Page 279 - GHR_NursingCMU2024_Final.indd

The Development of a Participative Management Model for Discharge Planning of
Stroke Patients, Chumphon-Khet-Udomsakdi Hospital, Thailand

1
1
U. Saeko, S. Purinthrapibal, and P. Thiangchanya 1
1
Faculty of Nursing, Prince of Songkla University, Thailand

Background: Stroke patients require continuing care from multidisciplinary healthcare team
during admission to after discharge. The study of the stroke discharge planning situation of
Chumphon-Khet-Udomsakdi Hospital found unclear roles and responsiveness, no backup plan,
working fragmentation, and a lack of data and information exchange. As a result, 12.2 % incompletely
prepared patients, 2.6% delayed discharge, 6.4 % primary caregivers felt a lack of consultation delivery
and 2.4% re-admission, were reported.

Objective: To develop a participative management model for discharge planning of stroke patients
in the Chumphon-Khet-Udomsakdi Hospital context and explore the model effects.

Methods: 97 Participants were involved in the study by purposive sampling including healthcare
administrators, hospital healthcare staff, community healthcare staff, and primary caregivers. The
model development followed the PAOR action research of Kemmis, McTaggart, and Nixon (2018).
Testing a model with 30 stroke cases. Measuring the effects of the model by i) A questionnaire of
hospital staff’s opinion of the model utilization (CVI = 1), ii) A questionnaire of community staff’s opinion
of the model utilization (CVI = 1), and iii) A questionnaire of readiness to care of primary caregivers
(CVI = 0.91).

Results: The participative management model with D-METHOD and IDEAL model integrative, consisted
of three strategies. I) Structural management: policy, roles and responsibilities, and communication
support II) Process management: admission, pre-discharge, discharge, and post-discharge stages. III)
Outcome management: feedback systems, data and information exchange, lessons learned
Poster Presentation Abstracts
activities, consultation, and continuous quality improvement. The effects of model implementation
showed the satisfaction score of hospital staff was at the highest level (M=4.22, SD=.59), and for the
community - staff was also at the highest level (M=4.40, SD=.57). The primary caregivers’ readiness
was at a high level (M=4.06, SD=.58). No incident of 28-day re-admission.

Conclusion: Comprehensive and explicit guidance and multiple levels of management strategies
can enhance multidisciplinary discharge planning for complex patients.

Keywords: stroke, management model, multidisciplinary, discharge planning

_____________________________________________________________________________________________________
Correspondence: Shutiwan Purinthrapibal, Faculty of Nursing, Prince of Songkla University, Thailand
E-mail: shutiwan.p@psu.ac.th

277