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Srithanya Hospital, Department of Mental Health Thailand.
Thailand

The Problem

Srithanya Hospital(SH)is a biggest psychiatric hospital in Thailand and service of 120,000 cases per years of OPD services. At out patient psychiatric services provides 500 cases per day and 120 cases are continuous and long term medication, To improve long term medication and maintenance care services. We developed one stop service clinic program under medical treatment,quality of care and hospital accreditation standard, we can provide speedy time access from 47 minutes to 5 minutes service with this speedy processing are more convenient for our client and also our staff as well.

Solution and Key Benefits

 What is the initiative about? (the solution)
Client-oriented and holistic care services are the most concern services in this clinic. First, we made the pilot study that result show our clients who's continuing long term medication have to waiting for psychiatrist for prescription,then after evaluated symptom and mental status sign of maintenance medication for same treatment programme allowed ot visit psychiatric nurse (whose well special training) at long term care clinic. Scecond, after symptom check up and counseling they have got prescription as same previous medication. Third, they have to come back for follow up every 3 months, 6 months and 1 years by psychiatrist. 2 years services clients satisfaction in one stop services clinic increase 96.8% when compare with the provious years is lower than 85%
Clients benefited from this service and continue long term medication then can prevent relapsing symptom. They can maintain their social life in community without burden of their family.

Actors and Stakeholders

 Who proposed the solution, who implemented it and who were the stakeholders?
The clinical leading team of out patient department.(CLT-OPD)are implement this services, all staffs know one stop service. The team composed of Psychiatrist, Psychologist, Social worker, Psychiatric Nurse, Pharmacist, Financial personnel, Social security personnel, Medical record and registration staff. The team involve as committee and services in this clinic.

(a) Strategies

 Describe how and when the initiative was implemented by answering these questions
 a.      What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
Previous process service
Registration 7 minutes
- ID check
- medical record filing
- return ID
↓
Right & benefit Unit 5 minutes
- check document
- type of payment
↓
Continuous long term medication clinic 9 minutes
- symptom check up
- prescription print out
- client prescription
↓
Pharmacy department 5 minutes
- cost - calculating
↓
Financial department 6 minutes
- Payment
↓
Pharmancy department 15 minutes
- medicine receive

(b) Implementation

 b.      What were the key development and implementation steps and the chronology? No more than 500 words
One Stop Service
1.by pre-service preparing 1-2 days.
2.one stop service process.

(c) Overcoming Obstacles

 c.      What were the main obstacles encountered? How were they overcome? No more than 500 words
One Stop Service
Continuous long term medication clinic 2 minutes
- clinic card
- symptom check up
↓
Financial department 2 minutes
- payment (pre-paid calculation)
↓
Continuous long term medication clinic 1 minute
- Medication (preporing 1 day before)

Remark : in case of gold card of health coverage card can take medicine with out payment

(d) Use of Resources

 d.      What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
2 main obstracles encountered are as following
1.team attitude
1.1 wasting time
1.2 prescription error
2.clients problem
2.1 antipsychotic drug side effect
2.2 loss follow up

They were overcome of 6 stretegies
1.report and confirm satisfaction services by client survey, prescription check-recheck method.
2.decrease workload and more amount clients service.
3.psychoeducation documents in relapsing sign and symptom watch, antipsychotic drug side effect and how to handle, services provide.
4.protocol for follow up by follow up letters, phone, msn.messanger.
5.counseling clinic, drug counseling clinic and education clinic available at OPD.
6.third party evaluation services.

Sustainability and Transferability

  Is the initiative sustainable and transferable?
Yes, in every dimension as following
1.timeliness
1.1.time access speedy processing from 6 steps 5 process in 47 minutes to 3 steps 2 process 5 minutes.
1.2.decrease crowded, waiting time
1.3.increase service from 200 cases to 400 cases perday
2.cliented - oriented because their own choice follow up and phone in to make an appointment or cancel
3.out-source evaluation by third party.
4.avialable access in case need to contact for more information such as hotline counseling, web site, e-counseling 24 house services.

Lessons Learned

 What are the impact of your initiative and the lessons learned?
1.interactive learning though action research
2.provide high-quality services by Continuous Quality Improvement (CQI) and quality control services.
3.maintenance quality services as best practice.
4.clients center and satisfaction, their own choice visit.
5.team work integrated.
6.national award from The Committee of Civil Servants Development in 2005.

Contact Information

Institution Name:   Srithanya Hospital, Department of Mental Health Thailand.
Institution Type:   Government Agency  
Contact Person:   Dr.Kiattibhoom Vong-rachit Ms.Phanomsri Sousarn
Title:   One Stop Service  
Telephone/ Fax:   66(2)5250981-5 Ext 1691, 1692
Institution's / Project's Website:   66(2) 5250491
E-mail:   noi_phanom@hotmail.com  
Address:   47 Moo 4 Tivanon Road, Maung District
Postal Code:   11000
City:   Maung
State/Province:   Nonthaburi
Country:   Thailand

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