Subjects, materials and methods
Phase of action research
Observations and informal discussions with hospital staff.
To inform content of focus group question template.
To capture an untainted picture of current practice before the formal focus groups.
2) Problem identification
Focus group with recruited participants from hospital staff.
Capitalises’ on the interaction between and among participants to stimulate and refine thoughts and perspectives’ (18).
Useful in deriving collective opinions of groups.
Useful when there are power differences between the decision-makers and/or professionals, when exploring the degree of consensus on a given topic (19).
3) Initial Action planning
Observations and informal discussions following the focus group.
To observe and discuss further opinions regarding pertinent points identified in the focus group.
To allow staff to speak more about the points discussed free from barriers such as seniority, gender, caste and internal politics.
To clarify the points raised and view them in action.
To facilitate the exploration of ideas around change.
Please can you describe the current patient demographics of the hospital?
What types of assessment forms are currently being used and can you give examples of these throughout the hospital?
Can you describe your thoughts on the current assessment and triage process? Who is responsible for doing this?
Does the process currently work?
Can you give some examples of the positives and negative aspects of this process?
What details would you want to capture from a foot assessment tool?
What do you perceive a successful assessment tool would achieve?
If you had the opportunity to change it how would you see structured assessment and triage working?
Is there anything else that anyone feels we should have talked about but didn’t?
Participant (P) code
Consultant General Physician
Consultant General Physician
Orthopaedic surgeon (Lead member of staff, key contact)
General surgeon (Head of service)
Consultant Sports Medicine
Consultant Diabetologist (Lead member of staff, key contact)
Head of Physiotherapy
Consultant Vascular Surgeon (Head of service/Unable to attend)
Consultant endocrinologist (Head of service/unable to attend)
Theme 1- Local definition and recognition of need describes the patient demographic and types of foot conditions the hospital and individual departments are dealing with day to day. Including how these problems are currently managed and the feelings of the professional group in relation to the points identified.
Theme 2 - Process of current foot assessment describes how the hospital currently assesses foot health.
Theme 3 – Barriers to current diabetic foot care highlights the operational structure and the existing problems within current practice that hinder the standardisation of foot assessment and management.
Theme 4 – Content of assessment describes what the participants believe would broadly make up the content of a foot health assessment tool.
Theme 5 - Desired Outcomes of foot assessment and the opportunity to change describes what a successful foot health assessment could achieve and also the desire to make changes and integrate them into current practice.