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The Study on Empowering the Elderly In 4 Accredited HPHs in Thailand. Auamkul, N ; Jongvanich, J ; Teechamahachai, C and Liengpanskul, S. The 13 th International Conference on Health Promoting Hospital, Dublin, Ireland May 18-20, 2005. 1 Result. 3

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slide1

The Study on Empowering the Elderly

In 4 Accredited HPHs in Thailand

Auamkul, N; Jongvanich, J;

Teechamahachai, C

and Liengpanskul, S

The 13th International Conference on Health Promoting Hospital,

Dublin, Ireland May 18-20, 2005

slide2

1

Result

3

Supp. physical, social & learning env. for health

6

HP

for people

In the

Comm.

1

Leadership

4

HP

for staffs

Resource

management

2

5

HP for clients

and Relatives

Standard of HPH

Thailand

1Leadership

2Resource management

3Supportive physical, social and learning env. for health

4HP for staffs

5HP for clients and relatives

6HP for people in the community

7Result

slide4

Objective

To study the driver, the system and the process conducted to empower the elderly for health in 4 accredited health promoting hospitals in Thailand.

slide5

Method

Method

- Qualitative study

- Interviewing

- Observation

- Reviewing the document

slide6

2

Nakon

Ratchasima

1

Chiangmai

Study

Sites:

HPH

3

Cholburi

4

Songkla

slide7

Study Population

- Administrators

- Hospital director

- Member of the local adm.

- Service providers

- Physicians

- nurses

- Public health personnel, etc

- Health Volunteers

- Aging people and their families

slide9

Hospital 1

(Mae aye Hospital)

  • Community hospital in the northern region
  • Thai people and highland population, migrant people
  • Health problems – HIV/AIDS, COPD
  • Risk group – orphans, elderly people
slide11

Hospital 1

  • Visionary leadership
  • Accreditation – HA and HPH
  • Intersectoral co-operation
  • Public and private sector co ordination
  • Active outreach approach
  • Integrated service for people of all age groups
  • Mobilization of external resources
slide12

Hospital 1

Empowering the aging people

  • Integrated health service
  • Holistic care
  • Strengthening community action
    • Income generation
    • Village fund
    • Friend help friend – Home visit
  • Health personnel as facilitators
slide13

Learning process

VISUAL

Learners

AUDITORY

KINESTHETIC

Learners

Learners

AKV, AVK, VKA, KAV and KVA

Source: Markava’s The Open Mind (1996) in Scholtes, P.R, The Leader’s Handbook, 1998, p 35-36

slide14

Plan

Act-Plan

Act-Plan

Theory

Application

Do-Study

Do-Study

Do-Study

PLAN

ACT

DO

STUDY

Continuous Quality Improvement

Source : Schlotes, P.R. The Leader’s Handbook, 1998, P. 34

slide18

Hospital 1

Result of empowerment

  • Elderly people
    • Healthy and happy
    • Elderly people who stay alone was taken care
  • Community
    • Mutual support
  • Hospital workload on curative service
slide19

Hospital 2

(Dan Khun Tod Hospital)

  • Community hospital in the northeastern region
  • Visionary leadership
  • Intersectoral co-operation
  • Accreditation – HA & HPH
  • Integrate health service from hospital to family and community
  • Empower patient and family
  • Empower elderly people club
slide20

Hospital 2

Planning together

slide21

บริการด้วยคุณภาพร่วมสร้างสุขภาพปวงชนบริการด้วยคุณภาพร่วมสร้างสุขภาพปวงชน

สนับสนุนเครือข่ายปฐมภูมิ

Strategic Map

ลดข้อร้องเรียน

ได้รับบริการที่ได้มาตรฐาน

สร้างความประทับใจ

พัฒนาระบบจัดการความเสี่ยง

พัฒนาเครือข่ายและ

ธำรงรักษาระบบเก่าที่มีอยู่แล้ว

พัฒนาระบบงาน

สารสนเทศ

ช่วยเครือข่าย

สร้างเสริมสุขภาพ

พัฒนาศักยภาพของคน

เพิ่มสมรรถนะบุคลากร

เพิ่มองค์ความรู้

เพิ่มรายได้ / ลดรายจ่าย

ลดความเสียหายจากความเสี่ยง

slide22

Chronic disease patient

Result :Decrease readmission

tb patients
TB patients

Result: Average increase of lung capacities100 cc. /mo.

in 85 % of patients participated in this empowering activities

slide24

Hospital 2

Result

  • Elderly people
  • knowledge and skill
  • quality of life
  • Hospital
  • readmission rate
slide25

Hospital 3

(Aue Udom Hospital)

  • Community hospital in the central region
  • Vision
  • Create learning environment for health in the hospital
  • Empowering aging patients
  • Empowering the caregivers of aging patients and chronic disease patients
  • Integrated health service from hospital to family and community
slide26

Hospital 3

Diabetic Volunteers in the Community

  • Empower the elderly diabetic patients to be volunteers
  • Facilitate them to organize activities eg. Exercise, food controlling, relaxation activity, self-evaluation and blood sugar level controlling
slide27

Hospital 3

Result

  • Elderly people
  • drug intake
  • FBS less than 140 mg/ml increased from 17% to 38%
  • FBS less than 180 mg/ml decreased from 52% to 24%
  • QOL
  • Hospital
  • workload
  • expense
slide28

Hospital 4

(Rattaphum Hospital)

  • Community hospital in the southern region
  • Visionary leadership
  • Accreditation – HPH
  • One of the empowerment activities for the elderly people is “ Exploring Rattaphum Club”
slide29

Hospital 4

“Exploring Rattaphum Club”

  • Started since October 2001
  • A group of six people initiated the idea of walking together for health (The director of the Rattaphum Hospital was one of the pioneers)
  • Not only walking for physical health but also for mental, social and spiritual health
  • Have regular activity on every Sunday since 28/10/01
slide30

Hospital 4

Schedules

  • Appointment notification (verse) before next Sunday
  • Prompt start at 6.30 a.m., 2-3 km. walking distance
  • If it is too far to walk, they will go by car pool and get off to walk
  • If the route is unsafe to walk, they will go there by car and do other type of physical exercise
  • The guide or the owner of the place visited will explain and provide information
slide31

Hospital 4

Schedules (cont.)

  • During breakfast
    • Read the next appointment verse
    • Read the last visit poetry, using the southern culture style
    • Introduce new member
    • Entertainment – singing, story telling
    • Knowledge sharing on health, economics, religious, culture, etc.
    • Comment and discussion
slide32

Hospital 4

Result

Elderly and other member

  • knowledge and skill on exercise for health
  • knowledge about good people / model people, products, activities and places in their own district
  • Able to provide the success story and district information to others
  • self esteem, proud to be Rattaphum people, Thai people
  • Healthy and happy
slide33

Hospital 4

Result (cont.)

Club

  • Members increased from 15 to 130
  • Average number of members that join every Sunday was 70-80
  • Until 6/3/05 the activities were held 157 times
slide34

Hospital 4

Result (cont.)

  • Community
  • unity
  • Hospital
  • workload on curative service
  • health communicators
  • Expansion of networking
slide35

Conclusion

Driver

System

Result

  • Leadership
  • Vision
  • Good governance
  • Com. responsibility
  • Soc. reponsibility
  • Strategic plan
  • Inf. sys.
  • HRD – Emp.
  • HR management
  • Sufficient resources
  • Healthy workplace
  • Service system
    • In hosp.
    • Outreach
    • Active>Passive
  • Networking system
  • Client
  • satisfaction
  • health literacy
  • well-being QOL
  • Hospital
  • readmission
  • reach the target set
  • Award
  • Cert. of recog.
  • Org. culture
  • & core value
  • Pop. health oriented
  • People centered
  • Holistic approach
  • Soc./com. resp.
  • Shared vision
  • Clear obj.
  • CQI/LO
slide36

Help PQ, MQ, EQ, SQ

Understanding needs of the elderly

(4 basic needs - to live

- to learn

- to love & beloved

- to leave & legacy)

Conclusion

Holistic care (body, mind, heart and spirit)

Manifestation of need & discipline

vision & alert

passion (love to do)

conscience (do what’s right)

Healthy Elderly People

slide37

Recommendation

  • Need leadership
  • Building capacity of the health personal empowerment
  • Create supportive environment for empowerment
  • Build partnership
  • Need knowledge sharing and knowledge management for continuous quality improvement