NDEP | National Diabetes Education Program

Quality of Care Measures

Clinical Documentation

Measures

The following should be documented in the medical record:

Results of the annual comprehensive foot examination including risk assessment.
Results of the visual foot inspection.
Occurrence of patient education.

Short-term Impact: A successful program will show an increase in the percentage of the population with diabetes for whom the following is documented:

A comprehensive foot exam and risk assessment in the past year.*
A visual foot inspection at each routine visit in the past year.
Foot care education in the past year.

A survey could be conducted to ask patients to report when they last had a sensory test, foot inspection, and self-care education in the past year.

Intermediate-term Impact: A successful program will show a decrease in the incidence of hospital admissions or emergency room visits for lower extremity infections, osteomyelitis, and ulcerations.

Long-term Outcomes: A successful program will show a decrease in the incidence of distal and proximal lower extremity amputations.

* This is the only action needed for providers to be in accord with the foot care component of a current set of national quality improvement measures. The Diabetes Quality Improvement Project (DQIP) is a collaborative effort to improve diabetes care and the quality of life for people with diabetes. DQIP uses a set of eight performance measures for diabetes, one of which specifies that “an annual foot exam for adults with diabetes” be documented.

Numerous public agencies (the Department of Defense, the Health Care Financing Administration, the Indian Health Service, and the Veterans Health Administration) and private groups (the American Diabetes Association Provider Recognition Program and the National Committee for Quality Assurance) are using some or all of the DQIP measures.

Includes information about managing the ABCs of Diabetes. Also features information for people with diabetes who are eligible for Medicare benefits.
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