Development of a Seamless Service Model for Colorectal Cancer : From Screening to Treatment – Ban Phai District Health Service Network, Khon Kaen Province.

Abstract

      This action research aimed to develop and evaluate a seamless service model for colorectal cancer, covering the continuum from screening to treatment, within the Ban Phai District Health Service Network, Khon Kaen Province. The study was conducted between July 2025-August 2026,utilizing the action research framework of Kemmis and McTaggart. It comprised three phases: 1) situational analysis and problem assessment; 2) model development through two cycles of planning, acting, observing, and reflecting; and 3) model evaluation. Participants involved in the development included 58 multidisciplinary personnel and network stakeholders, alongside the target population (individuals with positive FIT test results), colorectal cancer patients, and their primary caregivers. Research instruments included the seamless care model, guidelines for screening and colonoscopy preparation, a monitoring information system, clinical and service outcome record forms, and satisfaction assessment forms. Data were analyzed using frequency, percentage, mean, standard deviation, and content analysis.

      The research findings revealed that... The developed seamless service model comprises four key components: 1) standardized screening and collaborative care protocols; 2) an information technology system for monitoring; 3) case managers; and 4) communication channels among the multidisciplinary team. These elements link care across the community, primary care units, Ban Phai Hospital, and the regional hospital. Following the model's development, service outcomes have shown improvement. Screening coverage using the FIT test increased from 65.30% to 94.07%. The rate of colonoscopy uptake among those with positive FIT results rose from 91.67% to 94.90%, with the proportion undergoing the procedure within 30 days increasing from 75.76% to 92.47%. Meanwhile, the average time from a positive FIT result to colonoscopy decreased from 39.2 ± 14.6 days to 23.6 ± 8.4 days. Adequate bowel preparation quality improved from 84.85% to 95.70%, while instances of incomplete bowel preparation or procedure postponement dropped from 15.15% to 4.30%. Furthermore, the rate of patients undergoing surgery within four weeks rose from 66.67% to 91.67%; chemotherapy initiation within six weeks increased from 60.00% to 87.50%; radiotherapy initiation within six weeks rose from 50.00% to 75.00%; and referrals for continued follow-up within the network increased from 75.00% to 92.86%. Staff satisfaction with the overall model was at the highest level (mean 4.53 ± 0.42), as was the overall satisfaction of patients and primary caregivers (mean 4.57 ± 0.40), with staff attentiveness receiving the highest mean score (4.63 ± 0.37).