Abstract
This evaluation research was aimed at assessing the results of service system development of the Labor Unit of Srithat Hospital, Udon Thani, and its problems and providing a basis for making recommendations for the further development of the Labor Unit.
The qualitative data were obtained from relevant document reviews, in-depth interviews,
participatory and non-participatory observations, from October 1, 2007 to February 29, 2008. It was revealed that the Labor Unit had improved its service system in both process
and outcome as follows: (1) Capacity-building. The administrators assigned multidisciplinary staff members to the Labor Unit. A staff member visited Kumpawapee Hospital, the model hospital, to gain insight into the Labor Unit’s service system development.
The Unit organized training for staff to improve the quality of care for pre-labor, labor,
post partum, newborn, discharge plan and special equipment applications; (2) Facility
improvement. There was also structural development in that the pre-labor attending room
was separated from the Inpatient and Emergency Units. Essential equipment was procured and allocated to the unit; (3) Process improvement. Three service practice guidelines were developed by the multidisciplinary team to ensure good quality of care for
both normal and high-risk labor. The three practice guidelines were (a) care map for intra-partum and immediate post-partum care: low risk, (b) pregnancy-induced hypertension (PIH) care practices guidelines and (c) birth-before-admission practices guidelines.
A post-partum and newborn care handbook was also developed and distributed to mothers
before they were discharged from the unit in order to educate them on how to look after
themselves and their children. The results of improving the system were satisfactory. Client
satisfaction with the services of the Labor Unit increased from 75.2 percent to 88.4 percent. There was no infant and maternal death. Maternal complications also decreased.
Problems encountered in developing the Labor Unit service system were unfamiliarity
with the practice guidelines of staff for both normal and high-risk labor. Reporting on the
care given to patients was still incomplete. Recommendations for further development
included training on applications of the service practice guidelines, simplifying the practice guidelines, monitoring the reporting and establishment of continuous and systematic evaluation of the performance of the Labor Unit.
