New guide to reduce diabetes-related amputations
Diabetes UK has developed a new resource guide designed to encourage healthcare professionals to use root cause analysis (RCA) to help reduce the number of unnecessary diabetes-related amputations.
Up to 80% of diabetes-related amputations are avoidable but the number of amputations continues to increase and now stands at 20 a day in England.
RCA determines to what extent an amputation was avoidable or unavoidable, and whether or not it was the best possible outcome for the person with diabetes. If avoidable, completing an RCA will help identify what changes are required to reduce the likelihood of the same event happening again.
Dr Richard Paisey, Honorary Consultant and Diabetes Footcare Lead at South West Cardiovascular Clinical Network said, “Using this guide should provide each area with an accurate and up-to-date picture of the proportion of major amputations which were potentially avoidable by prompter intervention. Ultimately, using root cause analysis should highlight best practice and also facilitate follow up of missed opportunities in provision of care in each case.”
The new guide is based on the South West Cardiovascular Clinical Network’s Diabetes Foot Care Resource Pack, and is also the result of discussions with other experts including podiatrists, members of the Northern Footcare Network and a practice nurse. The guide includes a data collection template, a primary care data collection tool and a reporting template.
- DO involve the person who has had a diabetes related amputation, and their carer or family, wherever possible.
- DO inform commissioners and seek their involvement and support.
- DO monitor agreed actions.
- DO start completing RCAs as soon as possible. They will help identify areas for improvement that will help reduce diabetes related amputations.
- DON’T conduct an RCA in isolation. Involve primary, secondary and community services to get a full picture of the events that led to the amputation.
- DON’T focus the RCA on one service. Areas for improvement will be identified in each service at different times.
- DON’T underestimate the support local foot care and diabetes networks can provide. Link with these networks to share learning, problem solve, identify trends and support each other to improve services across regions.
Table: The Do’s and Don’ts of root cause analysis for diabetes related amputations.