Table 1.

Summary of the organizational mapping.

Area	Mapping results
Screening, admissions and visits	Professionals pointed out coordination problems with Primary Care (PC) regarding the prompt identification and management of ulcers/complications, leading to late diagnoses. Patients were therefore often admitted to the outpatients clinics with severe conditions and without previous DF assesment by their GPs. This was confirmed by the survey presented in Figure N.5.: foot check-ups by PC professionals were not a comman practice. Outpatient clinics also differed in the scheduling procedures for visits and diagnostics exams. Moreover, some HAs did not schedule dedicated slots in their radiology departments in agreement with the diabetology departments.
Revascularization procedures	The organization of this phase greatly differed between HAs. Some LHAs did not have catherization labs to perform lower-limb revascularization procedures so they had to refer their patients to other HAs. This implied a greater need for coordination among these providers. Other HAs provided some schedule hours during the week for the revascularization of lower limbs. In some HAs, revascularizations were usually performed without involving the diabetologists.
Surgery	In some HAs, interventions and follow-up treatments were often planned without involving the diabetologists. Lack of coordination occured both before and after surgery. Only in some HAs, diabetologists directly performed basic and minor surgical procedures.
Urgent path	Some professionals identified barriers to flexible and “fast track”, access, exams, revascularization procedures and interventions for patients with urgent needs because of a lack of coordination with other professionals.
Follw-up and continuity of care	Communication with PC professionals was also considered a critical aspect after discharges with regards to the management of lesions, wounds, ulcers and specific medications.
Education for patients and caregivers	Only in some organizations, educations for the prevention and treament of ulcers and lesions was provided for both individuals and groups of patients and caregivers. PC professionals were often not well-trained in preverting and recognizing DF problems and providing appropriate education for patients and caregivers.
Training professionals	Perodic educational meeting on prevention, treatment and team building, especially between diabetologists and PC professionals, were not held in every organization. These meetings should be held more in large hospitals (such as THs) and in those areas where the care path is fragmented among LHAs and THs.
Information Systems	The development and implementation of information systems are very different in each organization. Only some HAs quickly collected comprehensive information about their patients over time and easily shared them with other departments.