvitalroleanduniquecontributionintheprovisionofsafeandeffectivepatientcare.

THENEXTGENERATION:Strategiesshouldbedevelopedtoattractstudenthealthcareproviders to ISTAP. This should include sharing programs and tools with UniversityNursingandorMedicalprograms.

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ISTAPGoalsandObjectivesFlowChart

ISTAPMissionStatementTheInternationalSkinTearAdvisoryPanel(ISTAP)isanInter-professionalcollaborationdedicatedtoimprovingoutcomesforindividualsatriskofand/orexperiencingskintearsacrossthecontinuumofcarethrougheducation,research,andadvocacy.

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Goal#1 Goal#2 Goal#3

Buildeducationplatform ExpandSkinTearResearchfocus Raiseawarenessaboutskintearsgloballythroughadvocacy

Objectives Objectives Objectives

Develop&launchabiennialISTAPconferenceLaunchaELearningPlatformTargetUniversities/CollegeswithSkinTearinformationfortheircurriculumDevelopment/anadaptationofskintearBestPracticeRecommendationsTrademarkISTAPtosecurename

Cochranereviewonskintears–DimitriwillleadSurveywhattheglobaltermsthatareusedforskintearsandpublishonit–movetowardsstandardnameforskintearsLeadingthedevelopmentonqualityindicatorsofskintearsContinueprevalenceofskintearswithnursingstudentsOnerunningtrialonpreventionortreatmentofskintearsiereplicatetheAustralianstudy–

GlobalrecognitionofSkinTearsWHOICD-11-codeContinueISTAPeducationaltalksatInternationalwoundcareconferencesDeveloparepositoryofpatientinformationwherepeoplecangotogetinformationDevelopconsumereducationinformation–publishinjournals&

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DevelopInternationalSkinTearBestPracticeRecommendation–CAETisinterestedinpartneringforaCanadianSkinTearBestPracticeGuidelines

cantwicedailymoisturizerchangeoutcomesofskintears

newspapersBundleskintearinformationwithfalls,pressureulcersandIADandotherwouldtypesRedevelopISTAPwebsite&setupsocialmediastrategyAdvocateWUWHStoworkonajointpositionstaten]mentdocumentdocumentonskintears(Molnlyckeinterestedinsupporting

ISTAPStakeholders

Who?

Inform

Consult

Involve

Collaborate

Empower

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Whataretheirvalues?

Whataretheirloyalties?

Whataretheirlosses?

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ISTAPStakeholders

Objective:BuildISTAPawarenessinordertodisseminateknowledgeandimprovepatientoutcomes.

1. Patientsatriskoforwhoareexperiencingskintears

a. Family&orpatientcaregiversinthehome2. InterprofessionalHealthcareProviderswithawoundcarefocus

1. Nurses2. Physicians

a. Geriatriciansb. Dermatologistsc. GeneralPractitioners

3. Physiotherapists4. Pharmacists5. Podiatrists(USA)6. Chiropodists(Canada&UK)7. PersonalSupportWorkers

3. Administrators,Government,PolicyMaker

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ISTAPCollaborativePartnersObjective:Buildpartnershipswithalignedorganizationsinordertotransferknowledgeandimprovepatientoutcomes.1. PressureUlcerStakeholders

a. NPUAP,EPUAP,PPPIA2. WUWHS3. WOCN,CAET,WCET4. WoundCareAssociations

a. AAWCb. CAWCc. EWMAd. AWMAe. ETRSf. TissueViabilityNurses

5. DermNursesAssociation6. PediatricInternationalSociety7. GerontologicalAssociation

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ISTAPGovernance

“Settingtherightprocessforeffectivedecisionmaking” Governance has to do with decision-making rights—who makes which decisions andunderwhat circumstances. It also requires a framework or some structure to ensureaccountability.Andlastly,governanceisoutcome-driven; ithasasitsgoalencouragingcertainbehavior(and,byimplication,discouragingotherbehavior).Governance is also about overseeing the success of ISTAP. It is about agreeing onpriorities and monitoring progress towards them. Governance is about providingconstructivesupportandchallengetoleadersandmanagerstoenablethemtodotheirjobtothebestoftheirability.ISTAP must establish an infrastructure which has have high expectations of panelmembersto:• setthevision• establishstrategicdirection• promotehighstandardsofachievement• appointamanagementorganization(CAET)andholdthemaccountablefor supportingtheperformanceofISTAP

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• overseethefinancialperformanceofISTAPmakingsuremoneyisbroughtintoISTAPandspenttosupportthemission

GoodGovernanceLeadstobetterdecisionsDecisionsthatareinformedbygoodinformationanddata,bystakeholderviews,andbyopenandhonestdebatewillgenerally reflect thebroad interestsof thecommunity.This does notassume that everyone will think each decision is the right one. Butmembersofthecommunityaremore likely toaccepttheoutcomes if theprocesshasbeengood,eveniftheydon’tagreewiththedecision.Theywillalsobelesstemptedtocontinuefightingorattemptingtooverturnthedecision.Soeventhemostdifficultandcontroversialdecisionsaremorelikelytostick.ISTAPGovernanceStructurePosition Term LaunchdateandTermExecutive PastPresident 1year January1,2017–December31,2017

andthenoffPresident 2years January1,2017–December31,2018

andthenmovestoPastPresident

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Treasurer 2yearswith2yearrenewaloption (staggeredpositionforISTAPGovernancelaunch)January1,2017toDecember31,2017–firsttermthencanrenewfor2018-2020

Secretary 2yearswithatwoyearrenewaloption

January12017–December31,2018andthencanrenewfor2018-2020

InternationalPanelMembers

UnitedStates 2yearswith2yearrenewaloption January12017–December31,2018andthencanrenewfor2018-2020

Canada 2yearswith2yearrenewaloption January12017–December31,2018andthencanrenewfor2018-2020

Europe 2yearswith2yearrenewaloption January12017–December31,2018andthencanrenewfor2018-2020

UnitedKingdom 2yearswith2yearrenewaloption January12017–December31,2018andthencanrenewfor2018-2020

LatinAmerica 2yearswith2yearrenewaloption (staggeredpositionforISTAPGovernancelaunch)January1,2017toDecember31,2017–firsttermthencanrenewfor2018-2020

Australia/NewZealand

2yearswith2yearrenewaloption (staggeredpositionforISTAPGovernancelaunch)January1,2017toDecember31,2017–firsttermthen

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canrenewfor2018-2020Asia 2yearswith2yearrenewaloption (staggeredpositionforISTAP

Governancelaunch)January1,2017toDecember31,2017–firsttermthencanrenewfor2018-2020

Africa 2yearswith2yearrenewaloption (staggeredpositionforISTAPGovernancelaunch)January1,2017toDecember31,2017–firsttermthencanrenewfor2018-2020

ISTAPFirstElectionSlate:September2017# Name Position Country Governance

ProcessTerm

1 KimberleyLeBlanc

President Canada Appointment 2017-2019-1yearpastpresident2019-2020

2 KarenCampbell PresidentElect Canada Appointment 2017-2019–President2019-2021-PastPresident2021-2022

3 SharonBaranoski

PastPresident UnitedStates Appointment 2017-2018

4 AnnWilliams Treasurer UnitedStates Appointment 2017-2018–2yrrenewal

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option2018-20205 DianeLargemo Secretary UnitedStates Appointment 2017-2019-2yrrenewal

option2019-20216 MaryGloeckner PanelMember UnitedStates Appointment 2017-2019-2yrrenewal

option2019-20217 KevinWoo PanelMember Canada Appointment 2017-2019-2yrrenewal

option2019-20218 Dimitri

BeeckmanPanelMember Europe Appointment 2017-2019-2yrrenewal

option2019-20219 Samantha

HollowayPanelMember United

KingdomAppointment 2017-2019-2yrrenewal

option2019-202110 3candidates:

CarolynCarville,Anne-MarieDunk,NellieNewall

PanelMember Australia Appointment 2017-2018–2yrrenewaloption2018-2020

11 ?fromJapan PanelMember Asia Appointment 2017-2018–2yrrenewaloption2018-2020

12 Tobedetermined

PanelMember Africa Appointment 2017-2018–2yrrenewaloption2018-2020

13 VeraSantos PanelMember LatinAmerica Appointment 2017-2018–2yrrenewaloption2018-2020

ElectionSlate:ISTAP(September2016)(yellowandbluein#columnindicateturnover)

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ProposedConceptforISTAPOrganizationalStructure

ISTAPPanel

Stakeholders

CAET

CorporatePartners

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ISTAPStrategicBusinessDevelopment2016-2020CurrentBusinessManagement:2016

ISTAPisanofficialinterestgroupoftheCanadianAssociationforEnterostomalTherapywithathree-yearpartnershipagreementinplacewhichterminatesBenefitstoISTAP:(asInterestGroupofCAET)

• Businessmanagement/Custodyoffunds• StrategicPlanningsupport• Credibility• Managementoffunds• Communications–linktoCAETwebsite-accesstoCAETEBlasts• DataBaseaccess–askCAETmembersiftheywanttobeapartofISTAP/ISTAPresearchprojects&education

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• Evaluationandfollowup–sustainabilityBenefitstoCAETtohaveISTAPasanInterestGroupPositionsCAETasaleaderandcollaborator

• Internationalrecognitioninimprovingpatientoutcomes• Expandeducationaloffering-webinars• ProvideCDNETN’swithopportunitiesinresearch&education• PositonsCAETinanotherareaofexpertise• BRINGSVALUETOMEMBERS-providesopportunitiestoETNurses

• accesstoparticipateandhaveaccesstothemostcurrentinformationonskintears

• ProvidesresearchopportunitiestoETNurses• RaisestheprofileofETNursesasexperts• ValuetoCorporatesponsors

• ISTAPisnota“notforprofit”• ISTAPisanInternationalInterestGroupunderapartnershipagreement

withCAETandneeds:

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• Aformalstrategicplanningprocess• InternationalReach• Businessmanagement/custodyoffunds• Fundraisingmechanism/diversityofrevenuestreams• Lenstosustainability

Goal:ISTAPisanindependentnotforprofitassociationObjectives:• DevelopISTAPGovernanceandadecisionmakingprocess• FocusonfundraisingtosupportISTAPinitiatives• Diversifyrevenuestreams• Designafuturemembership/healthcareparticipationstructureforISTAP(iebiennialmeeting?)

• EstablishabusinessplantosupportISTAPasasustainable,independentorganization

• IdentifythehumanresourcesrequiredtoensurethelongtermsuccessofISTAP

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ISTAPFinancesGoal:ISTAPwillbeafinanciallyindependentandsustainableorganizationISTAPFinancialObjectives1) Establishanannualbudgetandtrackexpensesversusbudget(budgetyearwouldrunJan1-Dec31andwouldhavetobesetbyNovofthepreviousyear).

2) Identifyandbuilddiversifiedrevenuestreams.3) Developafinancialpolicyasapartoftheoperationalpolicy.

FinancialTrackingProcess:• CAETactsasthefinancialmanagerforISTAP• BookkeepingsoftwaresystemisQuickbooks• ThereisanISTAPsectionintheCAETinQuickbooks• AllrevenueandexpensesforISTAParetracked

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ExpenseApprovalProcess• ChequesarecutafterbeingapprovedbytheISTAPChairandortreasurerandtheCAETExecutiveDirector

• NofundsarereleaseduntiltheyaredocumentedinQuickbooksFinancialReconciliation• ISTASPrevenueandexpensesarereconciledmonthlywiththeCAETbankstatementsandarecheckedmonthlybythebookkeeperandExecutiveDirectorofCAET

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CurrentISTAPFinancialSituation:AsofSeptember2016Revenue Detail$600.00 movedfromQueen’UniversitytoCAETBankaccountandtrackedin

QuickbooksunderISTAP.$25,000 WUWHSCorporateSponsorship$25,600 TotalAsofSeptember2016Expense Detail$600.00 MovingtheISTAPwebsiteandrelatedfees$127.00 ISTAPbrochure$15,000.00 WUWHSworkshoptravelandaccommodation$15,727.00 Total2017ISTAPBudget;NeedstobeestablishedbyJanuary1,2017

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EstablishDiversifiedRevenueStreams

ThereisalsoIn-KindfinancialsupportformanagementfromCAET

Grants10%

Corporatesponsorship

65%

ISTAPproduct&servicessales10%

ISTAPMeeting/Confere

nce10%

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LookingintotheFutureThisnewstrategicplanallowsISTAPtobuildonit’sfoundationaleffortsandallowsforexpansion of scope into new skin tear opportunities. ISTAP must balance formalplanning of direction (with goals and targets) and needs to continually seek newopportunitiesthatwillallowISTAPtoengagequicklyanddevelopbeneficialinitiatives.Since ISTAP is engaging in a complexglobalhealthcare system, itwill benecessary tolookforareasofneedandbeabletoguidethroughbarriersandchallengestoachieveimprovedoutcomes.ISTAP is prepared to lead in advancing skin tear prevention and management. T hesuccess of ISTAP will be leveraged by partnerships with aligned stakeholders toimplementprograms/initiatives,demonstrateimprovements,andsharesuccesseswiththe skin and wound care community and beyond. ISTAP will explore becoming anindependentorganizationthatisindependentlymanagedandselffundedby2020.

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ISTAPStrategicPlanConclusion:ThisstrategicplanisatooltoguideISTAPinplanningandconductinginitiativesforthenext five years (2016-2020). ISTAP is committed to remain accountable to the globalhealthcare systems and all stakeholders by reporting on the progress and outcomesassociatedwiththisplan.Measurementandreportingwillalsobecrucialtobuildingacollectionofknowledgeandevidencetoinformfuturestrategicinitiatives.Skin tear prevention andmanagement improvement opportunities are starting to berecognizedandimplementedbydedicatedhealthcareprofessionalsandpatientsacrosstheworldeveryday–butthechallengetoraiseawarenessaboutskintearpreventionandmanagementissignificant.Thisisajourneythatneedsadedicatedorganizationandexpertsinthefieldtoultimatelybenefittheglobalhealthcaresystemandthepatientsthatweserve. Identifyingopportunitiestoreducetheriskofskintearsandto identifyand manage skin tears on those individuals who already have them need research,education and advocacy tomake an impact. ISTAP iswell on theway to leading andcoordinatingthiseffortonaglobal level.WiththeISTAPstrategicdirectionsetforthenextfiveyears,stakeholderswillactuallybeabletostartseeingskintearsbeingmorereadily identified when properly assessed and then managed more effectively withevidencebasedpractice.Therewillalsobeareductioninthenumberofskintearsasweworkedtowardsputtingstrategiesintoplaceforthosepatientswhoarehighrisk.This

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will contribute to safe and effective patient care andwill reduce costs to the healthsystem.

APPENDIX1ISTAPORALPRESENTATIONSFutureOralPresentationopportunities• EPUAPconferenceinBelfast2017(DimitriwillsubmitforISTAPtopresentasessiononSkinTears/SkinHealth)

• EWMAconference2017AmsterdamKim LeBlanc sent a letter 2 years ago asking if they would be interested inISTAPpresentingonSkinTears/SkinHealthElderly

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References1. Baggs,J.G.,&Schmitt,M.H.(1988).Collaborationbetweennursesandphysicians.Image:JournalofNursingScholarship,20,145-149.

2. Carville K, Lewin G, Newall N, et al. STAR: a consensus for skin tear classification. Prim Intent 2007;15:18-28.

3. Cooperrider,D.L.,&Srivastva,S. (1987)Appreciative inquiry inorganizational life.Research in Organizational Change and Development, Vol. 1, 129-169. RetrievedSeptember20,2004fromwww.appreciative-inquiry.org/AI-Life.htm.

4. Cooperrider,D;Whitney,D;andStavros,J.(2003).AppreciativeInquiryHandbook:The First in a Series of AI Workbooks for Leaders of Change, LakeshoreCommunications,Cleveland,OH.

5. Follet,Mary, (1940). Content fromMintzberg, H., Dougherty, D., Jorgensen, J., &Westley, F., (1996). "Some surprising things about collaboration-Knowing howpeopleconnectmakesitworkbetter."OrganizationDynamics,25(1),30-71.

6. Gray,B.(1989).Collaborating.SanFrancisco:Jossey-Bass.7. Henneman,E.A., Lee, J.L.,&Cohen, J.L. (1995).Collaboration:A conceptanalysis.JournalofAdvancedNursing,21,103-109.

8. LeBlanc K, Baranoski S; Skin Tear Consensus Panel Members. Skin tears: state of the science: consensus statements for the prevention, prediction, assessment, and treat- ment of skin tears. Adv Skin Wound Care 2011;24(9 Suppl):2-15.