title: Improving the efficiency and effectiveness of performing the diabetic foot exam.
abstract: Microvascular complications of diabetes can result in peripheral neuropathy and impaired sensation in the feet. These issues can significantly affect morbidity and quality of life. Regular foot exams play a major role in early detection of foot problems and may help prevent amputations. An initial review found that a comprehensive diabetic foot exam (CDFE) was documented 13.5% of the time. A quality improvement effort combined provider and staff education, a standardized documentation form, an electronic reminder, and a well-defined process to improve the frequency and completeness of diabetic foot exams. After the intervention, 44.5% of CDFEs found in dictated notes lacked at least 1 component of the exam, whereas less than 4% of charts using a standardized form lacked documentation of any part of the foot exam. These efforts demonstrate the benefit of engaging providers and staff in a quality improvement initiative to increase consistency and frequency of documentation of annual CDFEs.
authors.affiliation: Marshfield Clinic, 1000 N Oak Ave, Marshfield, WI 54449, USA. praxel.theodore@marshfieldclinic.org
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Praxel
authors.forename: Trina J
authors.initials: TJ
authors.lastname: Ford
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Vanderboom
mesh_terms: D019985:Benchmarking; D017719:Diabetic Foot / Q000175:diagnosis*; D006801:Humans; D008485:Medical Audit; D015146:Midwestern United States; D010808:Physical Examination / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods