Diabetes-Related Foot Care at 10 Veterans Affairs Medical Centers: Must Do's Associated with Successful Microsystems

Authors: Wrobel, James S.; Robbins, Jeffrey M.; Charns, Martin P.; Bonacker, Kristin M.; Reiber, Gayle E.; Pogach, Leonard

Source: Joint Commission Journal on Quality and Patient Safety, Volume 32, Number 4, April 2006 , pp. 206-213(8)

Publisher: Joint Commission Resources

Key:
Free Content - Free Content
New Content - New Content
Subscribed Content - Subscribed Content
Free Trial Content - Free Trial Content

Abstract:

Background: Well-coordinated interdisciplinary preventive foot care has been reported to significantly reduce diabetes-related foot ulcers, amputations, and hospitalization. However, the contribution of the specific components leading to these "successes" is not fully characterized. The microsystem conceptual framework was adapted to foot care to determine which of the microsystem success characteristics were associated with decreased major lower-limb amputation rates at 10 Veterans Affairs (VA) medical centers.

Methods: Two-day site visits were conducted using standardized interviews at the 10 VA medical centers.

Results: Six "must do's" for foot care in microsystems were correlated at ≥(−.30) with amputation rates: (1) addressing all foot care needs, (2) appropriate referrals, (3) ease in recruiting staff, (4) confidence in staff, (5) available stand alone specialized diabetic foot care services, and (6) providers attending diabetic foot care education in the past three years. Using multiple linear regression, the sum of these items described 59% of the variance (p = 0.006).

Discussion: Clinicians and managers may want to include the must-do's in system modifications to improve foot care for people with diabetes. Many of the sites displayed exemplary features in foot care, such as providing a formal orientation to the foot care clinics.

Document Type: Research article

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$20.00 plus tax      Refund Policy

 

OR

Back to top

Key:
Free Content - Free Content
New Content - New Content
Subscribed Content - Subscribed Content
Free Trial Content - Free Trial Content
Share this item with others: These icons link to social bookmarking sites where readers can share and discover new web pages.
Page Help Click here for Page Help
Shopping cart
Tools
Sign in






Need to register?
Sign up here
Text size: A | A | A | A