A Development of Acute Trauma Referral Operation System from Northern Khon Kaen Hospitals under the Ministry of Public Health to a Srinagarind Hospital under Khon Kaen University

Abstract

This action research was to study the acute trauma referral operation system after a mutual agreement upon the memorandum of understanding (MOU) between the northern Khon Kaen Hospitals under the Ministry of Public Health and Srinagarind Hospital under Khon Kaen University and to develop the system to be more suitable to the context. The procedures consisted of 3 steps: (1) study of the condition and the management of the inter-hospital referral system, (2) analysis of the lessons learned from 5 meetings among the referral service plan committees and the referral staff for further improvement of the system on a cycle basis, and (3) in-depth interviews with the co-operators from each referral center. The instruments included a survey protocol and an in-depth interview protocol. Descriptive statistical analysis and content analysis were conducted. Findings: other than the cooperation following the referral operation structure, the development of the system required 4 additional efficient working processes: (1) a referral operation guideline, (2) payment mechanism, (3) internal communication on the referral practices, and (4) enhancement of the personnel’s knowledge for the entire network. The outcomes after the MOU showed that the percentage of inter-hospital referrals from the northern Khon Kaen hospitals to Srinagarind Hospital was 3.6 times in comparison to Khon Kaen Hospital. The rate of the inter-hospital referrals from the northern Khon Kaen Hospitals to Khon Kaen Hospital was 9% lower. The mean of referral numbers from the northern Khon Kaen Hospitals to Khon Kaen Hospital was 2691.00 (SD=538.29), higher than the number before the MOU (mean=1815.75,
SD=861.02), and the referral distribution was also found lower. Thus, the development of the working process created from the efficiency of the systematical collaboration among the public health units under different organizations resulted in a positive impact on the entire system of public health service network in Khon Kaen.