Development of Medical Clinic Standards Inspection Guidelines Based on Risk Management Principles in Mueang Chon Buri District, Chon Buri Province

Abstract

Medical clinics play a key role in primary healthcare delivery. Ensuring compliance with legally required standards is essential for service quality and patient safety. However, the current inspection system applies uniform criteria to all clinics, limiting risk prioritization and appropriate inspection planning. This action research aimed to (1) assess the current situation and risk factors of medical clinics, (2) develop risk-based standard inspection guidelines, and (3) evaluate the appropriateness, feasibility, and usefulness of the developed guidelines. The study included five provincial and district health officers and 204 licensed medical clinics in Mueang Chon Buri District, Chon Buri Province, selected through purposive sampling. The research was conducted using three PAOR (Plan–Act–Observe–Reflect) cycles. Data were collected using interview guides, clinic information record forms, and the Department of Health Service Support's standard inspection checklist. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through content analysis. The findings identified personnel, budget, communication of regulatory requirements, and time management as the main challenges. The developed guidelines classified clinics into five risk levels and determined inspection frequencies accordingly. After implementation, the proportion of clinics meeting the required standards increased from 63.24% to 86.27%, while the numbers of high-risk clinics, legal violations, and public complaints decreased. In conclusion, the risk-based inspection guidelines developed through the PAOR process improved regulatory efficiency, optimized resource allocation, and enhanced compliance with clinic standards. The guidelines are recommended for wider implementation at regional and national levels.