The Development of Surgical Services Followed the One Province One Hospital Policy of Nakhon Phanom Province: Case Study of Srisongkram Hospital

Abstract

Objectives : This study aimed to determine the development of surgical services followed the One Province One Hospital Policy of Nakhon Phanom Province in Srisongkram hospital

Materials and methods : This action research study was implemented in Srisongkram hospital by applying the Continuous Quality Improvement concept. Studying in all patients who visited at surgical clinic between September 14, 2023 and October 31, 2023. There was one surgeon from Nakhon Phanom Provincial hospital worked at Srisongkram hospital a day per week for patients’ examination and surgery. Data were collected by developed data collection form and were analyzed by descriptive statistics such as percentage for quantitative statistics and content analysis for factors affecting the successfulness of policy implementation.

Results : During 1.5 months of the study period, there were 174 patients received the surgical services; of these, classified into surgical outpatients in 156 persons (89.66%) and patients who received the surgeries in 18 persons (10.34%); mostly found the Hernioplasty in 6 persons (33.33 %) followed by an excision in 5 persons (27.78%), respectively. There were 3 patients who received local anesthesia for tension-free herniorrhaphy which is the 1^st time for Srisongkram hospital and used telemedicine for pre-anesthesia assessment with the anesthesiologist from Nakhon Phanom provincial hospital. Factors affecting the successfulness of the policy implementation were administrative factors including clear policy, prioritized by executives and cooperation of related stakeholders and service factors including an expertise of surgeon and medical equipment and supplies, and patients received a high quality, comfortability and fast.

Conclusion : The development of surgical services followed the One Province One Hospital Policy of Nakhon Phanom Province in Srisongkram hospital resulting in the patients received a good quality of surgical services from expert surgeon at the community level with save, convenient, and fast and relief the overcrowding of service of provincial hospital and be the starter point for expanding the nodes hospital for the surgical service followed the One Health One Provine Policy in coming future.