การพัฒนารูปแบบการนำแผนยุทธศาสตร์ของโรงพยาบาลพุทธโสธรไปสู่การปฏิบัติ โดยการมีส่วนร่วมของบุคลากร

อุบลรัตน์ แสงเมฆ

Authors

อุบลรัตน์ แสงเมฆ Buddhasothon Hospital

Keywords:

Strategic Plan Implementation, Personnel Participation, BSH-MAP Model

Abstract

Strategic plan implementation in tertiary-care hospitals presents persistent challenges due to complex organizational structures and multidisciplinary workforces, resulting in
a substantial gap between planned strategies and actual practice. This study aimed to develop and evaluate the effectiveness of a participatory strategic implementation model
at Buddhasothon Hospital, a 650-bed tertiary-care hospital with 1,871 personnel.
A participatory action research (PAR) design, grounded in Kemmis and McTaggart's framework (2022), was employed alongside mixed -methods data collection across three phases (January 2025–February 2026). Phase 1 involved a quantitative surveyof 360personnel using validated questionnaires measuring knowledge, perception, and attitudes toward strategic implementation (Cronbach's Alpha =0.92) Phase 2 employed qualitative analysis through in-depth interviews, participatory observation, and focus group discussions with 41
key informants. Phase 3 involved the development and implementation of the model through the PAOR cycle with 185 personnel across five pilot units over eight weeks. Phase 1 findings revealed that personnel demonstrated moderate levels of knowledge (M = 3.06, SD. = 0.97) and favorable attitudes (defined as beliefs about the importance of strategic implementation, distinct from perception of actual implementation status) toward participation (M = 4.04); however, practical participation (M = 2.94) and resource allocation (M = 2.88) remained underdeveloped. Phase 2 identified six critical themes, including hierarchical perception gaps, top-down communication lacking feedback mechanisms, and disconnection between performance indicators and routine work. These findings collectively informed the development of the BSH-MAP Model, comprising six components: Balanced Communication, Stakeholder Participation, Horizontal Accountability, Managing Resources, Assessing & Tracking, and Practice Integration. Following eight weeks of model implementation, all pilot units successfully developed operational plans linking strategic indicators to routine tasks, achieving 82.00% of unit-level performance targets. Personnel perception of strategic implementation improved significantly (M=3.01to M = 4.22; t =16.34,P-value <.001,Cohen's d =1.58).Expert panels rated the model's appropriateness highly(M = 4.68), and personnel reported high satisfaction (M= 4.33) The BSH-MAP Model demonstrated effectiveness within a tertiary-care hospital context and should be scaled to other units, with the concurrent development of information systems to support long-term monitoring and evaluation.

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