Exploring Workflow Gaps in Diabetic Foot Care: Insights from Primary Care Clinics in Kuantan

The diabetic foot is a common complication of diabetes. According to the latest guideline on the management of diabetic foot (2018) from the Ministry of Health, it was suggested that primary care clinics develop foot protection teams to reduce hospital admissions, length of stay, and the amputation rate. However, there are barriers to establishing these teams. This research aimed to explore the current workflow for managing diabetic foot in primary care clinics in Kuantan. A purposive sample of 12 healthcare professionals was selected for this qualitative research project from four Kuantan primary care clinics with the highest number of recorded patients in the National Diabetes Registry. Semi-structured, focus group interviews were conducted via an online platform. Interviews were recorded and transcribed verbatim. The data were analysed via thematic analysis. The study identified three main themes: workflow, healthcare provider roles, and guideline implementation. Clinics lacked standardized workflows regarding operating hours, dedicated teams, and improper screening practices, which often deviated from established guidelines. The screening tools were outdated and not aligned with current guidelines. Guideline implementations appear lacking among healthcare providers mostly due to ignorance of the availability of the latest Clinical Practice Guideline (CPG). Before a diabetic foot protection team can be successfully built, several obstacles must be addressed. One potential project is the development of a clear workflow algorithm that can be employed in clinic settings.