Questions/Answers

Heart disease is the primary cause of death in people in the world. Every day, approximately 20,855 people of Thai people die of heart disease yearly. Between 2012 to 2016, the ratio of death caused by heart disease was likely to increase by 27 percent due to people's lifestyle, especially from food consumption, anxiety, and environmental changes. In Pattani province, 17,114 patients were diagnosed with heart disease; however, 10,856 patients received continual treatment because of Pattani province has the ratio of the most poorest people in the country, several Pattani people were impoverished and unable to receive quality healthcare services. Moreover, religious beliefs and roles of men influenced the people, particularly women and children, not to go and receive the potential healthcare services. Insurgency within the area is another factor that obstructs patients from traveling to obtain appropriate treatment. This project aims to (1) enhance the accessibility of quality healthcare service throughout the province; (2) establish a safer, errorless, and efficient treatment for heart disease; (3) reduce the number of heart disease patients; and (4) expand healthcare network and build heart disease clinic to help impoverished patients via integrated mechanisms from government sectors, public sectors, and the locals. The project was developed to cover all areas of Pattani province with cooperation from general hospitals, community hospitals, health-promoting hospitals, and other medical-related sectors for patients to access the services easily. The project is also supported by medical companies and the locals, making it capable to combat and solve the existing problems sustainably.

The outcome of the project aligns with Category 1 because the project has an effective heart disease combating program which covers all ranges of people, especially low-income and disadvantaged people, to access to free and equal healthcare service like ordinary people. The initiative effectively solved heart disease problems by integrating service systems, innovation, expanding service network by providing training programs to personnel in community hospitals, health-promoting hospitals to enhance their capabilities to treat heart disease. A feedback channel is open to receive suggestions and recommendations from the public to develop the project and make it sustainable.

This project aligns with SDG 3, Section 3.4 “Help reducing death and increasing effectiveness in heart disease treatment by integrating good healthcare service system” and Goal 10 “Reduce the gap by increasing the chance to access health service throughout especially impoverished people to be equally with others”. Heart disease patients received effective and quality medicine and vaccine with delivery service for impoverished people to be able to access the medical service conveniently and effectively. The project, furthermore, helps improve the patient’s accommodation and living environment with the guidelines to integrate good healthcare service system as well as devising new inventions (i.e. a pill-adjusting table, a heart disease recording graph, and a heart disease networking computer program for Pattani province, an innovation to prevent negative effects of heart-disease medicine and founding of healthcare service network in Pattani province that is charitable for impoverished people to receive convenient and thorough service with the cooperation with community hospitals, health promoting hospital, volunteers, social workers, and drug companies. Furthermore, the project was funded by people in Pattani province to manage the project to be forever sustainable.

The project will be sustainable due to the collaboration with several government and public sectors (Pattani Province Health Office, Pattani hospital, community hospitals, health-promoting hospital, volunteers, social workers, and partnership). This proves the project’s supporting service system to be effective and service network allowing people to be able to access service easily and equally. The project further helps impoverished people to sustain their life quality by improving their accommodation to be better place to live. The establishment of heart disease foundation is another assistance by donations from the locals and public sectors to aid the impoverished and disadvantaged heart-disease patients.

In the past, heart disease treatment was only provided at Pattani Hospital; therefore, the hospital was normally packed with many patients and lessened chances for poverty-stricken people to receive the treatment. Insurgency in the area and gender domination in families are also the factors preventing them to go to the hospital. With a collaborative network from government and public sectors and people along with the supporting funds, the launch of the project can solve proactive problems and aid those in need to receive the treatment equally and sustainably as defined in its objectives. The project is also developed through follow-up processes and assessments toward outcomes of sustainable healthcare service network development from The Healthcare Accreditation Institute (Public organization). The results disclosed that the mortality rate of the patients was reduced by 60%; 99.05% of the patients felt more secured; and all patients were able to access the medical treatment. More than 340,000 THB of traveling cost was saved yearly. All of these represent the effectiveness and inclusiveness of the project throughout Pattani province.

Due to personal beliefs, religions, customs and cultures of Muslim people as well as gender domination in the family, many girls and women did not receive proper healthcare service. The Integrated project and healthcare service system network of heart disease patients equally and throughout would help them to the essential services and maintain gender equality which reduces the mortality rate from heart disease and makes the patients have the better quality of life.

The target group of this project is all heart-disease patients in Pattani province. The achievement found from the project is that it can reduce the mortality of the heart-disease patients, while increase a chance for them to access the healthcare services. The treatment is safer, errorless, and time-saving. This project resulted in improvement of life quality in the heart-disease patients, especially impoverished patients to receive the service equally and effectively.

The project was originated from heart-disease patients in other areas of the province had to travel to receive healthcare service from internists only available in Pattani province; many service problems were identified. Therefore, Pattani Hospital established the Heart Disease Clinic in 2012 to treat heart-disease patients by expert doctors with the collaboration from doctor and pharmacist group and medical innovation. The emerging of medical tools made diagnoses convenient, errorless, and time-saving. In 2015, it was found that some heart-disease patients were late to the appointments and medication adherence, which made their heart condition worse. As a result, the issue was resolved by visiting patient’s houses to follow-ups the results. Late-to-appointment patients were found impoverished as they had difficult time travelling to Pattani Hospital and financial problems in the families. In 2016, we started expanding healthcare service network throughout the province to increase access coverage to healthcare service for the impoverished heart disease patients and patients living in risky areas to be able to access service easily, conveniently, fast, and equally.. We aim to facilitate people (i.e. managing car delivery service for patients who could not come to receive treatment) with a support from government and public sectors, and people. Therefore, this project was successful and sustainable.

After the expanding service system network throughout Pattani province was conducted, the medical history problem was found lost among the network hospitals Although the patients can receive medical services in every hospital, the medical history not current and was not interlinked. Therefore, In 2017, the online medical history system was developed Patients were able to bring only health identification books to hospital every time they come to see the doctors. and use the online treatment recording program to record the treatment they received, resulting in the complete and accurate medical information which will be used for continual and future treatment.

This project is an administrative innovation by building a healthcare service system network of heart disease patients throughout and equally in Pattani province, which improved the diagnosis service. Patients could see doctors, pharmacists, and nurses simultaneously, so service process and waiting time were minimized. Information technology such as the Line application is applied to support services contacts and coordination between personnel and doctors. This includes the graph record of heart disease diagnosis through an electronics system, which is easy to follow-up. Furthermore, the innovation has a feature to prevent danger that can occur from heart disease medicine usage.

“The improvement of service system” was originated by lean and seamless idea of The Healthcare Accreditation Institute (Public Organization) by eradicating loss and delay in “Building a healthcare service networking system” under the service plan of Ministry of Public Health with Seamless Health Service Network, creating access to righteous service and throughout and reducing the gap. “Heart disease diagnosis recording graph” was originated by the application of using pregnant women developmental recording graph while “Information technology usage” was originated from the idea that we wanted to reduce human error.

This project has been contributed to other departments in Thailand and Malaysia who are interested in studying the work processing method of treatment of heart disease patients in Pattani province. Pharmacy students in other universities (i.e. Prince of Songkhla University, Chulalongkorn University, Payap University) in Thailand are also interested in training. We were invited to give lectures in other conferences (i.e. The Heart Association of Thailand and heart disease conference at district service 12) as well as academic conferences in development of effectiveness in cardiovascular patients’ networking system at Songkhla, Satun, and Yala province, and academic conference of Southern Pharmacist Club. We were invited to the national academic contest to contribute work that is beneficial for other departments to apply (i.e. HA Forum academic conference of The Healthcare Accreditation Institute, Cardiac Network Forum academic conference, and The Pharmaceutical Association of Thailand conference). These ideas and innovations could be further developed and applied to treat other symptoms or expand to other provinces and in the national level that are facing the same type of problem.

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This project used the following resources: (1) Personnel were supported from medical personnel at Pattani Hospital and community hospitals, consisting of doctors, pharmacists, nurses, programmers, and health promoting hospitals consisting of nurses, public health volunteers, social workers; (2) Budget was allocated to support the project in several ways: Government sectors provided medical devices while partnerships supported patients’ identification books, and the people donated to establish The Heart Foundation.

The sustainability of this project originated from integrated collaborative work by establishing collaborative learning resources in the province and publicizing through social media channels such as Line application. Potential development training in personnel aimed to provide knowledge to people so that the project can be operated sustainably. with the integration among government and public sectors and people to support economic aspects such as establishing The Heart Foundation from people’s donation. Volunteering teams and social workers also play a role to help the impoverished people improve their living space to promote the living conditions and quality of life.

Yes

This project was evaluated by the internal department of Pattani Public Health Office by collecting related indicators that aligned with the objectives of the project process. The project was also evaluated externally by The Healthcare Accreditation Institute as they visited, observed the real places, and conducting the interviews with practitioners.

The indicators to evaluate the effectiveness of the healthcare service system were from the percentage of deaths from heart disease, percentage of safety in heart disease patients, percentage of the errors in service system, and waiting time. The indicators showed the inclusiveness of healthcare service system such as the percentage of impoverished patients receiving health service, travel budget, and external evaluation from The Healthcare Accreditation Institute evaluating network, which evaluated the effectiveness in holistic treatment throughout service networking system, continuously developmental process, collaboration, patients deliver, personnel development, mutual learning in the network, resource usage for the most benefit.

The results were found (1) an increase in access to healthcare services, especially impoverished patients and patients in risky areas to be able to receive service equally. 100% of impoverished patients received healthcare services; (2) an increase in the effectiveness in heart disease patients’ treatment to be safer, which rises from 91.05 percent to 99.05 percent. A decline in error of service system from 103.03 per a thousand prescriptions to 9.62 per a thousand prescriptions with a fall in waiting time to one hour; (3) the number of deaths from heart disease decreased by 60 percent (originally 20 people remained to 8 people per a hundred thousand population); and (4) data connection and collaboration from every sector could reduce travel budget by 340,000 baht. Life quality of population was better, and the project was accredited by The Healthcare Accreditation Institute to be the provincial healthcare service network in cardiovascular field. Thus, every sector put their effort and supported budget, resources, tools.

Personnel received the collaboration from medical personnel from Pattani hospital and eleven community hospitals. The responsibility of doctors was diagnosing heart disease while pharmacists’ was giving medicine consultant. The responsibility of nurses was giving treatment for heart disease patients from 128 health promoting hospitals. The sub-healthcare service division w consisted of nurses and visiting teams that played a role in basic treatment, and compromising primary patients transferring to hospitals, including visiting patients’ houses and village health volunteers could give basic advice and health care for patients in the villages. Furthermore programmers played a role in software development to fit the needs of medical personnel; and social workers supported them by providing financial aids and resources that were vital for the living of impoverished people. Development of living space and environment in the village which Pattani Public Health Office was a collaborator in healthcare service network.

Pattani Hospital with Pattani Public Health Office regulated the policy to develop in the service network by applying the brainstorming strategy within the network (Pattani hospital, community hospitals, Pattani Public Health Office) to find out the agreement and mutually practical methods as well as to create collaborative mechanism among government, public and private sectors, and people to establish the project. Partnerships and people likewise supported the budget and tools utilized. Village health volunteer teams and social workers for basic health care of people were founded in this project. We did follow-ups, screenings, home visits, provided aids, and improved the capabilities of the personnel in every hospital, village health volunteers by applying Pattani Hospital as the knowledge center and Line application as the learning resource. We created organizational behaviors about teamwork. We created programming teams to design the software. We mutually carried out the tasks according to practical methods and helped impoverished patients to be able to receive equal and effective services. We followed-ups and evaluated the result of service system and brought the result to improve continuous network development in the next phase. The result will be continuously adjusted for service development to respond to the most target groups.

There are still many impoverished people in Pattani province that did not receive healthcare service because Pattani province has a great number of poor people. Pattani Hospital with Pattani Public Health Office regulated the policy of cardiovascular healthcare service network in the province for impoverished heart disease patients to receive the service equally and inclusively by the coordination of the departments from government and public sectors and people, to relieve health disparity in access to healthcare services that are vital to the locals in the area. The success reflects the collaboration from every sector to promote the equality of impoverished people. Furthermore, this project has the plan to develop impoverished patients with disorders within the responsible area and to expand the process as stated from the district level to the national level.