การพัฒนาระบบผ่าตัดแบบเร่งด่วนในกลุ่มผู้ป่วยที่บาดเจ็บมือและเท้า โรงพยาบาลยโสธร

Santi  Sirirattanapan

doi:10.64960/srimedj.v41i2.270229

Authors

Santi Sirirattanapan Department of Orthopaedics, Yasothon Hospital, Mueang District, Yasothon Province, Thailand 35000

DOI:

https://doi.org/10.64960/srimedj.v41i2.270229

Keywords:

fast-track surgery, hand and foot injuries, multidisciplinary team, emergency triage

Abstract

Background and Objective: Fast-track surgery is a critical process in the management of patients with hand and foot injuries, aiming to reduce the risk of complications. This study aimed to develop and evaluate the effectiveness of a fast-track surgical system.

Methods: An action research design was conducted from July to December 2025, comprising four stages: planning, acting, observing, and reflecting. Qualitative data were collected through literature review and focus group discussions with a multidisciplinary team, while quantitative data were obtained from medical records. A total of 128 patients with hand and foot injuries were equally assigned to intervention and control groups. Data were analyzed using content analysis, descriptive statistics, Chi-square test, Fisher’s exact test and the Mann–Whitney U test.

Results: The development resulted in a fast-track surgical pathway comprising multidisciplinary team coordination, emergency department triage, and operating room prioritization. Evaluation of the system showed that the intervention group had significantly shorter ranked mean times from the emergency department to the ward (median time decreased from 1.9 to 1.0 hr.), from the emergency department to the operating room (median time decreased from 6.3 to 5.4 hr.), and to surgery within 24 hours (proportion increased from 65.6% to 81.3%) compared with the control group (p<0.001, p =0.018, and p=0.044). No significant differences were observed in time from the ward to the operating room, length of hospital stay, treatment costs, or complications (p>0.05).

Conclusions: The fast-track surgery system improved early surgical process efficiency and access to urgent surgery without increasing hospital stay, costs, or complications.

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