Development of a System for Classification of Patients in Outpatient and Emergency Departments at Chokchai Hospital

Abstract

This action research aimed to develop and measure effectiveness of the patient classification system for outpatient and emergency department at Chokchai Hospital. The study was conducted from January to July 2020. The researcher applied the concept of continuous quality improvement using the Deming cycle. The target groups in this research were 28 staff who worked in outpatient and emergency department and 520 medical records of the clients randomly selected from the clients who visited the department during March and June 2020. Instruments used in this study were the patient classification guidelines according to MOPH ED TRIAGE developed by the Department of Medical Services, the Ministry of Public Health. The instrument was checked for content validity for the patient classification. The data were collected through a participatory workshop and were checked for the data quality before being analyzed with a computer software package with descriptive statistics using frequencies, percentages, means and standard deviations.

Results from the patient classification using the new measures during 4 months between March and June 2020 showed the percentages of correct patient classification of 69.2%, 75.4%, 77.7%, and 85.4%, respectively. The percentages of incorrect patient classification were at 30.8%, 24.6%, 22.3% and 14.6%, respectively. The percentages of under triage during the four-month period were at 23.9%, 18.4%, 17.6% and 13.1%, respectively. The portion of over triage is 6.9%, 6.2%, 4.6%, and 1.5%, respectively. The portion of correct examination for severity classification is 83.1%, 82.3%, 86.2% and 85.4%, respectively while the percentages of the incorrect examination for severity classification were at 16.9%, 17.7%, 13.8%, and 14.6%, respectively.