Recommendations for Establishing Clinical Service for Delaying the Progression of Kidney Disease at Nam Phong Hospital: Application of the Soft Systems Methodology

Abstract

Objective: To propose recommendations for establishing clinical service for delaying the progression of kidney disease at Nam Phong Hospital, Khon Kaen by applying Soft Systems Methodology (SSM). Method: The researchers gained the understanding on the current service by observing service system, reviewing relevant documents, collecting the data on drug related problems (DRPs) and conducting in-depth interviews or focus group discussion in 3 key informant groups consisting of 6 of chief executive officers and related supervisors, 7 members of interdisciplinary team and 19 patients with chronic kidney disease and DRPs. The study analyzed the data using content analysis by applying Donabedian’s concept on quality dimensions of health services (structure, process and outcomes) and the key informants’ expectation as conceptual framework. DRPs were analyzed using framework of the Pharmaceutical Care Network Europe version 7.0. The researchers brought all pieces of information to formulate rich pictures and root description at the system level, to design activity model, to compare proposed activity model with the current on, and to propose the recommendation for establishing the services. Results: The proposed recommendation for establishing clinical service for delaying the progression of kidney disease at Nam Phong Hospital consisted of 5 short-term and 4 long-term plans Conclusion: SSM is a system method useful for proposing comprehensive recommendations for establishing clinical service for delaying the progression of kidney disease at Nam Phong Hospital through the participation of stakeholders. Therefore, the recommendations could be implemented through participative action research (PAR) in the future.