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Hello

I am thinking of carrying out a QI (Quality Improvement) report on whether nail surgery being offered as a part of our service would be beneficial for the patient as well as us, in terms of counting down on return visits etc.

I know that it would be beneficial however it seems to be seen as unnecessary at the moment in the hospital/community clinic where I work, as well as the benefit of aptient not suffering pain or discomfort most times when they have to see a Podiatrist.

As part of my QI report I wondered whether any actual research and statistics have been done on GPs carrying out nail surgery and there success rate. Australia based would be ideal as that is where I work, well Victoria specifically. It seems whenever I talk to patients and a GP has operated on them, it has been mostly unsuccessful so am wanting to clarify that so giving us more reason to offer the procedure here.
If anyone could point me in right direction or could offer any more suggestions I could put in my QI report that would be great,

Thankyou all :dizzy:

 

Why bother with the QI? Isn't nail surgery a core podiatry competency?

Just get on with it. GP's doing nail surgery is gradually becoming a thing of the past (like delivering babies and many other procedural skills).

LL

 

Hello,

Thankyou for replying!
I would love to get on with it as you say however the executive of the hospital currently sees it as an unnecessary part of our podiatry services and seems be outsourced to GPS.
The senior podiatrist has already put a proposal of sorts through and I thought the icing on cake would be quality report. I do not want to lose my core skills either and am wanting to do nail surgery.
thankyou again and any more thoughts welcome : )

 

I'm not aware of research into GP outcomes for nail surgery but I'm pretty sure there are a number of published papers concerning Podiatry's outcomes and they are very favourable. I agree with LL this is a core competancy and I'm sure there are papers detailing our expertise.
There are 2 potential tacts you could use to argue your case for podiatry doing this procedure

1. Podiatry's track record - hopefully with evidence based data to back up our assertions. The fact that GPs may not have this published data on their outcomes helps you argue the evidence based approach.

2. Cost - speaking from a UK perspective it is inevitably cheaper for the health service for a podiatrist to carry out this procedure over a GP. Cost can often be a big lever in persuading those who are tasked with decision making.

Faced with a strong evidence base and a lower cost it should become a no brainer.

M

 

Lisa Farndon did work around what constitutes "core podiatry" looking at some of her publications may help. Additionally this guide from the Society may be useful:

A guide to the benefits of podiatry to patient care - Society of Chiropodists and Podiatrists
www.scpod.org/easysiteweb/getresource.axd?assetid=26369&type...


Kind regards,
Dawn

 

Nail surgery is within the scope of practice the profession. Hospital executive is not the governing authority to dictate that. What if he thinks you shouldn't be prescribing orthosis, would you run a QI on that too. If you are qualified and competent to do nail surgeries than you should as the scope dictates.

Have a meeting with this chap on what his concers are with pods and nail surgery and address those issues. Is it competence or ability to handle complications of surgery (infection).