save a leg: building integrated diabetes foot …...education infographic flyer on diabetes foot...
TRANSCRIPT
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Save A Leg: Building Integrated Diabetes Foot Services in Western Sydney
Clare McGloin Senior Podiatrist Blacktown & Mt Druitt Hospitals WSLHD
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Case for Change
If you live in Western Sydney you are 2 -3 times more likely
to develop Diabetes
50% of people in our LHD are at risk of developing Diabetes 15% of people have Diabetes
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Summary of Key Solutions
• Solution 1 : Development & Implementation Of Two Stage Diabetes Foot Screening Tool
• Solution 2 : Practice Nurses to provide Diabetes Foot screening
• Solution 3: Electronic Referral Templates and Pathways
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Implementation of changes NEW! 60 second Minimum Standard Screening Tool
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Implementation of changes Education infographic flyer on diabetes foot facts and care
Monofilament
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Implementation of changes Electronic referral template to HRFS Clinics
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Summary
• Save A Leg developed a 60-second diabetes foot screening tool
• Educated patients, nurses and clinicians on the importance of using the tool and conducting regular foot checks at least annually.
• Electronic referral templates and clinical pathways were also developed, to facilitate the improvement of timely access to hospital foot services.
• Areas to improve:
– Roll out of implementation to wider community in Western Sydney
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Blacktown & Mt Druitt HRFS Team
• Podiatrist – Clare McGloin • Wound Care Nurse –Stacey Harrison, Lesley Jack • Diabetes Educator – Sian, Sonya, Annette (IC) • Dietitian – Sonia, Amber (IC) • Vascular Surgeon – Tom Daly, Mark Malouf, Vascular Fellow
(theatres BDH, WMH, Mt Druitt, private) • Endocrinologist – Rajini Jayaballa (IC) • ID Consultants – Shobini Sivagnanam, Ravi Dotel • Administration – Steve (Therapies), John Cruz (IC)
IC = Integrated Care
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Blacktown & Mt Druitt HRFS Clinics
• Podiatrist Mon, Wed, Thurs, Fri
• Wound Care Nurse weekly Wed Ulcer Clinic
• Diabetes Educator weekly Wed
• Dietitian weekly Wed (not co-located)
• Vascular Surgeon fortnightly Wed
• Endocrinologist weekly Wed
• ID Consultants weekly Wed (afternoon clinic)
• Administration Mon-Fri (Steve no co-located)
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Progress in 2016
• Silhouette camera (July)
• Outreach to Mt Druitt (July)
• Increase in Podiatry to full time service
• Wound CNC (September)
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Potential opportunities in 2017
• Additional Surgical time
• Endovascular services at BDH
• Ulcer Clinic weekly (medical support)
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Summary
• The HRFS at Blacktown meets the minimum or best practice standard for most of the NSW ACI High Risk Foot Services Standards
• Areas to improve:
- Formal mechanism to identify patients who present to ED
- Obtain allocated space to meet OH&S standards
- Access to computerised gait analysis and in-shoe pressure analysis
- Maintain an electronical database and monitor KPIs