Practical strategies were applied to establish a solid rehabilitation system in Ubonratchathani including establishing a collaborative network of rehabilitation, launching the community rehabilitation program, developing a data management and referral system, and strengthening the community for sustainable rehabilitation.
A collaborative network of rehabilitation was established by cooperation among Public Health Office of Ubonratchathani, a multidisciplinary team of Sunpasittiprasong central hospital and PT teams of community hospitals. The initiative has also coordinated with several government organizations and public/private sectors to provide rehabilitation services and multi-dimensional support simultaneously. These include Provincial Social Development and Human Security Office, Provincial Administrative Organization, Sub-district Administrative Organization, Department of Skill Development, Thong Phun-Pao Manat Vocational Rehabilitation Center, Special Education Center and Non-Formal Education Center of Ubonratchathani, and The Rotary Club in Thailand. Community health care volunteers, care givers, community leaders and established disabled societies have joined into the collaborative network. Multidisciplinary team functions as the hub of this collaboration.
A community rehabilitation program was implemented by multidisciplinary team of Sunpasittiprasong central hospital and PT teams of community hospitals to provide active rehabilitation service within the community instead of waiting for immobilized persons at the hospital. Multidisciplinary team including physiatrists, nurses, physical therapists and occupational therapists was responsible for providing rehabilitation services in the community once a week. The PT team including general practitioners, nurses and physical therapists was responsible for providing services in the community 3-4 times a week.
To organize this initiative smoothly and systemically, two newly developed software programs “PTSoft” and “PTSendRefer” were used as the data management and referral system for rehabilitation services in Ubonratchathani. PTSoft was applied to record the information of disabled persons including demographic data, disabled registration status, information related to caregiver, information related to disability (i.e., type and cause of disability, current status and problems, past medical history and treatment, complications of the disability, the needs for orthosis and other supports) and the received rehabilitation service. The data extracted from PTSoft could be used to organize a schedule and plan for community rehabilitation programs, and assess progressions and weak points that need to be improved. PTSendRefer was developed to apply for registration and recording the data of sub-acute patients after discharge from the hospital. The software then “sent” the patient information as the “referred” duty of continuous rehabilitation to community hospitals. According to this system, sub-acute patients could receive an appropriated rehabilitation program during the golden period.
Strengthening the community for sustainable rehabilitation was implemented by several methods. Education and training community health care volunteers and caregivers for basic rehabilitation procedures by multidisciplinary and PT teams were the main activities. Since it was not possible to send the PT team to the same community everyday, trained volunteers and caregivers have taken the duty of daily rehabilitation for disabled person in that community. On the other hand, the initiative empowered and supported the disabled persons to form their own society. Increasing the community strength to take care of their disabled persons was one of the top priorities of this initiative.