| 4. In which ways is the initiative creative and innovative?
|
|
There were four important steps in implementation of this HSH initiative. First step: Transformation step started in 1995 by introducing the information technology to the ordinary classroom in QSNICH e.g. Computer Assistant Instruction program(CAI) and eDLTV using offline technology, operated by NSTDA, MOST which was authorized by DFL. Families and patients were included in decision making to create a suitable IEP for them and also the local administrators and private sectors to share their suggestion and resources. The HSH initiative has been under the Patronage of H.R.H. Princess Maha Chakri Sirindhorn, and gained informal collaboration form BSE, sending two teachers to work fulltime in HSH. Second step was Transfer step. HSH model was continuously developed to create the qualified best practice of school in hospitals in the information age using ICT, therefore in 2005 QSNICH which is responsible for national child healthcare policy advocacy, proposed the HSH initiative to Department of Medical Service (DMS), MOPH to set the policy of transferring this model across the country, thus hospitals up country were included into HSH network. The bigger the networks, the more partners, the better whole-of-government service approaches in fostering the vulnerable human resources are. MOPH created six networks according to the strategic plan during this period. The third step was Inter-government agencies MOU. In 2009, the official MOUs between MOE, MOPH and MOST were done to ensure the transferable and sustainable of the initiative, thus accelerated the growth of HSH networks and coming together with sufficient resources e.g. MOE’s policy of having three teachers each HSH. Scheduled meetings were set to strengthen collaboration among all stakeholders and to share learning experiences. Together they set the clear vision and political will to promote the whole-of-government approaches in education service of the young chronically-ill patients for ease of access. Many new ICT technologies were added on to foster the holistic medical care, education and social inclusiveness of young patients in hospital both from the public and private sectors including citizens who volunteer. Continuous development is final step which has been done to ensure the better service in providing sufficient education for young patients meanwhile hospitalization or even at home in some cases, who could not go back to normal school, then the teachers from the Office of non-formal and informal education (ONIE), MOE provided them the non-formal and informal education. Evolution were as followings: In 2009 notebooks were introduced to support the bedside teaching which started in 2006 with simple teaching documents, Special Examination center in hospital was first started in 2011 thus patients could then study and be tested on their lessons without the need to re-take the exams after they are discharged from the hospital to answer all needs of patients, special program for children with learning disability (LDP) was launched in 2012 and also the completed online technology of eDLTV and infrastructure. Tablets were substituted notebook to suit the small young patients which have succeeded in increasing their willingness to learn. Last in 2013 the special program for autistic children named “Social Story Program (SSP)” was first distributed in HSH networks for testing its ability to increase autistic children focus and social inclusiveness. Inclusion of all stakeholders was the main goal, thus Social media: Facebook account named “IT for young patients in hospitals” was created in 2012 by NSTDA, MOST to promote the initiative and bolster communication of all users and workers allow them to feedback and share about all activities of the initiative to improve overall perspective. Moreover, in 2012 teleconferences were used to enhance communication among networks in sharing of suggestion, opportunity for improvement, and resources.
|
|
| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
|
|
HSH initiative is executed mainly by the committee of three ministries: MOE, MOST and MOPH according to the MOU, together with many stakeholders e.g. DLF, private NGOs, local administration office and 23 network hospitals nationwide including patients and families . 1) MOPH by QSNICH provides the HSH model development, medical and paramedical personals as the consultants and resource persons and budget to transfer HSH model nationwide and arrange the evaluation and monitoring of network performance by the three ministries monitoring team. 2) MOST by NSTDA provide the IT infrastructure (PC and Tablets), installation of e-Learning programs e.g. CAI, eDLTV, creation of LDP and SSP, training teachers to ensure teaching skill by using e-learning. 3) MOE by BSE provides teachers, assistant teachers who manage edutainment for patients at bedside, and teaching materials. Office of the non-formal and informal education (ONIE) provides vocational classes as scheduled for both patients and families and supports the establishment of an examination center in HSH. 4) DLF contributes a full range of eDLTV programs at no cost, not only accession online at http://edltv.dlf.ac.th/ and http://edltv.vec.go.th and authorized NSTDA to store the whole data to digital storage for all HSH can access offline anytime. 5) Some private NGOs and Local administration office can involve in HSH located in their geographical area to do edutainment and vocational education and community wisdom as appropriated. 6) Last the youth patients and families have opportunity to take part in designing or even teaching the children by themselves. The whole stakeholders cooperate to create the real holistic school in hospitals and foster the education of chronically-ill youth all over country thus they can live their childhood life with better physical and psychology health, and proper education together with sufficient social inclusiveness and become the qualified human resource of country in the future.
|
| 6. How was the strategy implemented and what resources were mobilized?
|
|
Human resources: Medical teams in hospitals under MOPH take care of the young patients’ physical and psychological health, and create their in–hospital education plan as IEP together with teachers and patients’ families. Three teachers from BSE, MOE, are fulltime staff in HSH, taking care of young patients’ education, and also edutainment both in class and bedside. These teachers need special skills: using IT equipment and e-Learning programs to aid their teaching. Teachers from ONIE, MOE, are part-time instructors, when the young patients need vocational education and special examination in hospital. IT teams from NSTDA, MOST, take care of implementation of infrastructure, program installation, special programs development, including Facebook development and maintenance, and operation to maintain and ensure that access ability to e- Learning is possible anytime anywhere. They also nurture teachers to ensure their teaching ability in information age. Last the volunteers and NGO groups, who willing to contribute to these vulnerable youths, visit HSH occasionally or as scheduled to arrange the varieties of activities and recreation for young patients in HSH thus nurture their mental health and promote social inclusiveness. Some local administration offices, where HSH located, may involve as local HSH committee or MOU in teaching the local culture and wisdom.
Budget: Mainly from MOE for the salary of three teachers in HSH, in 2014 MOE provide one more conference added on the one that MOPH arranged annually for sharing and monitoring, evaluation and promote the hospitals and local administration offices to transfer HSH initiative, thus contribute more than 30 million baht. MOPH by QSNICH contribute the over one million baht each year since 2005, for transferring of HSH model to the hospitals nationwide according to the strategic plan including monitoring and evaluation of this initiative. At hospital level, the administrators grant the area and renovation cost to suit a classroom and teachers office. Budget from NSTDA may not substantial compare to their technology and man-days. It is over 100,000 baht using mainly to travel among HSH networks to finish their tasks mentioned above.
Materials and Technology: The eDLTV is the intellectual property of DLF initiated by His Majesty King Bhumibol Adulyadej. The program provides education at primary, secondary and vocational levels which are compatible with the curriculum of MOE. It was first transmitted via satellite but now using modern information technology, the programs provides students at distance schools with a virtual learning environment. DLF authorized NSTDA to distribute and install the program to schools in needed across countries including HSH networks to educate all vulnerable groups. All e-Learning programs, CIA and special programs e.g. LDP and SSP are installed by NSTDA staff. Most of the PCs and tablets are the used computers being donated to NSTDA who distribute to those in need as HSH networks. The tablets, be introduced for bedside teaching because of some medical situations, patients cannot be moved. Together, all government agencies and citizens work together in contributing to the learning of young patients, who are the future of country.
|
|
| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
|
|
Tight communication and interaction among government agencies and citizens together with clear vision, strong willing and recognition of powerful IT, three ministries introduced a unique idea and new policy to promote the whole-of-government approaches in education and social inclusiveness of the vulnerable group thus created public high value. The most potential output is the percentage of patients, those can resume their normal education, has increased from 65% in 1994 to currently 99.4% after implementation. The number of students increased from 5,215 in 2004, to 34,592, 36,558 and 47,630 in 2011, 2012 and 2013 respectively and satisfaction is 93%, 95% and 98%. Replication of HSH is effectively executed thus HSH networks have increased in number 17 places during 2005–2014 compared to 4 places during 1995–2004, that is more than 4 times growth in the 10 year interval. Also, teachers have increases from 2 before 2009 to currently 3 in each HSH according to the policy of MOE that is 50% increasing in human resources. Beside e- Learning education, social inclusiveness was gained by using social media: Facebook account “IT for young patients in Hospital” and Skype account to a)contact and share with friends in social societies, b)communicate between teachers, patients and families c)interactive homework assist, d)data storage of learning history of patients which will be transfer to their current school after they can leave the hospitals, e)gather the recommendation from all stakeholders, f)distribute the merchandises made by patients and families. Thus FB followers have increased 66.6%, 72% and 86% in last three years. This initiative made the transformation within a large framework rather than incremental expansion. Using e-learning program making HSH achieved academic standard certified by MOE as patients can pass the examination of ONIE 100% consecutively since 2011. This also enhances the teachers’ capability to fulfill their ability in teaching various subjects that are needed for the patients. HSH was authorized by ONIE to be the first examination center outside regular schools. It is also the first start of the community to be involved in providing education to the youth, thus there are diversity among HSH network to fit the context of each community, such as the terrorist situation in the south of Thailand that schools often be attacked so they expanded the HSH to help the illiterates to study via e-learning in rural hospitals not only in provincial hospital.
|
|
| 8. What were the most successful outputs and why was the initiative effective?
|
|
The initiative is evaluated mainly using the indicators those are set in strategic plan and operational plan each year. The measures focus on all parameters: the achievement of patients and families, human resources, IT accountability, social media using, HSH networks capacity and ability, and the accountability of e-Learning program including the achievement of the HSH model replication. The measurements are the number of young patients involved by each HSH and total number each year, number of young patients that can resume their proper educational class, number of young patient that go to the non-formal and informal education system and those who pass the examination of ONIE. These measures evidence whether the HSH network is qualified as the standard school. Moreover the program monitors the performance of teachers by online testing to ensure their potential in teaching by using e-Learning program, the number of Facebook account users and followers, number of e-Learning classes viewed, customer satisfaction to HSH, number of teachers working in each HSH, number of new HSH and total number each year, so far we can ensure that the initiative is on track meeting the target set in strategic plan. The result of all indicators from 23 HSHs will be sent online to the representatives of all involved ministries. 2) Network meeting will be hosted annually by QSNICH (MOPH representative), the delegates are from three involved ministries, all HSH networks and also customers and stakeholders representatives. Since 2014, MOE by BSE hosted one more meeting thus now there is twice meeting a year. 3) Multidisciplinary Supervision team, consisted of QSNICH, BSE and ONIE (MOE representatives) and NSTDA (MOST representative), will visit HSH across the country six times each year. They aim to help the hospitals to start the HSH model efficiently and help existed HSH to solve their onsite problems. 4) Annually, the HSH project committee from involved three ministries will report to H.R.H. Princess Maha Chakri Sirindhorn, who is very interesting in helping all of the underprivileged citizens, and always encourage the involved government agencies to focus on this initiative. Each year the representatives from three ministries will together analyze the data collected from all networks and stakeholders including problems and suggestions and SWOT analysis in order to organize the operation plan for further development of the initiative.
|
|
| 9. What were the main obstacles encountered and how were they overcome?
|
|
The obstacles mainly are 1) Teachers turnover rate is high, only 48% of them worked longer than three years because HSH can’t provide them the suitable career path as working in real school, so they need to move out to pursue their career as teachers in schools. The solution is MOE now creating the career path for teachers in HSH networks that they can get promotion without moving out. 2) Budget, the more patients HSH catered, the more budget needed for all kinds of resources and management. Solution is increasing the government budget and HSH networks raise fund from local private sector for materials and management. 3) Place, HSH is only one in many tasks of hospitals, also space in some hospitals are very limited that HSH in those hospitals are not match the ultimate place for foster the holistic care and education for young patients. The solution is HSH inter-government-agencies committee set the criteria for hospitals to be recruited as one of the HSH networks, in which the proper space is one of the criteria. 4) The infrastructure, it is the shortage of PC or tablet, but the bedside learning is limited without high speed hotspot available in hospital especially in the ward that patients had been admitted. This solution is difficult but the inter-government-agencies committee is focusing on it. One of the permanent solutions is 3G+ telecommunication service for mobile equipment but it needs the collaboration of private companies, owners of 3G+ technology and takes time to become a reality. The transient solution is that the assistant teachers upload the programs or subjects into mobile equipments, covered the patients’ need according to their schedule each day, and redo it every day. This is not ultimate because it increases workload of the teachers, but it is currently the best.
|