Development of Psychiatric Care Process on the Psychiatric Ward for Service Area, Surin Province

Abstract

Background: Psychiatric disorders are a major public health problem, especially emergency psychiatric patients with an increasing trend in the Northeast Region. Psychiatric inpatient care still faces challenges of a psychiatrist shortage, lack of standardized tools and guidelines, and inefficient referral and information linkage systems. Objective: 1) To develop a psychiatric care process on the psychiatric ward for service area in Surin Province 2) To evaluate the developed psychiatric care process on the psychiatric ward for service area in Surin Province. Method: This participatory action research study was conducted in three phases: situation analysis, development and implementation, and evaluation. The sample consisted of 24 healthcare personnel who voluntarily participated in the healthcare service system and 39 psychiatric patients' relatives. Data were analyzed using frequency, mean, standard deviation, and statistical significance was tested using paired sample t-test. Result: It was found that general hospitals and community hospitals in Surin Province still lack resident psychiatrists, causing the practical guidelines for psychiatric patient care in hospital wards to not meet standards as they should, and the referral information linkage between networks remains inefficient. Five key measures were developed for psychiatric care : 1) Fast pass admission system, 2) Psychiatric severity staging, 3) Training programs for network, 4) Psychiatrist network, 5) Telepsychiatry. After system implementation, access to services for schizophrenic patients increased from 65.22% to 70.54% (5.32% increased). The monthly psychiatric bed occupancy rate decreased by 18.94%, the readmission rate decreased by 6.52%, and the referral rate decreased by 10.09%. Following the system development, both staff and patients' relatives reported significantly increased satisfaction across all aspects (p < .001). Conclusion: The development of a comprehensive psychiatric care process on the ward, utilizing technology, diverse strategies for staff development, seamless care system, and emphasizing participation, helps improve the quality of psychiatric inpatient care.