Good Practices and Innovations in Public Governance 2003-2011

2008 Category 2: Thailand
patient could go back home. Survey studies found that the total waiting time was five
hours 58 minutes per case. Patient satisfaction was 72.3% in 2004.
There were two to three complaint letters per day saying that “The hospital was a
slaughter house”; “The nurse should perform better service”; “Poor service”; “Wishing
the nurse would smile more”; “The hospital has only a few doctors and they come
rather late, making the patient spend a long time in the hospital”; “Patients need a
quicker service”; “There is an untidy and dirty environment and especially the toilets
– smell bad”; “The hospital should take better care at this stage”; and “The hospital
should cooperate with other care providers and not rely on patient self-help alone”.
Increasingly, when people became ill, they preferred to buy medicine or see a doctor
at a private hospital or private clinic. This increased patients’ expenses unnecessarily
and resulted in patients sometimes taking unnecessary drugs. People who take too
much medicine have higher risks of getting sick from adverse drug reactions, which
can be life threatening.
The Solution
A team composed of doctors, pharmacists, lab and X-ray staff, technicians, nurses,
ward officials, psychologists, physical therapists and other professionals was set up
and through brainstorming, teamwork, and cooperation the Hospital developed a
good front liner system with multi-disciplinary care teams that later received several
awards. It took a long time to brainstorm with all of the concerned units and
team work was given priority. That has meant holding frequent meetings to evaluate
all problems from patients who entered the medical cycle. Continuous Quality
Improvement (CQI) standards were introduced to guarantee high quality service
standards leading to an improved system that reduces steps and waiting time for the
patient’s well-being and ease. Building a positive environment with Thai music,
karaoke, and a meditation room, along with having a health club promotion has
also contributed to the Hospital’s success. An equally important part of its success
can be attributed to the clear policies set by the higher executives as well as the
increase in budgets and continuous evaluation and monitoring. Most importantly,
however, are the service providers’ continuous dedication and concern for patients,
as well as the efforts they made networking among communities and private sectors.
Every month there is a meeting to monitor the quality of services, and to
identify any problems.
Using the assessment of patient satisfaction by Dusit poll and Thailand Hospital accreditation
questionnaires, the Hospitals’ team collected data by randomly sampling
20 patients per day every morning for 30 days. Every day the data were summarized
and analyzed. The key performance indicators included patient satisfaction, patient
complaints, and service timing. After one month each patient from the analyzed re-
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