Table 3 List of quality indicators per domain, developed from evidence-based interventions identified through a scoping review
Domain: Organization of care | |||||
Intervention | Indicator | Numerator/Denominator | Level of care | Indicator type | |
Introduction of multidisciplinary foot care | 1 | Proportion of people with a diabetic foot ulcer receiving multidisciplinary foot care | Numerator: The number of people with a diabetic foot ulcer receiving multidisciplinary foot care Denominator: The total number of people with a diabetic foot ulcer | Hospital National | Structure |
Integration of a podiatric specialty in the multidisciplinary foot care team | 2 | Proportion of people with diabetic foot ulcer receiving multidisciplinary foot care with an integrated podiatric specialty | Numerator: The number of people with a diabetic foot ulcer receiving multidisciplinary foot care with an integrated podiatric specialty Denominator: The total number of people with a diabetic foot ulcer | ||
Implementation of a care management program for diabetic foot | 3 | Proportion of people with a diabetic foot ulcer treated within the context of a care management program for diabetic foot | Numerator: The number of people with a diabetic foot ulcer treated within the context of a care management program for diabetic foot Denominator: The total number of people with a diabetic foot ulcer | National | |
Implementation of a Pay-for-Performance program | 4 | Proportion of diabetic foot clinics that participate to a pay-for-performance program | Numerator: The number of diabetic foot clinics that participate to a pay-for-performance program Denominator: The total number of diabetic foot clinics | National | |
Implementation of nurse-led care | 5 | Proportion of people with a diabetic foot ulcer receiving nurse-led care | Numerator: The number of people with a diabetic foot ulcer receiving nurse-led care Denominator: The total number of people with a diabetic foot ulcer | Hospital National | |
Domain: Wound healing interventions | |||||
Intervention | Indicator | Numerator/Denominator | Level of care | Indicator type | |
Treatment with non-biological dressings | 6 | Proportion of people with a non-healing diabetic foot ulcer treated with non-biological dressings (umbrella indicatora) | Numerator: The number of people with a non-healing diabetic foot ulcer treated with any kind of non-biological dressing Denominator: The total number of people with a non-healing diabetic foot ulcer | Hospital National | Process |
7 | Proportion of people with a non-healing diabetic foot ulcer treated with non-biological dressings impregnated with antimicrobial agentsb | Numerator: The number of people with a non-healing diabetic foot ulcer treated with non-biological dressing impregnated with antimicrobial agents Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
8 | Proportion of people with a non-healing diabetic foot ulcer treated with non-biological dressings not impregnated with antimicrobial agentsb | Numerator: The number of people with a non-healing diabetic foot ulcer treated with non-biological dressing not impregnated with antimicrobial agents Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with bioengineered skin substitutes | 9 | Proportion of people with a non-healing diabetic foot ulcer treated with a bioengineered skin substitutes (umbrella indicatora) | Numerator: The number of people with a non-healing diabetic foot ulcer treated with at least one type of bioengineered skin substitutes Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
10 | Proportion of people with a non-healing diabetic foot ulcer treated with acellular dermal matrix | Numerator: The number of people with a non-healing diabetic foot ulcer treated with acellular dermal matrix Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
11 | Proportion of people with a non-healing diabetic foot ulcer treated with allogeneic skin substitute | Numerator: The number of people with a non-healing diabetic foot ulcer treated with allogeneic skin substitute Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
12 | Proportion of people with a non-healing diabetic foot ulcer treated with autologous skin substitute | Numerator: The number of people with a non-healing diabetic foot ulcer treated with autologous skin substitute Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with isolated cellular therapy | 13 | Proportion of people with a non-healing diabetic foot ulcer treated with isolated cellular therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with isolated cellular therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | Hospital National | Process |
Treatment with hyperbaric oxygen therapy | 14 | Proportion of people with diabetic foot ulcer treated with systemic hyperbaric oxygen therapy | Numerator: The number of people with a diabetic foot ulcer treated with systemic hyperbaric oxygen therapy Denominator: The total number of people with a diabetic foot ulcer | ||
15 | Proportion of people with a diabetic foot ulcer and adequate perfusion treated with systemic hyperbaric oxygen therapy | Numerator: The number of people with a diabetic foot ulcer and adequate perfusion treated with systemic hyperbaric oxygen therapy Denominator: The total number of people with a diabetic foot ulcer and adequate perfusion | |||
16 | Proportion of people with diabetic foot ulcer and inadequate perfusion treated with systemic hyperbaric oxygen therapy | Numerator: The number of people with a diabetic foot ulcer and an inadequate perfusion treated with systemic hyperbaric oxygen therapy Denominator: The total number of people with a diabetic foot ulcer and an inadequate perfusion | |||
Treatment with isolated growth factor | 17 | Proportion of people with a non-healing diabetic foot ulcer treated with isolated growth factor | Numerator: The number of people with a non-healing diabetic foot ulcer treated with isolated growth factor Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
Treatment with negative pressure wound therapy | 18 | Proportion of people with a non-healing diabetic foot ulcer treated with negative pressure wound therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with negative pressure wound therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
Treatment with physical therapy | 19 | Proportion of people with a non-healing diabetic foot ulcer treated with laser/phototherapy | Numerator: Proportion of people with a non-healing diabetic foot ulcer treated with laser/phototherapy Denominator: The total number of people with a non-healing diabetic foot ulcer | Hospital National | Process |
20 | Proportion of people with a non-healing diabetic foot ulcer treated with extracorporeal shockwave therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with extracorporeal shockwave therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
21 | Proportion of people with a non-healing diabetic foot ulcer treated with ultrasound therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with ultrasound therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
22 | Proportion of people with a non-healing diabetic foot ulcer treated with physical therapy other than laser, shockwave or ultrasound | Numerator: The number of people with a non-healing diabetic foot ulcer treated with physical therapy other than laser, shockwave or ultrasound Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with gas therapy | 23 | Proportion of people with a non-healing diabetic foot ulcer treated with topical oxygen therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with topical oxygen therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
24 | Proportion of people with a non-healing diabetic foot ulcer treated with ozone therapy or combined oxygen-ozone therapy | Numerator: The number of people with a non-healing diabetic foot ulcer treated with ozone therapy or combined oxygen-ozone therapy Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with nutritional supplementation | 25 | Proportion of people with a non-healing diabetic foot ulcer treated with a single nutrient supplementation | Numerator: The number of people with a non-healing diabetic foot ulcer treated with a single nutrient supplementation Denominator: The total number of people with a non-healing diabetic foot ulcer | Hospital National | Process |
26 | Proportion of people with a non-healing diabetic foot ulcer treated with a multi-nutrient supplementation | Numerator: The number of people with a non-healing diabetic foot ulcer treated with multi-nutrient supplementation Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with pharmacological agents | 27 | Proportion of people with a non-healing diabetic foot ulcer treated with pharmacological agents having an action on vessels | Numerator: The number of people with a non-healing diabetic foot ulcer treated with pharmacological agents having an action on vessel Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
28 | Proportion of people with a non-healing diabetic foot ulcer treated with pharmacological agents having an action on immunity | Numerator: The number of people with a non-healing diabetic foot ulcer treated with pharmacological agents having an action on immunity Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with debridement | 29 | Proportion of people with a non-healing diabetic foot ulcer treated with biological debridement | Numerator: The number of people with a non-healing diabetic foot ulcer treated with biological debridement Denominator: The total number of people with a non-healing diabetic foot ulcer | ||
30 | Proportion of people with a non-healing diabetic foot ulcer treated with enzymatic debridement | Numerator: The number of people with a non-healing diabetic foot ulcer treated with enzymatic debridement Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Treatment with surgical procedures | 31 | Proportion of people with a non-healing diabetic foot ulcer treated with amputation | Numerator: The number of people with a non-healing diabetic foot ulcer treated with amputation Denominator: The total number of people with a non-healing diabetic foot ulcer | Hospital National | Process |
32 | Proportion of people with a non-healing diabetic foot ulcer treated with bony surgical offloading | Numerator: The number of people with a non-healing diabetic foot ulcer treated with bony surgical offloading Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
33 | Proportion of people with a non-healing diabetic foot ulcer treated with soft tissue surgical offloading | Numerator: The number of people with a non-healing diabetic foot ulcer treated with soft tissue surgical offloading Denominator: The total number of people with a non-healing diabetic foot ulcer | |||
Domain: Peripheral artery Disease (PAD) | |||||
Revascularization | 34 | Proportion of people with diabetic foot ulcer and inadequate perfusion treated with endovascular surgery | Numerator: The number of people with a diabetic foot ulcer and inadequate perfusion treated with endovascular surgery Denominator: The total number of people with a diabetic foot ulcer and inadequate perfusion | Hospital National | Process |
35 | Proportion of people with diabetic foot ulcer and inadequate perfusion treated with open vascular surgery | Numerator: The number of people with a diabetic foot ulcer and inadequate perfusion treated with open vascular surgery Denominator: The total number of people with a diabetic foot ulcer and inadequate perfusion | |||
36 | Proportion of people with diabetic foot ulcer and inadequate perfusion undergoing revascularization based on the angiosome concept | Numerator: The number of people with a diabetic foot ulcer and inadequate perfusion undergoing revascularization based on the angiosome concept Denominator: The total number of people with a diabetic foot ulcer and inadequate perfusion | |||
Domain: Offloading | |||||
Intervention | Indicator | Numerator/Denominator | Level of care | Indicator type | |
Offloading with non-removable knee-high devices | 37 | Proportion of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer treated with a non-removable knee-high offloading device | Numerator: The number of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer treated with a non-removable knee-high offloading device Denominator: The total number of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer | Hospital National | Process |
Offloading with knee-high offloading devices | 38 | Proportion of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer treated with a knee-high offloading device | Numerator: The number of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer treated with a knee-high offloading device Denominator: The total number of people with a non-infected, non-ischemic plantar neuropathic diabetic foot ulcer | ||
Domain: Secondary prevention | |||||
Patient education | 39 | Proportion of people with a (history of) diabetic foot ulcer receiving patient education | Numerator: The number of people with a (history of) diabetic foot ulcer receiving patient education Denominator: The total number of people with a (history of) diabetic foot ulcer | Hospital National | Process |
Footwear and/or insoles | 40 | Proportion of people with a history of peripheral neuropathy (PNP) receiving therapeutic footwear and/or custom-made insoles, or custom-made shoes | Numerator: The number of people with a history of PNP receiving therapeutic footwear and/or custom-made insoles, or custom-made shoes Denominator: The total number of people with a history of PNP | ||
41 | Proportion of people with a (history of) diabetic foot ulcer receiving optimization by plantar pressure measurements of their custom-made footwear and/or insoles | Numerator: The number of people with a (history of) diabetic foot ulcer receiving optimization by plantar pressure measurements of their custom-made footwear and/or insoles Denominator: The total number of people with a (history of) diabetic foot ulcer | |||
Protocol-driven multidisciplinary prevention | 42 | Proportion of people with a (history of) diabetic foot ulcer treated within the context of a prevention management program for diabetic foot | Numerator: The number of people with a (history of) diabetic foot ulcer treated within the context of a prevention management program for diabetic foot Denominator: The total number of people with a (history of) diabetic foot ulcer | ||