The Study on Empowering the ElderlyIn 4 Accredited HPHs in Thailand

The Study on Empowering the ElderlyIn 4 Accredited HPHs in Thailand

Auamkul, N; Jongvanich, J;Teechamahachai, Cand Liengpanskul, S

The 13th International Conference on Health Promoting Hospital,Dublin, Ireland May 18-20, 2005

Standard of HPHThailand

Standard of HPHThailand

3Supp. physical, social & learning env. for health

4HP

for staffs

6HP

for peopleIn the

Comm.

5HP for clientsand Relatives

1Leadership

Resourcemanagement

2

1Result

1 Leadership

2 Resource management

3 Supportive physical, social and learning env. for health

4 HP for staffs

5 HP for clients and relatives

6 HP for people in the community

7 Result

H

P

H

s

H

P

H

s

ThailandThailand

ObjectiveObjective

To study the driver, the system and

the process conducted to empower the

elderly for health in 4 accredited health

promoting hospitals in Thailand.

MethodMethod

Method- Qualitative study

- Interviewing

- Observation

- Reviewing the document

StudyStudySites:Sites:HPHHPH

11ChiangmaiChiangmai

44SongklaSongkla

33CholburiCholburi

22NakonNakon

RatchasimaRatchasima

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

ResultResult

Hospital 1Hospital 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

Mae aye Hospital

Hospital 1Hospital 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

Hospital 1Hospital 1

• Integrated health service• Holistic care• Strengthening community action

• Income generation• Village fund• Friend help friend – Home visit

• Health personnel as facilitators

Empowering the aging people

VISUAL

AUDITORY KINESTHETIC

Learners

LearnersLearners

AKV, AVK, VKA, KAV and KVA 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

Theory

Application

Plan Act-Plan Act-Plan

Do-Study Do-Study Do-Study

Continuous Quality ImprovementSource : Schlotes, P.R. The Leader’s Handbook, 1998, P. 34

ACT PLAN

STUDY DO

Supportive Env.

HP for the clients

HP for the community

Hospital 1Hospital 1

• Elderly people• Healthy and happy• Elderly people who stay alone was

taken care• Community

• Mutual support• Hospital workload on curative service

Result of empowerment

Hospital 2Hospital 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

Hospital 2Hospital 2

Planning together

Planning together

บริ�การิด้�วยคุ�ณภาพริ�วมสริ�างส�ขภาพปวงชนสน�บสน�นเคุริ�อข�ายปฐมภ�ม�ลด้ข�อริ�อง

เริ�ยนสริ�างคุวามปริะทั�บใจ

ได้�ริ�บบริ�การิทั�$ได้�มาตริฐาน

พ�ฒนาเคุริ�อข�ายและสาริสนเทัศ

พั�ฒนาระบบจั�ดการความเสี่��ยง พ�ฒนาริะบบ

งานช�วยเคุริ�อข�ายสริ�างเสริ�มส�ข

ภาพ

เพ�$มสมริริถนะบ�คุลากริ

เพ�$มองคุ*คุวามริ��

พ�ฒนาศ�กยภาพของคุน

เพ�$มริายได้� / ลด้ริายจ�าย

ลด้คุวามเส�ยหายจากคุวามเส�$ยง

ธำ�ารงร�กษาระบบเก�าที่��ม�อย��แล้�ว

Chronic disease patientChronic disease patient

Result : Decrease readmission

TB patients

Result : Average increase of lung capacities 100 cc. /mo.in 85 % of patients participated in this empowering activities

Hospital 2Hospital 2

Elderly people• knowledge and skill• quality of lifeHospital• readmission rate

Result

Hospital 3Hospital 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

Hospital 3Hospital 3

• 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

Diabetic Volunteers in the Community

Hospital 3Hospital 3

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%• QOLHospital• workload• expense

Result

Hospital 4Hospital 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”

Hospital 4Hospital 4

• 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

“Exploring Rattaphum Club”

Hospital 4Hospital 4

• 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

Schedules

Hospital 4Hospital 4

• 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

Schedules (cont.)

Hospital 4Hospital 4

• 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

ResultElderly and other member

Hospital 4Hospital 4

• 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

Result (cont.)Club

Hospital 4Hospital 4

Community• unityHospital• workload on curative service• health communicators• Expansion of networking

Result (cont.)

Driver System Result

Leadership• Vision• Good governance• Com. responsibility• Soc. reponsibility

Org. culture& core value

• Pop. health oriented• People centered• Holistic approach• Soc./com. resp.• Shared vision• Clear obj.• CQI/LO

• 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.

ConclusionConclusion Understanding needs of the elderly

(4 basic needs - to live- to learn

- to love & beloved- to leave & legacy)

Holistic care (body, mind, heart and spirit)

Help PQ, MQ, EQ, SQ

Manifestation of need & disciplinevision & alertpassion (love to do)conscience (do what’s right)

Healthy Elderly People

• 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

RecommendationRecommendation

Thank You

Thank You

Sawasdee

Sawasdee