The การพัฒนาระบบการดูแลผู้ป่วยจิตเวชในโรงพยาบาลชุมชน จังหวัดอำนาจเจริญ: การบูรณาการการทำงานของทีมสหวิชาชีพและการติดตามผลอย่างต่อเนื่อง

The Development of a Psychiatric Patient Care System in Community Hospitals, Amnat Charoen Province: Integrating the Work of a Multidisciplinary Team and Continuous Follow-up

Abstract

Abstract

Objective: developing a mental health care system in a community hospital through the integration of multidisciplinary team collaboration and continuous patient follow-up, and evaluating the outcomes of the developed system on psychiatric patients and the multidisciplinary team.

Methods: This study employed a research and development (R&D). The study samples consisted of 60 psychiatric patients receiving care at a community hospital in Amnat Charoen Province and 15 members of a multidisciplinary team. Research instruments included a continuity of care assessment, a patient safety and clinical outcomes assessment, a suicide prevention assessment for high-risk patients, and a multidisciplinary team satisfaction questionnaire. Data were analyzed using descriptive statistics, paired t-test, and Wilcoxon signed-rank test.

Results: The results showed that after system implementation, the missed appointment rate among psychiatric patients significantly decreased from 6.8 ± 2.1% to 2.0 ± 1.2% (p < 0.001), and no readmissions within 28 days were observed. No incidents of harm from physical restraint or serious adverse events were reported (0.0%). In addition, 90.5% of patients with schizophrenia received continuous care. Among high-risk psychiatric patients for suicide (n = 19), the mean score for risk surveillance increased from 3.01 ± 0.72 to 4.41 ± 0.51, and the family involvement score increased from 2.88 ± 0.65 to 4.25 ± 0.56, both with statistical significance (p < 0.001). The system successfully prevented repeated suicide attempts in 100% of high-risk patients during the follow-up period. For the multidisciplinary team, satisfaction with the mental health care system significantly increased across all dimensions, with overall satisfaction rising from a median of 3 (IQR 3–4) to 5 (IQR 4–5) (p < 0.001).

Conclusion: the developed mental health care system effectively improved the quality of care, enhanced continuity and patient safety, reduced missed appointments and readmissions, strengthened suicide prevention among high-risk patients, and increased the efficiency of multidisciplinary team collaboration. This system demonstrates strong potential as a model for improving mental health care services in other community hospitals with similar contexts.