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Research Report Thai COC Program for the Quality Criteria Results of Home Visit Services : Surin Province

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Research Report Thai COC Program for the Quality Criteria Results of Home Visit Services : Surin Province 0 Research Report Thai COC Program for the Quality Criteria Results of Home Visit Services : Surin province By Miss Pasinee Nakdee Expertly Professional Nurse The chief of Community Health Nursing Department Surin Hospital a Preface This research is an action research to study the effect of using the Thai COC program on the quality of the result from the homecare services in Surin Province with the research methodology as follows. b Content page Preface a Content b Table Content c Diagram Content c Chapter 1 Background 1. Introduction and objectives 1 2. Objective 4 3. Inclusion criteria 4 4. Definition 5 5. Outcomes 5 Chapter 2 Concepts, theories and related researches 1.Concepts and theories 6 2. Related researches 29 Chapter 3 Research Methodology 1. Population and Sample Group 33 2. Research Process 33 3. The Research Tools, the quality inspection of the tool, and data collection 34 4. Data Analysis 35 Chapter 4 Research Result Phase 1 Planning 36 Phase 2 Action 37 Phase 3 Observing, monitoring and supervising 40 Phase 4 Reflect/Feedback 40 Chapter 5 Research Conclusion, Discussion and Recommendation 1.Research Discussions 56 2.Recommendation 58 3.Reference 59 c Table Content Table No. page 1 Amount and percent of patients classified by ratio of requested and accepted cases of homecare patients 45 2 Amount and percentage of homecare patients classified by general grouping 46 3 Amount and percentage of feedback from homecare patients categorized by patient levels and report cases 48 4 Amount and percentage of dependent patients categorized by report cases and transfer time 50 5 Percent of the patients categorized by the patient levels and health conditions 51 6 Percent of the patients categorized by the satisfaction ratings 52 7 Percentage of the service provider categorized by the satisfaction ratings 53 d Figure Content Figure No. page 1. Home care nursing concept 9 2. Conceptual Frameworks for Research 32 1 Chapter 1 Background Introduction and objectives In 2002 Thailand has established its universal health coverage (UHC). The scheme aims to make healthcare services accessible to all Thai citizens. In addition, the service is optimally standardized to provide the services to Thai people equally. One of the most important policies is the primary healthcare; it includes to implement a family and community health promotion, to provide primary healthcare services in the district healthcare level, so to reduce the number of patients in the tertiary hospital and to reduce the health expenses in the family and federal healthcare budget. The data from Thai Minister of Public Health (MOPH), department of policy and prevention showed that, in 2008 there were 17.5 million patients with chronic diseases. It was estimated that 308,337 million Baths in a year was spent to provide services to this group of patients. The cost of care per year is expected to rise. It is estimated to cost the government and private expenses around 335,539 million Baths per year (Department of policy and prevention, 2008). One of many strategies in meeting the primary healthcare objectives is to provide healthcare services in the patient’s own home, called home ward, because it showed to reduce the workload and healthcare cost. (Clenment-Stone, Eigsti &Mc Grire,1995, cited in Nursing Office, Thai Ministry of Health, MOPH, 2013: 3) The national health expenses (cost of medication, cost of care) per household has been rising from 71,067 Baths in 193 to 381,387.50 Baths in 2016 (http://social.nesdb.go.th/ social Stat Health 4, Public Health resources) nl thf ehT hr l ot fo thtrop ehT lpb s eT1f pb t rfh ir%i eT 1ff h 17r1ni in 2016. b p f bro h l Tr s f hr l tp e T b slh lpi 1lfhTe1 t eb pb b br1l pb pf l t f T ehTh 1lfhTe1 eetT teb pb h eb1lf e1 l teb pb (Data from 2011-2015) (4 tpf T hr ohoe1 pTt of i T ehTh 2n1 ) nleb f thf 1hTbeb T se l l f thf hr Surin hospital, increase the number of in-patient, out-patient pTt l s t h11rte t fp . SeT1 2n11, i spb f thf t lp l Tr s f hr hr -tp ieT 2 increased from 2,121 to 2,818 t p e T b per day, iT-t p e T increased from 626 to 876 tp e T b per day pTt l s t h11rtpe t fp increased from 54.74% to 105.52%. ( rfeT 7hbte poh 2n17) Continuing care at home is an important strategy, to promote self care in the 1h rTe tfhiet b s 1h rTe l po l 1pf shfe f, lp 1pT f tr1 t lhbte po o t l hr b p , 1hTb er T o f tr1 b l po l1pf 1hb r shr eTre hr 1pf eb t reT t pb p lhoeb e1 1pf lp responding to patients needs and patients problem lp tfhiet b h tp e T s trfeTt lhbte poenp ehT l T 1hT eTr teieTt to them after discharging er 1pf eb b eoo f eref tr nl tp e T b lh eb tpf hr l healthcare facalities lp 1pT s rb t h rp1eooe p tp e T b 1pf . t l nl rp eo seoo s tfhiet eThso tt hr 1pf h pTt fpeT t h s pso h brtthf l tp e T by the healthcare team, that they can s 1hT p1 t 2 lhrfb p tp for t T1 brtthf r (ofpteT ap pTph1ff3) nl lh 1pf b fie1 b is p tfe pf l po l1pf b fie1 that s1hoop se l o7 policy. It provides an integrated care which includes health promotion, health prevention, basic treatment and rehabilitation, to support self-care of the people and to encourage their family and community to participate in health self-management. It also enhances and expands the nurse’s authority in their roles and scope of practice in using fundamental of nursing care in home care. In the primary homecare model, the nurse acts as a case manager who collaborate with other healthcare team in transition care from hospital to homecare. This practice helps to reduce the gap of care between primary, secondary and tertiary care by providing knowledge of care and facilitate effective communication to provide effective care for the continuum. To using discharge planning can maintain continuity of care more effective. In 2016, Surin Hospital found that the homecare services were not achieved the quality standard of home visit (set by the Department of Nursing Office, MOPH) due to the communication model between hospital and home care service. Surin Hospital, Surin Public Health Department and Data and Statistic centre in Public Health Faculty in Khon- Kaen University agreed to develop Thai COC Program. It is planned to create a database system to collect patient data, connect the network of data communication between each 3 healthcare service from tertiary healthcare centre to secondary and primary healthcare centre in Thailand. This system helps to promote faster and effective communication and interaction between healthcare providers, as a result it helps to prevent complication from delay care, hospital readmission, and it helps to promote patient recovery and wellbeing. Since the COC has been established, it has been used extensively by the members of healthcare providers. This program and collective databases support the use of information database in the following ways. 1) Using data to analyse the causes of delaying communication and suboptimal care between every levels of healthcare providers by taking into consideration of risk and benefit of individual as followings: 1.1) Able to report a current outcome of homecare, so to follow up and reduce workload of the healthcare worker 1.2) The care workers are able to access their data in their level of care and authority, so security of data is optimal. 1.3) The healthcare index can be analysed in each disease in each geographic area. 1.4) The COC communication network creates a spot map which can be used in a smart phone, tablet and computer. 1.5) There is a survey for customer service satisfaction and quality of life of the patient in the Thai COC, provided in the link via the smart phone. 1.6) The healthcare user can add more care pathway for other disease if needed. 2) To facilitate the meeting between the programmers and users to analyse the problem and update the system if needed. 3) Use the data to develop the Thai COC under the Thai Care Cloud Platform. 4 4) The program was first tested and updated in Surin Province at Gaeyai sub- district Health Promotion Hospital. 5) The program was first roll out on the 5th of September 2016 to the user in Surin province and other provinces, the training was provided to all users inside and outside the regions. 6) Established a continuity care committee in district, provinces and regional level. 7) Created a practice guideline booklet for each disease in a hard copy and uploaded into the Thai COC. 8) Followed up and monitoring the healthcare index target achievements through the meeting at the level of province, district and sub-district. 9) Established an administrator team to monitor and update the system in each level of the healthcare provider, and established the Line group for faster and more effective communication between administrators. Now, the Thai COC is used in 9 health region, covered 39 from 77 provinces in Thailand, by 12,005 users, 4,463 healthcare centres, and 251,166 patients and log in 321,333 times (Data from Thai COC 15th October, 2018).
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