Development of the One Province One Labor Room Network Model in Kanchanaburi Province

Abstract

Objectives: To develop the One Province One Labor Room (OPOL) network model incorporating with a Tele-Line Consulting System (TLCS) in Kanchanaburi Province.

Methods: This research and development study was conducted from fiscal year 2021 to 2024 among admitted pregnant women, obstetricians and obstetric care physicians in Kanchanaburi using the OPOL TLCS system. The research instruments comprised: 1) the developed OPOL TLCS system, which included the assignment of obstetricians from Phaholpolpayuhasena Hospital to provide 24-hour consultation, mandatory daily reporting of all admitted obstetric and gynecological inpatients by physicians in every hospital, and mandatory initial assessment of fetal well-being upon admission; 2) a record form for referrals and data on pregnant women admitted for delivery at Phaholpolpayuhasena Hospital; 3) a maternal mortality report form and minutes of the Kanchanaburi Provincial Maternal and Child Health Board meetings; and 4) a satisfaction questionnaire for obstetricians and obstetric care physicians and physicians caring for obstetric and gynecological patients regarding their use of the OPOL TLCS system. Data were analyzed using descriptive statistics and content analysis.

Results: Prior to the implementation of the OPOL TLCS system (fiscal year 2021), there were two direct maternal deaths and 266 obstetric referrals. Following the implementation of the OPOL TLCS system, direct obstetric maternal deaths decreased to 1, 1, and 0 cases, and obstetric referrals decreased to 262, 228, and 206 cases in fiscal years 2022-2024, respectively. Among the 69 physicians who used the OPOL TLCS system, 98.11% reported a high to very high level of satisfaction (levels 4-5), with a mean score of 4.19 (SD=0.34).

Conclusion: The collaboratively developed OPOL TLCS system, supported by consistent specialist involvement, contributed to a reduction in direct obstetric maternal deaths. Continued monitoring and development of the consultation and referral system are recommended to further reduce maternal mortality.