Lower-Limb Preservation Demonstration Project

In response to Ontario’s high rate of lower limb amputations among people with diabetes and peripheral vascular disease, specifically here in Hastings and Prince Edward Counties, Ontario Health has introduced a two-year Lower Limb Preservation Integrated Care Program.

A team of diverse providers, including members from primary care, home and community care, virtual care leads, Indigenous partners, and patients with lived experience, came together to determine initiatives that will help reduce the risk of lower-limb amputations in Hastings and Prince Edward Counties (HPE).

Some of these initiatives include an education and communication campaign, a standardized foot screening tool for primary care providers, and advanced screening and diagnostics for high-risk patients or patients with lower extremity wounds.

In July 2023, the Bancroft Community Family Health Team was selected as the pilot site within HPE to begin initial work on developing and implementing these initiatives to reduce the risk of lower-limb amputations.

Wound Care at Bancroft Community Family Health Team

For patients with a lower limb wound, a treatment plan will be put into place in collaboration with the patient and the primary care provider. Referrals may be made to the following providers or programs in the Family Health Team (FHT):

• Chiropodist—A foot specialist who focuses on preventing, assessing, and treating conditions associated with the foot. A chiropodist has advanced training in treating foot wounds and ulcers, including supporting patients with off-loading casts and appropriate footwear to support healing.
• Diabetes Education Program—A team of health providers focused on reducing diabetes symptoms and delaying or preventing the onset of diabetes complications. Diabetes educators support patients to have better blood sugar control to help with wound healing.
• Dietitian—A nutrition professional who can support patients with eating well to help heal a wound faster and fight infection.
• Smoking Cessation Program—A nurse or respiratory therapist focused on helping patients to quit smoking.

For patients with more complicated wounds or health, care may need to be increased to specialty services outside of the Family Health Team, including:

• Vascular or endovascular surgery
• Vascular imaging and intervention
• Outpatient Complex and Chronic Wound Care Clinic
• Home and Community Care Support Services