Developing a patient classification system for the outpatient department. Kaeng Sanam Nang Hospital, Kaeng Sanam Nang District, Nakhon Ratchasima Province.

Abstract

     This study was an action research study using Deming's quality development framework. The objectives were to develop a patient classification system and study its effectiveness in the outpatient department of Kaeng Sanam Nang Hospital between October 1, 2023, and September 30, 2024. The target group consisted of eight professional nurses and patient assistants working at the triage point or outpatient department, and data from 390 medical records. Data were collected using the patient classification manual, interview forms, and focus group discussion guidelines. Descriptive statistics were used to analyze the data.

     The study found that system and service provider outcomes included improvements to the patient triage manual, reviewing and enhancing emergency personnel, preparing assessment tools, identifying responsible individuals, engaging in development, and continuously developing personnel capacity. Patient outcomes included an increase in the rate of correct patient triage (>95.00%) before the development (2023). Improvements in Cycle 1 (January 5th to February 15th, 2024) and Cycle 2 (April 1st to September 30th, 2024) showed an increase of 98.74, 98.56, and 99.32 percent. Undertriage decreased by 1.21, 1.30, and 0.62 percent, respectively. Patients received timely care for severity levels (40.49, 42.74, and 49.09 percent of patients in the urgent emergency group, respectively). The average time for patients to be assessed and treated according to criteria in the urgent emergency group was 26.74, 25.76, and 23.54 minutes, respectively. Waiting times were reduced to 107 minutes from 113 minutes.