In Episode 5 of Healing By Design, hosts Jennifer Bierhup and Therese Laub are joined by wound care experts Diane Krasner, Jeanine Maguire, and Beatriz Coccaro-Word for an important conversation about skin failure, pressure injuries, and the need for greater clarity in how clinicians assess, diagnose, document, and communicate these conditions.

The discussion explores one of the most challenging questions in wound care: when is skin breakdown truly a pressure injury, and when is the skin itself beginning to fail?

Drawing from clinical experience, research, advocacy, and real patient cases, the group examines why clinicians must look beyond the wound itself and consider the whole patient. Perfusion, nutrition, mobility, chronic disease, organ failure, medications, and overall clinical decline can all change how a wound should be understood and treated.

They also discuss the difference between skin failure and unavoidable pressure injuries, the importance of accurate provider documentation, conversations with patients and families, and PAWSIC's ongoing advocacy for dedicated ICD 10 codes for skin failure.

At the center of the conversation is a shared goal: making sure the right diagnosis leads to the right care.

In this episode:

• Skin failure vs. pressure injury
• Why clinicians need to assess the whole patient
• Acute, chronic, and end stage skin failure
• Avoidable and unavoidable pressure injuries
• The role of perfusion, nutrition, organ failure, and comorbidities
• Why provider diagnosis and documentation matter
• Communicating skin failure with patients and families
• The potential impact of dedicated ICD 10 codes
• Education and implementation across the continuum of care
• PAWSIC's ongoing advocacy for recognition of skin failure

WHITE PAPER AVAILABLE SEPTEMBER 15

This episode coincides with the release of PAWSIC's new position paper on skin failure, bringing together the evidence, clinical perspective, and rationale behind the need for greater recognition and dedicated coding of skin failure.

The paper takes a deeper look at why accurate diagnosis matters, the implications across clinical, regulatory, and legal settings, and the work being done to move skin failure recognition forward.

Read the Skin Failure Position Paper beginning September 15:
https://pawsic.org/skin-failure-position-paper/read/

Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.

In Episode 4 of Healing By Design, hosts Jennifer Bierhup and Therese Laub sit down with wound care leader Alicia Bobak to explore one of the biggest challenges facing healthcare today: the lack of standardized wound care education.

Drawing from years of experience leading wound care programs, educating clinicians, and consulting across post-acute care, Alicia shares why education cannot stop after graduation. Together, they discuss the barriers clinicians face, including limited training, time constraints, reimbursement challenges, and the overwhelming number of products and educational resources available today.

The conversation also examines the role of collaboration, accountability, and critical thinking in wound care, emphasizing that successful patient outcomes require far more than choosing the right dressing. From nursing school curriculum to bedside decision-making, this episode challenges healthcare professionals to rethink how wound care education is taught, applied, and prioritized.

Whether you're a nurse, nurse practitioner, physician, therapist, administrator, or healthcare leader, this episode offers practical insights into building stronger clinical knowledge and improving patient outcomes through lifelong learning.

In this episode:

• Why wound care education lacks standardization
• The education gap in nursing and medical training
• The importance of interdisciplinary collaboration
• Common barriers clinicians face, including time and reimbursement
• Why critical thinking matters more than dressings alone
• AI, templates, and the future of wound care education
• Building accountability through lifelong learning
• Improving patient outcomes through better education

Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.

What can healthcare providers learn when they stop talking and start listening to the patient?

In Episode 3 of Healing By Design, hosts Jennifer Bierhup and Therese Laub sit down with Joe Balusik to discuss his journey following a spinal cord injury that changed his life overnight. After decades of living with paralysis and navigating chronic wounds, Joe shares the lessons he's learned from both the patient chair and the healing journey that followed.

Joe reflects on rebuilding his life, overcoming pressure injuries, and the partnership he developed with his wound care team. Through humor, resilience, and honesty, he offers a perspective that every clinician, caregiver, and healthcare leader should hear.

Together, they explore the importance of patient engagement, communication, trust, and why successful wound healing depends on treating the whole person, not just the wound.

This conversation is a powerful reminder that the patient perspective is one of the most valuable tools in healthcare, and that healing happens best when patients and providers work as one team.

In this episode:

• Joe's spinal cord injury and life changing diagnosis
• Living with paralysis and chronic wounds
• The patient perspective on wound healing
• Building trust between patients and providers
• The role of communication and education in healing
• Resilience, humor, and maintaining hope
• Why healing is a partnership

Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.