Development of Care System for Foot Ulcer Prevention in Persons with Diabetes

Abstract

Development of care system for foot ulcer prevention in persons with diabetes in collaboration with the multidisciplinary team and health promoting hospital in the health service network was done using 4 steps of Deming cycle (PDCA: Plan, Do, Check, and Act).  The development process were: 1) Plan, the plans for revising databases of diabetes patients registry information system, and setting up of diabetic foot clinic, and appointment system in special clinics were developed; 2) Do, implementation of developed plans into practice were done; 3) Check, evaluation of practice, policies, and problems and obstacles for implementation were checked: and 4) Act, solving problems for implementation, policies and obstacles found in steps three, such as revising foot assessment practice guidelines for the high risk groups, foot care management, and setting up funding to support patients who do not meet the criteria for health insured.  Outcomes: results of the developed care system revealed that there were reduction of numbers of diabetic foot, and cost of care.  Both of health personnel and clients were satisfied with the reoriented care system. Suggestion from this lessons’ learned can be applied to develop the care system for foot ulcer prevention within the similar contexts.