The Study on Empowering the Elderly In 4 Accredited HPHs in Thailand

1. 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

2. 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

3. Thailand H P H s

4. 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.

5. Method Method - Qualitative study - Interviewing - Observation - Reviewing the document

6. 2 Nakon Ratchasima 1 Chiangmai Study Sites: HPH 3 Cholburi 4 Songkla

7. 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

8. Result

9. 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

10. Mae aye Hospital

11. 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

12. 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

13. 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

14. 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

15. Supportive Env.

16. HP for the clients

17. HP for the community

18. 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

19. 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

20. Hospital 2 Planning together

21. บริการด้วยคุณภาพร่วมสร้างสุขภาพปวงชนบริการด้วยคุณภาพร่วมสร้างสุขภาพปวงชน สนับสนุนเครือข่ายปฐมภูมิ Strategic Map ลดข้อร้องเรียน ได้รับบริการที่ได้มาตรฐาน สร้างความประทับใจ พัฒนาระบบจัดการความเสี่ยง พัฒนาเครือข่ายและ ธำรงรักษาระบบเก่าที่มีอยู่แล้ว พัฒนาระบบงาน สารสนเทศ ช่วยเครือข่าย สร้างเสริมสุขภาพ พัฒนาศักยภาพของคน เพิ่มสมรรถนะบุคลากร เพิ่มองค์ความรู้ เพิ่มรายได้ / ลดรายจ่าย ลดความเสียหายจากความเสี่ยง

22. Chronic disease patient Result :Decrease readmission

23. TB patients Result: Average increase of lung capacities100 cc. /mo. in 85 % of patients participated in this empowering activities

24. Hospital 2 Result • Elderly people • knowledge and skill • quality of life • Hospital • readmission rate

25. 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

26. 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

27. 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

28. 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”

29. 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

30. 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

31. 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

32. 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

33. 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

34. Hospital 4 Result (cont.) • Community • unity • Hospital • workload on curative service • health communicators • Expansion of networking

35. 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

36. 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

37. 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

38. Thank You

39. Sawasdee