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Team based care in Saudi Arabia involves a collaborative approach to healthcare delivery where different healthcare professionals work together to provide comprehensive and coordinated care to patients. Team based care typically includes physicians, nurses, allied health professionals, and sometimes even community health workers, all working together to address the needs of patients.
Team-based care (TBC) Approach composed of two levels of a multidisciplinary teams (panel, and network team) who work collaboratively on identifying population needs, understanding their culture, and managing their health, by offering a holistic and integrated care to shift the focus from a disease-based system to a patient-centric and wellness system to achieve effective, comprehensive, compassionate and integrative care along with good continuity of care .
Medical assessments: These assessments are conducted by physicians and may include physical examinations, diagnostic tests, and medical histories to diagnose medical conditions and develop treatment plans.
Nursing assessments: Nurses perform assessments to evaluate patients' physical, psychological, and social well-being. This may involve monitoring vital signs, assessing pain levels, and evaluating patients' responses to treatment.
Pharmacological assessments: Pharmacists assess patients' medication regimens, including reviewing drug interactions, evaluating medication adherence, and providing education on proper medication use.
Psychosocial assessments: Social workers conduct psychosocial assessments to evaluate patients' mental health status, assess social support systems, and identify any psychosocial stressors or barriers to care.
Nutritional assessments: Dietitians assess patients' nutritional status, dietary intake, and nutritional needs to develop personalized nutrition plans and promote healthy eating habits.
These assessments are often conducted collaboratively within multidisciplinary healthcare teams to ensure comprehensive evaluation and holistic care planning for patients. The integration of diverse assessments helps address the complex healthcare needs of patients and contributes to improved health outcomes.
Care Planning: Based on the assessment findings, the healthcare team develops a personalized care plan tailored to the patient's needs and preferences. This plan outlines specific interventions, treatments, and goals for managing the patient's health condition or addressing their healthcare needs.
Assignment of Roles and Responsibilities: Each member of the healthcare team is assigned specific roles and responsibilities within the care plan based on their expertise and scope of practice. This ensures that each team member contributes effectively to the patient's care and that there is clear accountability for tasks.
Collaborative Care Delivery: The healthcare team works collaboratively to implement the care plan, with regular communication and coordination among team members. This may involve regular team meetings, care conferences, or electronic communication platforms to share information and updates on the patient's progress.
Monitoring and Evaluation: Throughout the care process, the patient's progress is monitored closely, and the care plan is adjusted as needed based on changes in the patient's condition or response to treatment. This ongoing evaluation ensures that the care provided remains appropriate and effective.
Registration of patient through the following ways:
Automatic registration; By appointing to primary health care centers through the appointment platform.
Visit the PHC; Inviting references to join the medical team during their visit to the center, whether through reception or nursing or physician clinic.
SEHATY application.
· X-rays
· Ultrasound
· ECG (Electrocardiogram)
Common screening tests include those for:
