The quality improvement model for warfarin clinic according to service plan criterion in Buntharik Hospital, Ubon Ratchathani Province

Abstract

Warfarin Clinic is a special health care service system that provided in cardiovascular care group. This action research aimed to develop the quality improvement of care in the warfarin clinic according to the standard of the health regional service system in Buntharik district Hospital, Ubon Ratchathani province. The 86 randomized samples were selected from the stake-holders, patient, relatives and caregivers. Quantitative data were collected and analyzed by using descriptive statistics; percentage, mean, standard deviation and inferential statistics such as Wilcoxon Matched-pairs Signed rank test. Qualitative data collection by group discussion, and interviews approached content analysis to analyses.

            The research found that there are 7 steps in this study; 1) data collection, 2) appointment team, 3) data analysis, 4) planning, 5) plan implementation, 6) monitoring and 7) reflection and lessons learnt. After the operation was found that the service providers have increasingly changed their knowledge, participation and satisfaction in service provision. Regard to the patients, there was positive changed in knowledge, behavior and satisfy to care service. And the relatives / caregivers found that there were significant changed in knowledge and satisfaction of care than the beginning of development processes. The number of patients with International Normalize Ratio (INR) in the normal range (Therapeutic Range) increased from 41.67% to 51.28%, as well as we can see the primary model of pharmaceutical care model which based on ECRS principles such as Eliminate, combine, re-arrange and simplify.

In summary, the key success factor comprised 1) policy direction to set up a special clinic of warfarin care 2) enhancing and capacity building of care providers with specialized skills and techniques in the multidisciplinary team and 3) retention the functional team on the principle of continuous improvement and participation.