Questions/Answers

To turn a small, public community hospital located in the outback of Thailand, lacking both basic modern medical equipment and capable human resources and saddled with several million baht of debts into a “Dream Hospital with Smart Services” with the final objective of gaining back the trust, confidence and support of the community. To expand our services to remote areas to give equitable healthcare services to the people living in poverty and the marginalized people living along our border areas with the Republic of the Union of Myanmar who are not able to travel to our hospital. To involve the whole community to fully participate in our development efforts for a sustainable and truly community-owned hospital.

Category – delivering inclusive and equitable services for all under the principle of leaving no one behind. We have integrated technology to our services aiming to increase the medical care access for people of all genders, ages and types of medical care benefits even those living in poverty and the marginalized along our border with the Republic of the Union of Myanmar. We have created a connection of patient’s personal and treatment information between our hospital and community health promotion centers in our network to accommodate the patients who live in faraway areas.

a. Our initiative aligns with SDGs number 3 – good health and well – being. Patients seeking medical services in public hospitals encounter a long waiting time. This have affected the attitude of the people because they consider ‘seeing a doctor’ as a disturbance to their daily routine and their occupation. Due to changes in our service system, the waiting time to receive the services were reduced. Patients spend less time in the hospital which make ‘seeing a doctor’ affect their occupation a lot less than it used to. The connection of treatment information between our hospital and community health promotion centers in our network facilitates patients who live in faraway areas, the elderly and bedridden. These enhance the equity of those living in poverty or vulnerable and marginalized people, including foreigners living along our border areas with Myanmar located just 50 kilometers away, to receive immediate and long-term medical care near their residences without the need to travel to our hospital.

b. The initiative regained the confidence and trust of people in our community which enhanced the engagement of our stakeholders. Fund raisings have been successful. Philanthropists continuously donated money and medical equipment to our hospital. Our prompt and convenient services lessen the time people spend in the hospital that it no longer disturbs their working time. Medical treatments can now be obtained in community health promotion centers near their residences reducing travelling time of people living in faraway areas. The improvements done on our hospital environment created a healing atmosphere for our patients and a happy workplace.

a. Difficulties of access to public medical services in this region have been a major concern and an important issue for long time. By ‘thinking outside the box’ we initiated the use of technology in our services to lessen the waiting time. We developed our staffs’ capabilities and services behavior. We provided quality treatments along with the use of modern medical equipment. Our Primary Care Center located only a few meters away from our main hospital building is tasked with determining first-hand what kind of medical service a person needs then sends them to the relevant department in our hospital. Pregnant mothers are given advice and guidance on pre-natal care and children are all given age-appropriate check-ups and free vaccinations. Schools in our community are visited to perform health checks on all school children to determine their healthcare needs and coordinate with teachers and school principals on their findings and recommendations. They also visit homes of the elderly people and the bedridden on a regular basis to give them primary health checks and bring their medications. Everyone can now access our medical services which resulted in the decrease of complications and mortality rates.

On the gender inequality issue, we treat people of all genders, all ages and all medical care benefits, even those without any, equally and without any prejudice. We give equal medical services to everyone in the same standard. We uphold the principle that healthcare is a fundamental right of every human being.

Our “Dream Hospital with Smart Service” initiative targets every single patient who comes to us without regard to religion, skin colour, ethnicity, social or economic standing. It improves the quality of life of people in our own community, those from other communities in adjacent areas including foreigners living along the border areas. By using modern technology, people living in poverty, the elderly and bedridden, the vulnerable and marginalized living in faraway areas can now avail themselves of free healthcare. Our work increases opportunities of access to healthcare that everyone has fundamental rights to receive.

a. We traced that the root causes of our financial crisis which left us with very limited budget for any innovative changes, decreased the morale and brought unhappy work life to our staff. We found out that people in our community lacked the confidence and trust in our hospital along with the difficulties in accessing our medical services. They preferred to seek healthcare services from other hospitals in other areas. We responded to the problems by establishing a working committee which consisted of many public sector institutions including hospital management committee, chiefs of Danmakhamtia public affairs, community leaders and monks. We collaborated with local temples to do fund-raising activities and we also received donations from philanthropists. We were then able to make many changes and improvements using the funds we received from these sources. We modified technologies at all service points to facilitate patients’ convenience and simplify our work flow. By using this technology, patients can make their appointments on-line and use only one ID card to access all our services. We linked the patients’ information and medical record data between our hospital and community health promotion centers in our network to deliver healthcare services to those in faraway areas. We brought modern medical equipment to support the quality of our treatments. The hospital environment and in-patient accommodations were renovated for better healing atmosphere. With the changes that we have done under our teamwork and support from many public sector institutions, we gained back the confidence and trust from our community. We are now proud to be a true “Dream Hospital”. Big challenges remain for us to continue the high standard of our services, to keep our community and all our stakeholders’ engagement for a sustainable survival and to progress as a leader among other public hospitals in the region.

With a very limited budget we encountered many difficulties to make any improvement. We also did not have the confidence of the people in the community. We got through those obstacles by using our strong teamwork and public and private sectors’ collaboration. We did fund raising. We elevated the standard of our services and modernized our medical equipment. These, and all the many other changes that we made, obviously caught the public eyes and attention. Well-off members of our community and business owners from adjacent areas are now more willing to donate financially to improve our medical equipment.

a. Danmakhamtia Hospital broke a new ground of public healthcare provider through innovative ideas and the ‘thinking outside the box’ attitude of our management. We changed our staff perspective towards the work. We created a staff engagement using the idea that everyone is a stakeholder of the hospital, that the hospital’s success is their success. Our landscape and interior renovations made us to be the very first public hospital that looks like a private hospital.

Our hospital director, Dr. Prawat Kithammakunnit, who brought the initiative to our organization, was inspired by Ajarn Chalermchai Kositphipat – National artist in visual art category. Ajarn Chalermchai once said “Among the bad circumstances, do it if you have an affection for it. Do not hesitate. Do not concern yourself about revenues. Learn things, especially things you do not know yet. There is no coincidence; we are the director of our own ways.”

Our rise from a little-known small district hospital with negative finances, and without the confidence and trust of members of its own community to receive medical treatments to a hospital that is being featured in a documentary film of success story has spread all over the country. Many staff of other hospitals and other business sectors, both private and public, big and small, have visited our hospital to learn first-hand just exactly how we did it. We do not keep any secret nor we are worried that they will duplicate our initiatives. We tell them exactly how we did it, we welcome all their inquiries and, if someday, even if just one hospital succeeded just like us, we will be very happy.

Our hospital has been a role model for many hospitals who come to observe and learn from us. Most public hospitals in Thailand are debt-ridden and are just relying on funds from the central government for their existence. We were in this same situation before we started this initiative but we were able to rise up and free our hospital from debts by thinking outside the box and doing things differently. We encouraged all the many hospitals that come to visit and learn from us to start making changes, to be proactive and think differently towards improvement.

a. Our “Dream Hospital with Smart Services” initiative uses financial resources from the budget allocated by the central government, funds from patients’ healthcare and/or insurance benefits paid to us on per patient and medical services received basis, money collected from community fund raising and donations of philanthropists from our community.

b. Our initiative is sustainable over time due to our community people’s and all other stakeholders’ full engagement and support and their trust and confidence in us. They all realized that if we all work together nothing is impossible to achieve. Our initiative is also in line with the Thai Ministry of Health’s policy which encourages all public hospitals to be a “Smart Hospital”.

Yes

Our “Dream Hospital with Smart Services” initiative won a Public Sector Excellence Award in Public Service Category in 2019. The award was given by the Office of the Public Sector Development Commission (Thailand) OPDC. The award was given to honor the government agencies with public service improvements including convenience, promptness, transparency, fairness and satisfaction.

We have done our own in-house evaluation of the success of our initiative by using data collected from our own out-patient and in-patient database and questionnaires given to relevant persons. We use five indicators including: numbers of people visit to our out – patient department, time from patient registration to receiving medical services, patient’s satisfaction towards our services, and staff’s satisfaction towards work and working environment.

In 2018, the average number of people visit in our out – patient department has been rising from 241 to 301 per day. The duration from patient registration to receiving medical services has been decreasing from 64 to 55 minutes. Patient’s satisfaction towards our services has been increasing from 89.91 to 90.53 percent. Staff’s satisfaction towards work and working environment has been increasing from 64.39 to 82.75 percent. Numbers of patient’s complaint has been decreasing from 15 to zero per year. Our improved services create people’s confidence on us. As more and more people come to receive our healthcare services our finances gradually improved. Our initiative’s success is also evident in the attentions we have earned from philanthropists in and outside our community. Their belief in us made them donate more money to help us in our work to improve our services, medical equipment and environment.

We cooperate with many government sector institutions. The Danmakhamtia District Chief is our main coordinator, who helps us coordinate with local organization leaders, community leaders, monks, and philanthropists to hold fund-raising activities to help us pay our debts out, purchase many medical equipment and make improvements in our general environment.

The success of our initiative to become a ‘Dream Hospital with Smart Services’ is the result of full the engagement and participation of our staff, local government sectors, monks, people in our community and our valued donors. We work under the principle of growth mindset; we always support learning to develop our own potential. The improvements in our work and seen by the public create a strong faith from people under our service. We all have a feeling of mutual ownership of a healthcare provider for all. This created a strong bond of teamwork among our stakeholders.

Our hospital was in debt, our community did not trust us and our own personnel were not happy. We decided to make a change by thinking and doing things differently. We realized that we cannot stay in the same framework as all public hospitals. The new idea of ‘thinking outside the box’ helped us got through the crisis. In the process, we became a happy organization for our staff. We have improved the quality of life of people in our community and adjacent areas such that they are now fully engaged and supportive of us.