Streamline and Redesign of Public Work Processes of Integrated Provincial Management, A Case Study: The Development of Health Care Service System at Maharat Nakhon Ratchasima Hospital

Abstract

On May 19, 2003 the Ministry Cabinet approved the proposal of streamline and redesign of public work processes, which was presented by the Public Sector Development Commission in order to improve public work efficiency and effectiveness. The main objectives are to reduce inefficient time by 30 to 50 percent. The reduction in inefficient activities is to provide faster service. This research focuses on the development of the annual health care examination scheme which is the most basic public health care service. The study focuses on incorporating concepts as shown below: 1) Problem findings: The survey from the clients shows inconvenience in all service processes, lack of public relation, ambiguous examination procedures and late test result. 2) Implementation: According to the findings, a one-stop service approach is implemented. Computers are employed to systematically and effectively collect the clients data. Computers are also used to evaluate and show test results as an e-government approach. Moreover, a mobile x-ray vehicle is utilized as an active service strategy. 3) Methodology and Evaluation: The first sample group, a mandatory group, is recruited and analyzed from June 2003 to April 2004. The results are stated in four different dimensions. Firstly, an efficiency dimension of the new processes show a decrease in time consumption, from 77 minutes to 32 minutes per person (p-value=0.000) after diminishing the service points from seven to the one-stop service point. With the current process, it is able to report a test result within one week, compared with the previous three-week wait for test results. The improved outcomes are evaluated in a group of less than 100 clients. Second is the mission of effectiveness dimension. The improvement of the streamline and redesign health care service system is illustrated by reducing time consumption by 58.4 percent. Next, service quali6y dimension, the client satisfaction rises from 78.5 percent to 90.5 percent. Lastly, the organizational development dimension, the hospital’s net income increases from ฿1,764,628 to ฿3,197,435 after implementation of the new health care service system, which is accounted for 90.5 percent increase. Furthermore, there are clients increasing from 5,628 persons to 8,128 persons which is accounted for a 72.2 percent increase. Finally, One-stop service could be applied to other service clinics. However, collaboration among related work agencies and multi-professional teamwork plays an important role in the successful implementation. An implementation of the streamline and redesign work processes should be monitored and evaluated. Also, related and professional standard should be set to ensure service quality. Furthermore, the implementation should be a continuous process.