The process of outcomes management in male paraplegia: an action research at a tertiary hospital
Keywords:process of outcomes management, male paraplegia, tertiary hospital
AbstractThis action research was to develop outcomemanagement process for male paraplegia in a tertiaryhospital at the northern region of Thailand. Participantsincluded multidisciplinary team members, personnelin the setting, male paraplegias and caregivers.The study took 3 phases for 23 months. The firstphase, situational analysis for 6 months, indicatedthat outcome management process was not fullyeffective in areas such as patient centered cares,insufficient cooperation among multidisciplinaryteam, inadequate continuous quality improvement.These resulted in complication occurred in patient,unable to self care, hence higher cost, longer lengthof stay, re-admission, and unsatisfied with providedservice. The second phase, process for 15 months,the research team then took part in solving thoseproblems. Patient centered care was given, teammembers were encouraged to collaborate, primarynurse provide continuous care. The research teamalso helped to make effective discharge planningand continuing care including prescribe desirableoutcomes and clinical pathway. The third phase,evaluation for 2 months, after perform those changes;all the above problems were satisfactorily improved.Those were shorter length of stay as withoutcomplication, able to self care, no re-admission,and more satisfaction with service, also changeboth personnel and care process. As well, the teamobtained an outcome management process modelfor male paraplegia that composes of primary nurse,patient centered care, continuity, clinical pathway,multidisciplinary teamûs collaboration, and continuousquality improvement.
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