Development of a Nursing Administration Model for Enhancing the Efficiency of Patient Referrals within the Satun Hospital Network

Abstract

Background and objectives The referral system is a crucial component of the healthcare system, ensuring equitable and accessible health services throughout Thailand. Its primary goals are to ensure patient safety and provide standardized care. This study aimed to develop a nursing management model to enhance the efficiency of patient referrals within Satun Hospital’s network, ensuring quality, safety, and user satisfaction.

Methodology This study employed a research and development design, grounded in Transition Theory as the conceptual framework. The study was conducted in three phases:
1) exploration of problems, situations, and referral practices with 12 participants; 2) development of a nursing administration model for effective patient referral; and 3) evaluation of the model’s effectiveness. The sample in phase three consisted of three groups: professional nurses from community hospitals in Satun Province, nurses from the referral coordination center of Satun Hospital, and relatives of referred patients, with 60 participants in each group.

Research instruments included: an interview guide for model development; a questionnaire assessing opinions on the patient referral process (Cronbach’s alpha = 0.97); an evaluation form for emergency medical dispatch center operations (Cronbach’s alpha = 0.97); and a satisfaction questionnaire for patient relatives (Cronbach’s alpha = 0.92). Data were analyzed using descriptive statistics, paired t-test, and content analysis.

Results

1. The study on problems, situations, and referral practices among network community hospitals of Satun Hospital identified four major issues: 1) communication problems, 2) insufficient competency of healthcare personnel in patient referral, 3) excessive workload, and 4) inadequate and unavailable equipment.
2. A nursing administration model was developed to enhance the efficiency of patient referrals within the Satun Hospital network by creating a comprehensive referral manual. The manual includes referral procedures, patient assessment, and nursing guidelines aligned with Transition Theory, covering the phases before and during patient transfer, communication processes, and the preparation of emergency vehicles, medications, equipment, and medical devices required for patient referral.
3. The effectiveness evaluation of the nursing administration model for enhancing the efficiency of patient referrals within the Satun Hospital network revealed that nurses’ perceptions regarding the use of the nursing administration model significantly improved after implementation
   (t = 3.20, p < .05). Nurses’ perceptions of the operational performance of the dispatch center also significantly increased following implementation of the model (t = 7.52, p = .001). In addition, relatives’ satisfaction with the patient referral process significantly improved after the implementation of the nursing administration model (t = 4.18, p = .001)

Conclusion and Recommendations The developed nursing administration model for improving patient referral efficiency within the Satun Hospital network is practical and beneficial for both service recipients and healthcare providers. It is recommended that this model be implemented in similar healthcare settings to enhance the quality and standardization of patient referral systems.