Developing a model for emergency patient transfer services in remote area with the participation of com-munity networks: A Case Study of Omkoi district, Chiang Mai Province

Abstract

This research aimed to develop a model for emergency patient referral services in remote areas through collaboration among network partners. It was a research and development project conducted in the Omkoi district of Chiang Mai province during 1^st July 2021 – 30^th June 2022. The study was divided into three phases. Phase 1 was a situational analysis, which involved collecting qualitative data through interviews with healthcare personnel and network partners who had experience with patient referrals. This also included gathering secondary data from Omkoi Hospital and Omkoi District Public Health Office. Phase 2 involved developing the model for emergency patient referral services, which included creating a training curriculum to enhance the capacity of community health workers in providing emergency patient referral services. Phase 3 was the evaluation process, which involved testing and training community health workers using the developed curriculum. Additionally, the developed emergency patient referral transfer protocol was tested through simulation exercises.

Results: The outcome of Phase 1 found that patient referral times were longer than normal due to difficult transportation and communication issues. The network of support from the community was limited. In Phase 2, based on this information, we developed two models of emergency patient referral systems: transfer by car and by air ambulance. We also created a capacity development curriculum for community health workers to improve their abilities in transferring emergency patients. During the evaluation phase, we used the developed curriculum to train community health workers who work in the Omkoi district. The results showed that the scores after training were higher, and the difference in scores before and after the training was statistically significant (t=-8.5, p<0.001). Regarding the implementation of the emergency patient referral model, it was found that the operational plans and responsibilities to support the transfer of emergency patients were successfully carried out.

Conclusion: Therefore, the emergency patient referral service model developed through collaboration among the network community can be applied. However, it is important to increase the knowledge and capabilities of network partners because, in emergency situations, providing assistance to patients and reducing referral time are crucial to saving lives and improving quality of life.