Quality Improvement of Services in Diabetes Mellitus Clinic at Tambon Yangwai Health Promoting Hospital Khonsawan Distric Chaiyaphum Province

Abstract

The improvement of services in diabetes mellitus clinic, Tumbon yangwai health promoting
hospital, having the objectives to develop quality of service of diabetes clinic and to support
diabetics behaviors management. The Chronic Care Model and Donabedian model are applied to
evaluate diabetics care. The target group consists of 5 diabeties clinic staffs and 30 existing diabetics
having blood glucose levels over 180 ml per deciliters. This research uses evaluation form of
diabetics behavior management and evaluation form of service satisfaction and analyzes by
qualitative analyzing method and quantitative analyzing method with average percentage and Paired
t-test. The development was conducted between May 2013 and September 2013. Research
procedures include 3 steps, 1st step is preparation of situation analysis and problem solving with
service providers and patients, 2nd step is the execution of service quality development, and 3rd
step is result evaluation and consequent planning.
The result: of study represents the problems of diabetes clinic in service management
structure, limitation of staffs, unclear roles of interdisciplinary team, lack of long term strategic
plan, lack of learning activities among patients for self management, lack of knowledge media,
unstructural knowledge sharing, lack of clear approach on house visiting, discontinued health
promoting of community, lack of analysis and planning for service from the patients information
recorded in computer system, and unsuitable self management of patients for food, exercise and
medicine. These problems lead to the development of service provide team and diabetics. After
development, the structure and work process are more clear, diabetics have significant different
average score of self management after development (P<0.05), and satisfaction score from
diabetics and service providers are high. For clinic result, average blood glucose levels in blood
is significantly lower (P<0.05).