Cultura

Strategic Alignment Of Medical Departments In Designing Patient Care Strategies: A Comprehensive Review Of Governance, Workforce, And Clinical Integration Models

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

Mamdouh Rasheed Almutairi, Lamyaa Mohammed Albalawi, Abdullah Faisal Rubayyi Almohammadi, Abdullah Mohammed Alshamrani, Rana Fawaz Nasser Albenayan
Shifa Ali Khudeer, Wad Ahmed Mohamed Abu Radia, Khalid Mansour Althobaiti, Abeer Ahmed Mohamed Abu Radia, Norah Saleh Albalawi

Abstract

Healthcare systems increasingly face challenges arising from fragmented service delivery, siloed departmental structures, and misalignment between organizational strategy and patient care processes. Addressing these challenges requires a strategic approach that aligns medical departments around shared patient-centered goals. This comprehensive review examines how governance structures, workforce alignment, and clinical integration models contribute to the effective design and implementation of patient care strategies across healthcare organizations. Using an integrative review approach, evidence from recent international literature is synthesized to identify key mechanisms that support cross-departmental coordination and strategic coherence. The review highlights the critical role of shared governance frameworks, interprofessional workforce collaboration, and integrated clinical and operational processes in improving patient safety, care continuity, and overall system performance. Findings demonstrate that strategic alignment among medical departments enhances patient experience, optimizes resource utilization, and supports sustainable quality improvement. The review further proposes an integrated perspective that links leadership, workforce capabilities, and clinical pathways into a unified patient care strategy model. These insights provide practical guidance for healthcare leaders and policymakers seeking to strengthen system-level coordination and advance patient-centered care through strategic departmental alignment.

Keywords : Patient care strategies; Strategic alignment; Medical departments; Integrated care; Healthcare governance; Workforce integration; Clinical integration.
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