Home Visit Protocol of Thaphra-Donhun Primary Care Cluster, Khon Kaen Province

Abstract

Objectives: 1) To examine home visit protocol currently used by Thaphra-Donhun primary care cluster; 2) To perform a SWOT (strength, weakness, opportunity, threat) analysis of home visit service, and 3) To revise and strengthen the home visit protocol. Methods: This qualitative research collected the data by using face-to-face interviews (n=13) and a focus group discussion (n=11). Participants with experience on home visit included doctors, nurses, public health providers, nutritionist, physiotherapist, and pharmacists. The study collected the data during June to August 2020. Ten interview questions were used focusing on the current home visit protocol and opinions towards this service. The focus group discussion emphasized SWOT analysis, revision and strengthening of home visit protocol. Content analysis was performed using published recommendations for the home visit and internal and external factors of the home visit team as a framework. Results: Home visit protocol comprised of three phases: pre-visiting, visiting, and post-visiting. However, some steps were missed in each phase. The pre-visiting phase lacked an intensive team meeting. The visiting phase missed recording INHOMESSS and IFFE data. Moreover, roles during the home visit were not assigned to team members. The post-visiting phase lacked an intensive team meeting and a proper data record. Also, the team missed referring patient’s information between health providers. Thaphra-Donhun primary care cluster had key strengths, namely, human resources and a clear shared value. Some opportunities existed including financial support and collaboration from local organizations. The revised home visit protocol focused on the improvement on intensive meeting, data recording, and referral of data. Conclusion: According to home visit recommendations, several gaps were identified for the protocol used by Thaphra-Donhun primary care cluster. This study has revised and strengthened the home visit protocol. However, the feasibility in practice should be tested before implementing it in this setting and other primary care units.