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.
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