The Development of Synergetic Outpatient Services System in Reducing the Incidence of Patient Arrest in the Outpatient Department at Nakornping Hospital, Chiang Mai Province

  • ปิยะเนตร ทาจวง แผนกผู้ป่วยนอก โรงพยาบาลนครพิงค์
  • ชูศักดิ์ ยืนนาน วิทยาลัยพยาบาลบรมราชชนนี เชียงใหม่
Keywords: Outpatient department services, Cardiopulmonary resuscitation, Collaboration


The study of the development of synergetic outpatient services system to reduce the incidence of outpatient services was carried out in the outpatient department at Nakornping Hospital, Chiang Mai Province. This study aimed to develop a synergetic model of outpatient services in reducing the incidence of cardiopulmonary arrest at Outpatient Department. The Deming cycle circuit for developing the system in conjunction with a thematic analysis was employed in this study. In addition, the cardiac risk assessments for patient arrest by implementing procedures to reduce the incidence of cardiac arrest were used in this study. Participants consisted of the head of the outpatient department, nurses and outpatient care workers. Research tools included 1) group discussion and brainstorming sessions and 2) the risk assessment tool for respiratory arrest and cardiac arrest. The Likelihood ratios (LRs) were applied. The results revealed that 1) the Outpatient Service Model to reduce incidence of respiratory arrest and cardiac arrest at Nakornping Hospital, Chiang Mai province involved patient observing from the beginning of the service, zoning of risk patients, alertness of health staff in service, collaboration to assess and acceptance of participation and 2) the statistical analysis for evaluation accuracy or reliability of the risk assessment tool was considered by Likelihood ratio of positive at 11.59. The result shown the patients were evaluated by the assessment form had at least one symptom referred to the signs of cardiac arrest. The prediction is able to increase the chance of being as a crisis patient at 11.59 times compared to before the pre-test probability. While, likelihood ratio of negative test, the patients without symptoms may reduce the chance of becoming a critical patient to 0.52 times compared to before the assessment. According to the area under the ROC curve (AUC), it indicated that the assessment model can accurately predict the occurrence of the crisis of patients at 73.12 percent.


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How to Cite
ทาจวงป., & ยืนนานช. (2018). The Development of Synergetic Outpatient Services System in Reducing the Incidence of Patient Arrest in the Outpatient Department at Nakornping Hospital, Chiang Mai Province. Journal of Health Science and Community Public Health, 1(2), 115-130. Retrieved from
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