Development of the Home Ward Care: A Case Study of the Health Promoting Innovation of Khlong-Yai Hospital, Trat Province

Abstract

This qualitative research aimed to analyze the process of the health promoting innovation for home ward patients’ care in the Klong-Yai hospital, Trat province. The concept of health promotion, the Ottawa charter was applied for the study framework. A purposive sampling was used to recruit 25 informants from July to August 2014. Data were collected by using focus group, in-depth interviews, observation, voice recording, and related documents. Trustworthiness was ensured by triangulation method and content analysis technique was used to analyze the data.

          The results revealed that the development process consisted of 4 stages. First, initiation of the policy aimed to reduce the hospital occupancy rate, the re-admission rate and costs. Second, formulation of the health care team was designed to organize a concept of one-bed hospital at home. The nurses primarily trained to caregivers who care for patients at home the same as at the hospital. Moreover, the care plan for home ward patients was called “grand round” which was organized by multidisciplinary team. Third, the care-team networking, such as helping groups, organization, volunteers, was created, which supported and funded by the local administrative organizations. Lastly, the home ward care model was developed. Medical equipment’ warehouse was established. The patient’s assessment system and the holistic care have also been operated. There were collaborations between nurses the local organizations, and other groups. Therefore, the networks for continuing health care activities have been spread throughout Khrong-Yai district. Consequently, the hospital occupancy and the re-admission rates were decreased. In addition, the complication rate of patients was lower than the criteria. These findings indicate that nurses could obtain to use for development of home ward care in other community setting congruence with the local health care district context.