Implementation strategies to overcome barriers to diabetes-related footcare delivery in primary care: a qualitative study
Leanne Mullan
A F , Karen Wynter A B C , Andrea Driscoll A B and Bodil Rasmussen A B C D E
+ Author Affiliations
- Author Affiliations
A Deakin University School of Nursing and Midwifery, 1 Gheringhap Street, Geelong, Vic. 3220, Australia.
B Centre for Quality and Patient Safety, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia.
C Western Health Partnership, 176 Furlong Road, St Albans, Vic. 3021, Australia.
D Faculty of Health and Medical Sciences, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
E Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Campusvej 55, DK-5230 Odense M, Denmark.
F Corresponding author. Email: leannemullan@hotmail.com
Australian Journal of Primary Health 27(4) 328-337 https://doi.org/10.1071/PY20241
Submitted: 13 October 2020 Accepted: 5 March 2021 Published: 7 July 2021
Abstract
The aim of this study is to identify, from the perspectives of key health policy decision-makers, strategies that address barriers to diabetes-related footcare delivery in primary care, and outline key elements required to support implementation into clinical practice. The study utilised a qualitative design with inductive analysis approach. Seven key health policy decisions-makers within Australia were interviewed. Practical strategies identified to support provision and delivery of foot care in primary care were: (a) building on current incentivisation structures through quality improvement projects; (b) enhancing education and community awareness; (c) greater utilisation and provision of resources and support systems; and (d) development of collaborative models of care and referral pathways. Key elements reported to support effective implementation of footcare strategies included developing and implementing strategies based on co-design, consultation, collaboration, consolidation and co-commissioning. To the authors’ knowledge, this is the first Australian study to obtain information from key health policy decision-makers, identifying strategies to support footcare delivery in primary care. Implementation of preventative diabetes-related footcare strategies into ‘routine’ primary care clinical practice requires multiparty co-design, consultation, consolidation, collaboration and co-commissioning. The basis of strategy development will influence implementation success and thus improve outcomes for people living with diabetes.
Keywords: primary health care, diabetic foot, diabetes, prevention, Australia, foot disease, policy.
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