Early Identification and Referral of Patients With Diabetic Foot Complications in the Emergency Department.

BACKGROUND

Prolonged length of stay (LOS) in the emergency department (ED) and lack of post-ED follow-up pose a risk of worsening infection and amputation among patients with diabetic foot complications.

LOCAL PROBLEM: Excessive ED LOS posed a risk of delayed foot care, and triage providers underutilized post-ED telehealth referrals.

INTERVENTIONS: A graphic icon on the ED dashboard, nurse-initiated order set, and staff education were implemented.

METHODS

A pre-/postimplementation design was used. Outcomes included usage of the graphic icon and order set, ED LOS, and telehealth referrals.

RESULTS

Use of the graphic icon and order sets significantly increased ( P < .001). The rate of telehealth referrals upon discharge also increased but was not significant ( P = .086). Interestingly, LOS increased after the intervention.

CONCLUSION

Using the graphic icon and order set can streamline patient referral to telehealth care. Various factors lead to an extended LOS.