Diabetic Foot Care Project Aneurin Bevan Health Board

Diabetes affects about 20% of patients treated at the participating hospital and acute foot problems are the most common reason for diabetes-related admission to hospital.

The team developed process and outcome measures to track improvement, including:

• a review by the diabetes foot team within 24 hours of admission
• engaged staff members to take an active role in quality improvement
• provision of an information checklist to A&E team
• assessment by a diabetes nurse of the suitability of the patient to self-administer insulin and monitor blood glucose
• better communication between teams
• better staff engagement and feedback.

The main changes were implemented using the Institute for Healthcare Improvement (IHI) Model for Improvement and small tests of change that could be spread once they had been shown to be reliable in the pilot areas.

Who was involved?

The team had representation from both clinical and non-clinical staff. In addition, initial shadowing work showed the importance to these patients of catering staff, porters and domestics, so representatives from these groups were also included on the working group.