New Initiative: Lower Limb Preservation
Taking an upstream approach to reducing preventable amputations
The province of Ontario has a lower-limb amputation rate that is significantly higher than that of other similar jurisdictions with public health care systems, with 24 amputations taking place every week due to diabetes and peripheral vascular disease (PVD). 15-20% of people over the age of 70 have a diagnosis of PVD1, and we know that poorer outcomes are concentrated in communities without consistent access to quality health care, including indigenous communities, racialized communities, and homeless communities. As a result, lower limb preservation has been identified as a key provincial priority and an area where more upstream, integrated care can provide real benefits to patients.
The Ottawa Hospital (TOH)’s Vascular Surgery Clinic and the Ottawa Health Team - Équipe Santé Ottawa have been selected as a demonstration site for Ontario Health’s Lower Limb Preservation Strategy. TOH and the OHT have received new funding to improve integration of Lower Limb Preservation care for clients, with the goals of reducing avoidable, non-traumatic major lower limb amputation, and improving equitable access to high-quality screening, and risk factor modification.
Initial planning work began in January 2022 and a steering committee has been implemented with a strong focus on representing communities who experience disproportionate rates of amputation. Current partners include:
Centretown Community Health Centre
Carefor Health and Community Services
Ottawa Inner City Health
Sandy Hill Community Health Centre
Wabano Centre for Aboriginal Health
Client and family partners
The Steering Committee is currently focused on reviewing current care pathways for people at risk for amputation and identifying high-value change ideas that support early identification and preventative management of vascular wounds in community settings.
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