Cultura

Laboratory-Emergency Department-Nursing Triadic Model: Optimizing Turnaround Times For Critical Laboratory Values In Saudi Arabian Hospitals

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Saad Faza Mirsal Alshammari, Mariam Fayadh Rabean Alenezy, Albanaqi Amal Dughayyim M, Alanazi, Bader Qasem S, Manal Alshami Rafi Alanazi, Mousa Dhaifallah Alotaibi Surur, Waleed Sunaid Khalifah Alshammari

Abstract

Critical laboratory value reporting remains a fundamental component of patient safety in emergency departments, yet prolonged turnaround times continue to compromise clinical outcomes and increase mortality risk. This paper proposes a Laboratory-Emergency Department-Nursing Triadic Model designed to optimize the communication and workflow processes surrounding critical laboratory values in Saudi Arabian hospital settings. Through systematic review of existing literature and analysis of current practices, this study identifies key barriers to timely critical value reporting, including communication breakdowns, technological limitations, workflow inefficiencies, and insufficient interprofessional collaboration. The triadic model emphasizes structured interdisciplinary partnerships among laboratory personnel, emergency department physicians, and nursing staff, supported by standardized protocols, technological integration, and continuous quality monitoring. Findings indicate that implementation of coordinated triadic workflows can significantly reduce turnaround times from laboratory result availability to clinical action. The model addresses contextual challenges specific to Saudi Arabian healthcare systems, including organizational culture, staffing patterns, and resource allocation. Recommendations include establishment of dedicated communication pathways, implementation of real-time notification systems, role clarification among team members, and adoption of quality indicators specific to the triadic interaction. This framework offers a practical, evidence-based approach to enhancing patient safety and clinical efficiency in emergency care settings through optimized laboratory-clinical collaboration.

Keywords : critical laboratory values, turnaround time, emergency department, interprofessional collaboration, patient safety.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty