Development of a new care system for Outpatient in Warfarin Clinic Sirattana Hospital, Sisaket

Abstract

          Sirattana Hospital is a community hospital with 60 beds (F1). Outpatiently receiving warfarin for 252 people, we conducted action research to manage problems and develop the warfarin new care system. A system for collecting patient information through Google Forms, questionnaires, and evaluating warfarin use; labels to help with taking warfarin; and tools to assist doctors in their work, including an application for calculating warfarin doses. Sirattana Hospital, through AppSheet, was developed. A comparative study of the old care system between 1 May and 31 October 2023, with 841 samples, and the new care system during the period of 1 November 2023 to 30 April 2024, with 907 samples
           The results showed that the number of times patients attended warfarin clinic appointments at Sirattana Hospital increased to 75.52 percent (from 65.19 percent). The INR value of patients in the treatment range increased to 65.71 percent (from 60.05 percent) when comparing the results of reducing the time for calculating the warfarin dose. Through an application to calculate warfarin dosage, we found that it took an average of 0.97 minutes per minute (from an average of 4.16 minutes per minute). In terms of developing a system to prevent errors in ordering and dispensing warfarin, it was found 1 time, 0.11 percent (from 11 times). Complications from the use of warfarin decreased, found 19 times, 2.09%, without finding a major bleeding event (out of 49 times, 5.83%, with 1 major bleeding event, 0.12%). Cooperation problems Patients' use of warfarin decreased, and patient compliance problems decreased. and from the assessment of worker satisfaction. Overall, workers are at the highest level of satisfaction. Patients therefore receive services that are convenient, fast, safe, and efficient. and maximum efficiency. Operators are the most satisfied.