Development of Emergency patient Referral system at Tha Uthen Hospital Nakhon Phanom Province

Abstract

     The purposes of this participatory action research were: 1) to study the current situation and problems of the emergency patient referral system, 2) to develop the emergency patient referral system, and 3) to evaluate the developed the emergency patient Referral system. The participants comprised 30 health care providers were selected by purposive sampling and emergency patients who were referred to hospitals with higher-level during the research period. The research instruments were used focus group discussion questions. Questionnaires were used for evaluating satisfaction with the application of the emergency patient referral system. The content validity was verified by three experts, and their IOC values were between 0.67- 1.0. The Cronbach’s alpha reliability coefficient of questionnaires was 0.82. The qualitative data were analyzed by content analysis, and statistical devices used for research data analysis were mean and standard deviation. Comparison of satisfaction before and after development was used Paired T-test
     The research findings were as follows. Knowledge, skills, and experience of personnel were inadequate. No planning of human resource development continuously. Equipment and medical supplies unavailable, unclear guidelines, ambulances were not ready for use, In cases where the patient's symptoms change during transfer and they are unable to communicate with the doctor , and delayed coordination of referrals between hospitals. The development of the emergency patient referral system consisted of 1) Input factors: personnel readiness, ambulance readiness, equipment readiness, medical equipment readiness, modern and fast communication systems, standard pre-referral, during and post-referral care processes, and efficient referral support and coordination systems. 2) Process: personnel training, emergency patient referral manual development, installation of a telemedicine ambulance system, preparation of necessary medical equipment and medicines, consultation and assistance system when problems occur in patient care during referral, equipment checklist, and preparing readiness of emergency patients and relatives.
     The result after the developed the emergency referral system revealed that overall personnel satisfaction before the development was at a moderate level. After the development, personnel were at the highest level of overall satisfaction, significantly higher than before the development of the emergency patient referral system at a statistical level of .05.