The Result of development’s referrals system for surgical inpatients from network in Udon Thani Province

Abstract

This action research aimed to develop a system for surgical inpatients from network
hospitals in Udon Thani province between December 2019 and February 2020. The
samples were users of patient referral guidelines at every community hospital in the province.
and were patients with surgical indications who were referred from community hospitals in the
province to obtain treatment at Udon Thani Hospital during the specified time. Quantitative
data were analyzed using descriptive statistics. The operation was divided into 3 phases. Phase
1 analyzes the situation, conditions of problems and needs. Phase 2: providing knowledge,
developing clinical practice guideline (CPG) and referral systems. Phase 3: evaluating and
adjusting the operating system. The research results found that there was an increase in
coordination calls between referring doctors and specialist doctors from 45% to 85%. Lab
and basic investigation preparations for community hospitals were 100% completed. There
was regular coordination from the referral coordination center before sending patient to Udon
Thani Hospital. As a result, the mortality rate from surgical sepsis decreased from 11.5%
to 5.0%. Rupture appendicitis rate decreased from 9.3% to 5.7%. Percentage of acute
abdomen surgery within 12 hours from 76% to 80%. Acute appendicitis surgery within 8
hours increased from 46% to 87%, reflecting effective management. This approach should
be used as a guideline for transferring patients requiring surgery in the hospital network; and
the guideline could be benefitial for other provinces.