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Interdisciplinary HRFS Accreditation

NADC Collaborative Interdisciplinary Diabetes HRFS Accreditation

DOWNLOAD EOI HERE

In conjunction with the National Association of Diabetes Centres (NADC) Collaborative Interdisciplinary Diabetes High Risk Foot Service (iHRFS) Standards, the NADC has released the Pilot NADC Collaborative Interdisciplinary Diabetes HRFS Accreditation program.

The NADC Collaborative accreditation for Interdisciplinary Diabetes High Risk Foot Services is the only national accreditation of its kind, aimed at the improvement of quality and safety within Interdisciplinary Diabetes HRFS. The accreditation model is focused on a three-pronged approach combining governance, clinical and quality criteria. The objective of the NADC Interdisciplinary Diabetes HRFS accreditation is to assist Diabetes HRFS to achieve quality patient care through improved interdisciplinary team based care including improved governance and centre structure, as well as providing opportunities for clinician education and research.

During 2020, NADC in collaboration with our partners have extensively reviewed the iHRFS Standards and we are pleased to present Version 2.0. 

*You may access and download a copy via the links below

Legends: Centre of Excellence Core Standards

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Core Standards Awardees

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As part of NADCs role in setting National iHRFS Standards and an Accreditation program, the next step is to assist in connecting services with other services that have been identified as leaders in iHRFS. If you are wishing to make a connection with one our of accredited services to discuss models of care and service provision, please email admin@nadc.net.au

Accreditation

Accreditation is one tool in a range of strategies that can be used to improve safety and quality in a health based organisation. It is a way of verifying:

  • Actions are being taken
  • System data are being used to inform activity
  • Improvements are made in safety and quality

The NADC Collaborative Interdisciplinary Diabetes HRFS accreditation also aims to define and and harmonise the standard of service delivered by Interdisciplinary Diabetes HRFS across Australia in an effort to meet key goals under the National Diabetes Strategy 2016-2020, namely, practices and procedures resulting in improved care, improved quality of life among people with diabetes, and a reduction in the prevalence of diabetes-related complications.

Applicability of the Interdisciplinary Diabetes HRFS Standards

The NADC Interdisciplinary Diabetes HRFS Accreditation Standards have been written to set a benchmark level for Interdisciplinary Diabetes HRFS within Australia however they can be used as a guide by any foot services aiming to benchmark and improve the quality and range services provided to people with diabetes receiving foot care.

Overlap with other standards

Many Interdisciplinary Diabetes HRFS are already accredited in their affiliation with a larger hospital or health service. There are deliberate synergeries and overlap with existing accreditation systems to ensure a robust accreditation framework.

Who needs to complete the NADC Collaborative Interdisciplinary Diabetes HRFS accreditation?

An Interdisciplinary Diabetes HRFS provides coordinated multidisciplinary treatment for people with limb threatening diabetes-related foot complications primarily foot ulcerations, Charcot neuroarthropathy and foot infections. Interdisciplinary Diabetes HRFS provide care in a patient centred, continuing, comprehensive and coordinated manner. The Accreditation Standards are wholly relevant to all Interdisciplinary Diabetes HRFS that meet this definition.

Benefits of NADC Collaborative Interdisciplinary Diabetes HRFS accreditation

There are wide-ranging benefits to achieving such accreditation. This includes, but is not limited to:

Recognition - Interdisciplinary Diabetes HRFS that complete accreditation will have their status updated to indicate ‘Accredited NADC Collaborative Interdisciplinary Diabetes HRFS’, which will be promoted on the NADC website, in NADC member lists, HRFS maps published on the website, and in information provided to other health professional organisations.

Knowledge-sharing – the ability to leverage knowledge from other accredited Interdisciplinary Diabetes HRFS to improve service delivery and care

Far reaching quality improvement – the opportunity for your Interdisciplinary Diabetes HRFS to become part of a broader goal of improving diabetes related foot services nationwide, including by mentoring and educating smaller services

Benchmarking – the opportunity for your Interdisciplinary Diabetes HRFS to compare performance against other peer centres and to identify opportunities for improvement

Business expansion – opportunity to broaden your Interdisciplinary Diabetes HRFS’ reputation and patient base

Status and Reputation – opportunity to benchmark your Interdisciplinary Diabetes HRFS against peer services

Service improvement – opportunity to utilise the evidence gained from the accreditation process to lobby for increased funding and resourcing in areas where your Interdisciplinary Diabetes HRFS can be enhanced

Interested in applying for NADC HRFS Accreditation?
APPLY NOW FOR THE NEXT ROUND OF ASSESSMENT IN FEBRUARY 2022

DOWNLOAD IHRFS STANDARDS

The NADC Collaborative Interdisciplinary Diabetes High Risk Foot Service Accreditation Program had a successful pilot phase. Seven High Risk Foot Services throughout Australia have completed the accreditation process, with the aim to assess their service and to also provide feedback on the accreditation process.

We are now accepting iHRFS Accreditation Expressions of Interest (EOI) for the next rounds in the year 2025.

  • Round 1 – EOIs close Friday, 31 February 2025 with Commencement Accreditation Round 1 Monday 3 March 2025
  • Round 2 – EOIs close Friday, 25 July 2025 with Commencement Accreditation Round 2 Monday, 4 August 2025
Interdisciplinary HRFS Standards Workable Gap Analysis Template is available to service looking to undergo the NADC iHRFS Accreditation Program. 
 
It is a word document that allows a gap analysis to be undertaken –
  • allowing for in-depth service review
  • the collection and gathering of supporting evidence
  • identify any areas for improvement, both short and long term.  
 
This gap analysis is designed to be undertaken at any time prior to applying for accreditation.  This will allow for a smooth undertaking of the accreditation program once the service is ready to apply.   
Download Workable Gap Analysis Template Here

Accreditation costs

$95 Core Standards
$185 Centre of Excellence

HRFS accreditation will be awarded for a period of 4 years, after which time, reapplication is required to retain HRFS accreditation status.

To register your Interdisciplinary High Risk Foot Services Expression of Interest (EOI) in the NADC Collaborative Interdisciplinary Diabetes HRFS Accreditation program, download the Expression Of Interest (EOI) form. You may also download the NADC Collaborative Interdisciplinary Diabetes High Risk Foot Services (iHRFS) Standards HERE

Once completed, please send the EOI form to the NADC via email at: admin@nadc.net.au with the email subject title: “iHRFS Accreditation EOI *name of service*”

Any further questions in regard to the process can be emailed to: admin@nadc.net.au

DOWNLOAD EOI HERE
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Royal Prince Alfred

High Risk Foot Clinic

Centre of Excellence

Areas of Excellence

  • True interdisciplinary team.
  • Integration of orthopaedic and vascular surgery.
  • Strong links with education and upskilling other services.
  • Patient focussed management and continuity of care.
  • Strong research profile, data collection and auditing.

Royal Melbourne Hospital

Diabetic Foot Unit

Centre of excellence

Areas of Excellence

  • Comprehensive service
  • There is evidence of excellent continuity of care across the inpatient, outpatient and community settings
  • Strong research and conference presenting profile
  • Access to a vast range of specialists.
  • On-site orthotist and plaster technician is a fantastic addition to the foot service.

View Website

Monash Health

High Risk Foot Service

Centre of Excellence

Areas of Excellence

  • Monash Health High Risk Foot Service is a comprehensive service, that has an equal mix of inpatient and outpatient services to support High Risk Foot patients.
  • Strengths include integration with the vascular team.
  • Two HRFS coordinators
  • Research projects within the team is to be commended, the assessors note the collaboration between Monash Health and Monash University is a great initiative.
  • There is evidence of significantly experienced clinicians contributing to the HRFS’s development and research projects.
  • Monash Health HRFS are clear leaders in education and research
    Patient involvement and patient care goals.
  • Development of clinical pathways.
  • Strong leadership group coordinating and contributing that has led to a wealth of experience and knowledge within the HRFS team and therefore service setting.
  • Auditing of the potential missed patients within the inpatient setting and the patient centred care focus

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Fiona Stanley Hospital

Multidisciplinary Diabetic Foot Unit

Centre of Excellence – Dec 2018

Areas of Excellence 

  • Comprehensive service with exceptional availability of specialist care.  
  • Provision of footwear for patients.
  • Clear role delineation for clinicians in HRFS
  • Research
  • Medical photographer.

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Liverpool Hospital

High Risk Foot Service

Centre of Excellence

Areas of Excellence

  • The Liverpool Hospital High Risk Foot Service provides a comprehensive, holistic care for this high risk patient cohort
  • Research and leadership are key attributes of the service, with contributions to both National and International guidelines and meetings 
  • Strengths include the variety of multidisciplinary clinics available, and the multitude of written resources for patient education 
  • Access pathways and use of the Hospital in the Home services are well utilised resource
  • There is evidence of increased telehealth service provision, a credit to the service and reflect the meeting of current demands given the COVID-19 pandemic  
  • Patients having access to both inpatient and outpatient multidisciplinary amputee clinic and consultations are to be commended
  • Advanced scope of practice for podiatrists in a range of areas assists in timely care of the high risk foot patient group
  • Areas of Excellence include the use of evidence based guidelines, well established data collection system and the services range of resources

St. Vincent's Hospital Sydney

High Risk Foot Service

Centre of Excellence

  • St Vincent’s Hospital Sydney High Risk Foot Service is a comprehensive service that is providing a high level of comprehensive and holistic care for this high risk patient cohort.   
  • Research, leadership and data collection processes are key attributes of the service, with contributions to both National and International meetings, guidelines and data developments.   
  • Strengths include research and the development of the REDCap database for National usage.   
  • Patients have access pathways to key interdisciplinary team members for timely management of their foot disease.  The service is cohesive and displays strong patient outcomes.    
  • There is evidence of a high level of leadership shown from this service both internationally and nationally.  Several research projects are currently underway with inter-institutional relationships.   The coordination and development of the SyD FiG group is to be commended. 
  • Access to a wide range of health professionals with timely access to appointments with interdisciplinary clinics, inpatients services, parallel clinics and outreach clinics, including homeless health.   
  • Commendable involvement in educating and leading our health services to uptake this database to encourage National Benchmarking.  

St Vincent's Hospital - Melbourne

High Risk Foot Service

Centre Of Excellence

Areas of Excellence

  • St Vincent’s Hospital Melbourne High Risk Foot Service is a comprehensive service that is providing a high level of holistic care for this high-risk patient cohort.
  •  The team has demonstrated tremendous commitment and proficiency in rapidly establishing a leading service nationally, navigating complex clinical pathways and funding arrangements to deliver a sustainable service and excellence in clinical care.
  • Patients have access pathways to key interdisciplinary team members across a spectrum of outpatient and inpatient services. Notably, the inpatient service operates daily and incorporates weekly interdisciplinary ward rounds, with Vascular Surgery, Infectious Diseases and Antimicrobial Stewardship involvement. This inpatient model would be of interest to services nationally.
  • There is evidence of a high level of leadership shown from this service with respect to delivering professional education and undertaking clinically relevant research.
  • Accessibility to vulnerable population groups is worthy of recognition, extending to people who are from regional areas, socially disadvantaged, homeless and incarcerated. Unique avenues to fund footwear are in place to support such individuals.
  • Prompt adaptation to provide interdisciplinary telehealth input during the ongoing pandemic, including to Aged Care Facilities, is commendable.   

Sir Charles Gairdner Hospital

High Risk Foot Service

Centre of Excellence

Areas of Excellence

  • North Metropolitan Health Area Service – High Risk Foot Service is providing a high level of comprehensive and holistic care for this patientcohort.

  • Strengths include the strong relationships amongst the healthcare team, led by the Vascular Surgery team who are at the cutting edge of aggressive revascularisation techniques in limb salvage and tissue preservation.

  • Patients have access and referral pathways to key interdisciplinary team members that support their high risk foot journey.

  • There is evidence of highly skilled leadership shown from this service.

  • Further evidence was demonstrated of education provided to a range of disciplines within their own service, but also included external service providers in primary care and across Western Australia.

  • There is a sense of strong teamwork and partnership within this service, with every member having their role within the team including support to achieve service outcomes.

  • Established relationships for access and referrals to a wide range of professions are evident and lead to improved health outcomes for patients.

  • Commendable involvement in HRF research and inclusive of the broader team.

Cairns Diabetes Centre

High Risk Foot Clinic

Core Standards

Areas of Excellence

  • Interdisciplinary team
  • Regular auditing that direct improvement projects.
  • High frequency of outpatient clinics
  • Podiatry prescribing is supported and evaluated.
  • Patient goal setting.
  • The prevention outpatient Clinic
  • Data collection and auditing
  • Telehealth
  • Excellent processes are established to detect foot issues in patients admitted to hospital with aid of an inpatient HRFS coordinator.
  • Patient Resources

View Website

Eastern Health

High Risk Foot Service

Centre of Excellence

Areas of Excellence

  • Eastern Health is a comprehensive service that is providing a high level of comprehensive and holistic care for this high risk patient cohort.
  •  Strong interdisciplinary collaboration across multiple specialties and avenues to subspecialty care via a variety of clinics, which are supported by comprehensive clinical pathways.
  • The Service is underpinned by good governance and communication, as well as clearly documented clinical management protocols and procedures.
  • Engagement with community services and partner organisations, including local education activities, is commendable.
  •  Contribution of the Service extends nationally and enriches the field of diabetes-related foot disease, through leadership and research activities.
  • Data collection and clinical audit processes are well developed and integrated into Service operations.

Royal Perth Hospital

High Risk Foot Service

Core Standards

Areas of Excellence

  • Range of specialists involved in team
  • HRFS bed card
  • Dedicated plaster clinic
  • Footwear and orthoses provisions
  • Extensive patient information leaflets.
  • Research, education
  • Video conferencing and the ability to connect with regional patients and support staff in remote communities.

View Website

Mater Hospital

High Risk Foot Service

Core Accreditation

Areas of Excellence

  • The Mater Hospital High Risk Foot Service offers a comprehensive service despite its inception only two years ago.
  • Mater Hospital High Risk Foot Service is recognised as a service leader in the local area.
  • The service is to be congratulated on the regular and detailed service review processes and quality of documentation.
  • There is evidence of sharing of knowledge both externally and internally within the hospital with a particular focus on student education.
  • Strengths include the variety and access to medical specialities and the incorporation of these into the service.
  • There is strong evidence of patient-centred care and holistic service provision.
  • There is also evidence of a well-established multidisciplinary service embedded within a tertiary hospital setting.
  • Referral pathways support the service and work well, for example, the emergency department to admission pathway.
  • Data collection and service review is embedded within the patient-centred service

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Northern Adelaide Local Health Network

Interdisciplinary High Risk Foot Service Lyell McEwin Hospital

Core Standards

Areas of Excellence

  • Strong research and research involvement.
  • Grant funding and links with UniSA.
  • Links with the local general practitioners, and community health professionals.
  • Telehealth

Foot Procedure Unit Northern Health

Core Standards

Areas of Excellence:

  • The Foot Procedure Unit is a comprehensive service that provides a high level of care from acute to sub-acute outpatient and inpatient
    management, with clinics available for efficient follow up of patients within the interdisciplinary High Risk Foot Service (iHRFS).
  • There is evidence of a highly organised interdisciplinary service with strong administrative support that is well integrated within the team.
  • Strengths include the use of depression and nutrition screening tools for holistic patient care.
  • The undertaking of general practitioners and nursing staff training to raise the awareness of diabetes related foot pathologies within this cohort
    is commended.
  • The assessors recognised the team’s participation in many research projects which have been presented at a number of conferences and some in development for future publication.
  • Access to comprehensive clinics across the weekly timetable with daily access to urgent appointments are valuable initiatives.
  • Areas of Excellence include the defined referral pathways and urgent referrals to other medical and surgical specialists, casting clinics and
    orthotics. There are pathways in place for consultants to refer to other health professionals assisting patient care.

Western Health

Diabetes Foot Service

Core Standards

Areas of Excellence

  • Strong community partnerships and commitment to education.
  • Credentialing of clinicians with regards to Total Contact Casting.
  • Regular audits KPIs including amputation rates and time to first clinic appointments.
  • Access to a variety of specialists and a true interdisciplinary team.

Flinders Medical Centre

Multi-Disciplinary High Risk Foot Service

Core Accreditation

Areas of Excellence

  • The Flinders Medical Centre – High Risk Foot Service is a newly developed service.
  • Relationship with the vascular team aiding early intervention for revascularisation, admission pathway and an emergency bypass protocol and guidelines.
  • Onsite Pedorthist clinic and an endorsed podiatry prescriber as part of the team. This represents and facilitates strong patient centre care.
  • Breadth of patient education resources are commendable.
  • Access to a wide variety of allied health professionals including dietitian, social workers, indigenous health worker and exercise physiologist is admirable
    The collection of quality of life data throughout the episode of care.

View Website

Central Adelaide Local Health Network

Multidisciplinary Foot Service

Core Standards

Areas of Excellence

  • The Central Adelaide Local Health Network Multidisciplinary Foot Service is a comprehensive service that is currently providing a high standard of evidence-based care for patients with diabetes–related foot disease.   
  • Strengths include rapid access to the HRFS for individuals with both urgent and non-urgent referrals, including strong triage systems and the capacity to manage rural patients. 
  • There is evidence of a strong multidisciplinary team with excellent access to vascular and podiatry reviews.  
  • Access to and collaboration with a range of health care providers optimising patient care.   
  • Areas of Excellence include: Adherence to evidence-based guidelines, pressure offloading protocols and wound management policies, as well as having access to advanced wound care therapies. 

Illawarra Shoalhaven LHD

High Risk Foot Service

Core Standards

Areas of Excellence

  • The Illawarra Shoalhaven Local Health District (ISLHD) High Risk Foot Service is a comprehensive service providing a high level of patient centred care for a high risk cohort.  
  • Strengths include patient-reported outcome measures and patient involvement in their care from the initial appointment.  
  • The utilisation of standardised documentation templates for clinicians to promote consistency within the team, to enhance patient management.  
  • There is evidence of a high standard of data collection engrained within the service. 
  • High level of patient engagement with the provision of information and brochures to utilise during their treatment journey.     
  • Access by the multidisciplinary team to the PEDAR system and throughout the patient management process.  

Royal Darwin Hospital

High Risk Foot Service

Core Standards

Areas of Excellence

  • The Royal Darwin Hospital – High Risk Foot Service is a comprehensive service providing patient centred care for a high risk cohort over a vast geographical area within the Northern Territory.

  • Royal Darwin Hospital is to be commended on their contribution to improving foot care in their region and particularly their relationship with Aboriginal and Torres Strait Islander people.

  • Strengths include significant interdisciplinary involvement despite an apparent limited HRFS budget. 

  • The utilisation of the ‘Hot Foot Phone’ for patients to access and the organisation’s open door policy for patients to return to the service is highly commended.  

  • The High Risk Foot Service is providing care to an extensive geographical area with minimal community health coverage.  

  • There is evidence of well-integrated vascular service in the Unit.  

  • Comprehensive pathways are in place for both Charcot Neuroarthropathy and for intake and access; these pathways are clear and effective.  

       

Macarthur

High Risk Foot Service

Core Standards

Areas of Excellence

  • The Macarthur High Risk Foot Service is a comprehensive service providing a high level of holistic patient centred care. 
  • Strengths include strong local guidelines particularly for sharp debridement, and ED presentations of diabetes related foot infections. 
  • ED management of diabetes related foot infections is a valuable asset to patient care.   
  • There is evidence of integration of a variety of professions including Allied Health Assistants which is commended. 
  • The assessors noted the high quality, consistent documentation with comprehensive involvement of the interdisciplinary team members.  
  • A variety of brochures and patient education is available to patients and supports their health literacy. 
  • Early development of research relationships with podiatry faculties is a positive step in raising your services’ research profile.   

Bendigo Health

High Risk Foot Service

Core Standards

Areas of Excellence

  • The Bendigo Health High Risk Foot Service is a comprehensive service providing a high level of patient centred care for a high risk cohort.   
  • Strengths include robust data collections tools and auditing processes.  
  • The utilisation of ultrasonic debridement, negative pressure wound therapy, the use of pressure guardian clinical kit is an asset in optimising clinical care for patients.   
  • There is evidence of a strong relationship with La Trobe University and therefore collaborative research projects and opportunities.     
  • Extensive range of high level clinical services, supported by well documented care pathways and access to specialist care, is commended. 
  • Initiatives such as the development of a podcast and your services contribution to the education of other local health services is very impressive.

CENTRAL COAST LOCAL HEALTH DISTRICT

High Risk Foot Service

Core Standards

Areas of Excellence

  • The Central Coast Local Health District High Risk Foot Service is a comprehensive service providing a high level of patient centred care for a high risk cohort.
  • Strengths include a comprehensive multidisciplinary team approach across multiple locations to service the vast geographical area.
  • The utilisation of a cohesive team approach to allow all professions to input into patient care is commended.
  • There is evidence of highly skilled podiatrists who can undertake total contact casting clinics to support the gold standard of offloading and evidence-based practice.
  • High level of upskilling, hands-on training with educational support to students and undergraduates to further develop their understanding of the complex cohort.