The results of practical guideline of referral system of Phrae Hospital, Phrae Province=ผลของแนวปฏิบัติการส่งต่อผู้ป่วยผู้ป่วยโรงพยาบาลแพร่ จังหวัดแพร่

Abstract

Background:  In the past , The development of  referral system has continuously encountered various  problems especially during organization restructuring of management, services , and  health insurance. There was also no linkage between health service networks including unclear direction of  practical guideline. This study will help to standardize the referral system which is safe and appropriate for patients.

Objective: The purpose of this study was to determine the results of practical guideline of referral system of Phrae Hospital.

Study  design: Phrae province by using Mason ^, s (Mason^, Technique  one group pretest – post test technique in order to compare between existing and new  practical guidelines. The forty (40) studied samples were registered nurses and drivers who were responsible for referral system in Phrae Hospital. Data analysis were Descriptive Statistics, Percentage, Mean, Standard Deviation, and exact  Mc Nemar test and Paired t-test.

Results:  The study found that structured standard of Phrae Hospital comprised of four  (4) standards, and three (3) process an foutcomes standards. Structured standard comprised of 1) Standard 1:24 hour readiness of vehicles and drivers the study found that after participating the program , studied samples did higher scores than before participating the program (5.90, 5.50). There was no statistically significant difference.2) Standard 2: medical equipment and supplies in the ambulance the study found that after participating the program, studied samples did higher scores than before participating the program (4.00, 9.90). There was statistically significant difference (p- value = 0.034) . 3) Standard 3: readiness and adequacy of nurses and staff the study found that after participating the program, studied samples did higher scores than before participating the program (2.45 , 3.96). The was no statistically significant difference.4) Standard 4: effectiveness of information recording system during the referral the study found that after participating the program, studied samples did higher scores than before participating the program (4.16,4.50). There was statistically significant difference (p- value = 0.047). Process and outcome standards comprised of : 1) readiness of patient before referral the study found that after participating the program, studied samples did higher scores than before participating the program(3.90 ,3.93). There was no statistically significant difference.2) Standard 2: taking care of patient during referral the study found that after participating the program, studied samples did higher scores than before participating the program (4.86 ,5.50). There was statistically significant difference (p- value = 0.046). 3) Standard 3: patient and relatives relief the study found that there was no difference between before and after participating the program.

Conclusions: Clean –cut and Standardized  guideline  implementation  improve quality  outcome of patient transfer.

Keywords: Referral to the patient, practical guideline of referral system of Phrae Hospital