Development of Quality for Intermediate Care by Participation of Atsamat Network Roi-Et Province

Abstract

Purpose: To study the development of quality for intermediate care by participation of Atsamat  network, Roi-Et Province.

Design: Action  research

Materials and Methods : The study participants included : 20 multidisciplinary personals from Atsamat hospital, 26 personals work in health promoting hospital and 100 caregivers. Data were collected by observation, record and focus group discussion during October 2018 to May 2019. Research design used PAOR process from Kemmis & McTaggart included 4 steps; 1) Plan: Analyzing situation of the patients treatment in hospital and plan operation to achieve objectives in service plan policy 2) Action: Establish guidelines for intermediate care, making tools for patient care, training caregivers and home visit by multidisciplinary team 3) Observe: In hospital, observe the participation of relatives or caregivers, progress of patient care, the readiness of patients and relatives before returning to community and home visit to observe rehabilitate progress and quality of life of patients 4) Reflect: Listen to the opinions of patients and relatives in appropriate care, listen to each patient’s problem and follow progress of patients rehabilitation. Data were analyzed by content analysis.

Main findings:  The development of quality for intermediate care by participation were suitable patient care guideline, patients receive standard care, continuous care in the community, forward information and issue in suitable time, according receive to golden period, allocated medical resources that suitable for the problem, relatives take care patients correctly and appropriately. From the operation in 2019 (8 months) found that 61.90% patients get better symptoms and perform daily activities by themselves, 89.95% Barthel Index increase, 12.69% with complications, 6.35% palliative care and 3.17% patient died. Can be seen patient care for intermediate care still in rehabilitation to golden period must be continuously monitored for another 6 months.

Conclusion and recommendations: Development of quality for intermediate care will result in the patients receiving continuous standardized care, forwarding the problem data to be followed in a timely manner. Patients are treated according to the golden period and relatives can take care of patients correctly.