Quality improvement of health centers in Phachi district, Phra Nakhon Si Ayutthaya

Abstract

Purpose : To evaluate the efficiency of health centers in Phachi in Phachi district, Phra Nakhon Si Ayutthaya province concerning quality improvement in working environment though an adoption of Five 5. Objectives : To assess the quality improvement in physical environment and infrastrcture of health centers, including customers' satisaction with working environment. Method : A cross sectional survey was carried out, with direct observations using checklist evaluation forms about working environment, as well as self-administered questionnaire of satisfaction. Main results : only two health centers scored higher than 80% which were health center A *92.8%) and health center B (80.9%). At the same time they both were also scored in 'good' level inpleasantness of the health center. The respondents stated tha the barriers to the implementation of the Five S program were : (1) equipment and facilities were not in good conditions, some were broken while some were in need for more (2) human resources (insufficient number of staff, the staff did not pay much attention to their jobs) (3) financial constraint to support the Five S implementation (4)Infrastructure. The benefits from the implementing the Five S program- : the health center were clean and tidy, attract more customers, prepared the health centers to provide quality services, easier and more convenient for them to perform their work, higher quality, more convenient and faster and safer services Staff considered that financial support, facilities and equipment, and materials are needed, to implement Five S progam continuously. Staff additionally indicated that staff must be responsible and cooperative, and the management team must prioritize and continually monitor this program. Respondents also stated that contests and good management in implementing the Five S program are needed in the primary care units to achieve the goal. The findings revealed that most customers were highly satisfied with all primary care units working environment except health canter 'E' in which the customers felt was in 'fair' level. Conclusions : It does not only make the health center or primary care units organized, clean and pleasant to work, it also contributes to high satisfaction from the customers. however, proposed to focus at the staff and solve problems occurred from the staff to achieve the success in the implementation and to continually run the program, not providing funds.The management team or relevant staff must be clear and have accurate understanding of problems and obstacles which should be used to correct and improve the Five 5 activities and continue its implementation in the health centers.