Caring for people with diabetic foot ulcers requires both specialist skills and specialist care settings. In Germany, these parameters are required to be assessed according to the guidelines provided by the German Working Group on the Diabetic Foot (2003), which includes such measures as patient outcomes. In this paper, the authors compare the outcomes of diabetic foot complications in inpatients and outpatients in 130 specialist care centres.

In Germany, legislation demands measurement of the quality of management of outpatient and inpatient facilities. In 2003, the German Working Group on the Diabetic Foot developed certification requirements for diabetic foot centres. These certification requirements established proceedures by which specialised centres for the treatment of the diabetic foot syndrome could verify their management quality. In addition, this certification fulfils the demands of the 2006 IDF Global Guideline for Type 2 Diabetes (IDF Clinical Guidelines Task Force, 2006). The goal was to establish comparable diabetic foot centers with clearly defined treatment structures.
    Conditions for the certification are quality parameters of the facility’s structure, treatment procedures and patient outcomes (Box 1; Schaper et al, 2003; IDF Clinical Guidelines Task Force, 2006). Structural quality was based on the qualifications of staff, the facility’s spatial conditions and a minimum provision of equipment. Staff members of certified centres must visit each other. Also assessed are the application of available guidelines and documentation systems, the establishment of a multidisciplinary team approach between the facility’s staff and other experts involved.