Development of Fast Track Service System for Patients with Stroke Wapipathum Hospital and Service Network

Abstract

Objective : To develop the fast track service system for patients with stroke in Wapipathum Hospital and service network.

Methods : The study design used an action research process. Participants in the research consisted of patients with stroke, caregivers, and health care providers. The research was conducted from July 2014 to September 2016. The study process was composed of three phases: 1) situational analysis, 2) service process development, and 3) evaluation. Data collection instruments included the data record form for patients with stroke, an evaluation form for practice related to the standard care and referral pathway, questions for interviewing patients and caregivers, and questions for focused group. Data were analyzed by frequency, percentage, mean, standard deviation, and content analysis.

Results : Situational analysis phase: problems of fast track service were reported in both process and outcome domains. Development phase: three action research cycles were as following 1) rapid access to stroke fast track 2) patient screening 3) care process 4) development of the standard care and referral pathway and 5) patients follow - up. Evaluation phase: 100% of health care providers followed the standard care and referral pathway. The average duration of symptom onset was 72.22 minutes. The average duration of receiving a rapid assessment, accessing an electrocardiogram, and preparing for referral practices after an initial treatments were 4.39, 3.67, 5.42 minutes, respectively. The total average duration of accessing the special care was 13.47 minutes. There were no patients dead after referring.

Conclusion : The results indicate that the developed fast track service system for patients with stroke help with decreasing duration of accessing the special care of these patients in order to meet the standard of care.

Keywords : Fast track service system, stroke