• Run by the Diabetes Team at Aneurin Bevan Health Board in Wales.
  • Aimed at developing a pathway to excellent care experience for patients admitted to hospital with an acute diabetic foot problem.
  • Particularly focused on ensuring improvements were based on an understanding of the service through the patient’s eyes.
  • Data was collected between April and September 2013.

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. 

Further reading

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