Implementing an Integrated Care Pathway For General Foot Screening

Vivek Bhaskaran, Royal College of Surgeons in Ireland

A proposal Submitted in Part Fulfilment of the Degree of MSC in Quality and Safety in Health Care Management Institute of leadership, Royal College of Surgeons in Ireland, Dublin 2014

Abstract

It is evident from the literature that foot problems can lead to discomfort, pain, ulceration and increased risk of falling in older people. Good and timely foot care can help individuals remain independent, active and mobile and, more importantly, prevent footwear related falls in older people. According to Age Action Ireland, the population of Ireland is ageing rapidly and the number of people aged 65 and over will rise from 532,000 in 2011 to almost 1.4 million by 2046. The Health Service Executive currently provides a range of foot care services for older people but these services are not well developed or standardised nationally. This project aims to design and implement an Integrated Care Pathway for general foot care and to improve the quality of the foot clinic services in one of the Health Service Executive nursing homes.

The HSE Change Model was used to guide the implementation of the change project and quantitative tools were used to inform the change process. Data in regards to inappropriate referrals, waiting times and documentation audit were collected prior to implementation of the change process and were used to evaluate the impact of the change process, which showed significant improvement as a result of the successful implementation of care pathway. The limitation of the project was the small data size used for evaluation. Based on the success of the change process, the implication for replicating the project was made.