Cultura

System-Wide Medical Department Contributions To Patient Strategy Development: A Review Of Interprofessional Coordination And Outcome-Based Care 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

Sultan Odhab Althafiri, Salem Osaimer H Almutairi, Hussain Ahmed Ali Almutawabojabra, Majed Mahdi Almutairi, Almutairi Sultan Omar, Maha Hamood Alanazi, Adel Awwadh Almutairi, Salem Abdullah Alharbi, Maher Hameed Almoteri

Abstract

The increasing complexity of healthcare systems has highlighted the limitations of fragmented, department-specific approaches to patient care. As healthcare organizations move toward value-based and outcome-oriented models, there is a growing need for system-wide patient strategy development that integrates the contributions of all medical departments. This review aims to synthesize current evidence on how coordinated, interprofessional collaboration across clinical, diagnostic, supportive, and administrative departments contributes to the development of effective patient strategies and improved health outcomes. Using an integrative review approach, studies published in peer-reviewed journals were analyzed to examine coordination mechanisms, care continuum alignment, and outcome-based care models. The findings indicate that patient strategies developed through system-wide collaboration are associated with improved clinical outcomes, enhanced patient experience, increased safety, and more efficient use of healthcare resources. Key enabling factors include multidisciplinary teamwork, shared governance structures, digital health integration, and standardized yet flexible care pathways. Conversely, organizational silos, communication gaps, and misaligned performance metrics remain significant barriers. This review underscores the importance of adopting a holistic, system-level perspective when designing patient strategies and provides insights for healthcare leaders, policymakers, and researchers seeking to strengthen interprofessional coordination and advance outcome-based care models.

Keywords : Patient strategy development; interprofessional collaboration; system-wide healthcare; outcome-based care; integrated care models; healthcare quality improvement.
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