Establishing clinically meaningful and comparable KPI's for diabetes foot care services
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Authors: Bolton,T.;Nube,V.;Veldhoen,D.;Molyneaux,L.;Constantino,M. I.;Mcgill,M.;Wu,T.;Twigg,S. M.
Start Page: A165
A lack of standardised reporting in diabetic foot disease outcomes limits benchmarking of services. This study aimed to develop clinically meaningful service key performance indicators (KPI’s) by retrospectively examining systematic data collected in our High Risk Foot Service. A 4 year interval audit of patients with diabetic foot ulcers (DFU) with 2 yrs follow-up was undertaken: 492 pts with 1564 DFU attended with a mean 3.2 DFU/pt. Mean age was 65.4Â±13.3 yrs, diabetes duration 15.5 (range 9.1-22.6) yrs, 72% were male and 55% anglo-celtic; at follow-up 13% of pts had died, and 15% were referred elsewhere. Ulcer severity by Texan Grading showed 34% were infected, 13% ischemic, and 20% both infected and ischemic. Most were superficial (71%), 9% to tendon and 6% to bone. Time to presentation was 0.4 (0.1-1) months with new pts delayed to 1.0 (0.5-2.1) months. Ulcer healing was 86% with a median 1.7 (0.8-3.6) months. The other 14% required amputation, mainly minor. Re-ulceration (any location) was 66%, and 34% pts had more than 1 DFU averaging 4.3 past DFU. Based on these data, Fig. 1 indicates our proposed minimal dataset of Primary and Secondary KPIs. These KPIs include items linked to healing and re-ulceration and to local service factors, they are comprehensive and compare favorably with available published data. We recommend the KPIs be considered in reporting to aid benchmarking in diabetes foot care services. (Figure Presented).