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PodCast: A rural and regional service model for podiatrist‐led total contact casting

journal contribution
posted on 03.08.2021, 02:51 by Adam McLean, Marcus GardnerMarcus Gardner, Byron PerrinByron Perrin
Problem: Diabetes-related foot disease causes significant health system costs and is a leading cause of morbidity and disproportionately affects rural populations. Total contact casts or instant total contact casts are gold standard for management of foot ulcerations resulting from diabetes-related foot disease. The aim of this study was to evaluate the impact of a podiatrist-led casting service model within a rural and regional setting. Design: The implementation of the service model was evaluated over a 12-month period using a quality improvement approach, informed by multiple methods. Quantitative and qualitative methods were used. Setting: An outpatient high-risk foot clinic and community-based podiatry services within a large regional health service. The location was central Victoria, servicing rural communities within the Loddon Mallee region. Key measures for improvement: Patient-related data included information relating to demographics, diabetes and foot pathologies. Service-related data included occasions of service, locations and the number and type of casts applied. Strategies for change: Upskilling podiatrists to provide the service in a safe, supportive and sustainable manner and ensuring the podiatrist-led casting service model was sufficiently adaptable for patients to access at the rural sites. Effects of change: Increased access to total contact casts and instant total contact casts, comparable wound healing times to other studies and the model was able to be sustained. Lessons learnt: Podiatrist-led casting resulted in increased utilisation of total contact casts and instant total contact casts. The increased use of instant total contact casts in particular may help address the lack of uptake of this treatment for people with diabetes-related foot disease, thereby improving rural health outcomes.

Funding

Funding was provided, in part, by the Victorian Department of Health and Human Services.

History

Publication Date

01/01/2019

Journal

Australian Journal of Rural Health

Volume

27

Issue

5

Pagination

5p. (p. 433-437)

Publisher

Wiley-Blackwell

ISSN

1038-5282

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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