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¡°√“§¡ - ¡’π“§¡ 2554

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Health promoting hospital standard (HPH) benchmarking with MBNQA : Health care Jaruwun Jongvanich Public Health Officer, Senior Professional Level Chuen Techamahachai Medical Physicial, Dr. Piriya Wattanarungkarn Public Health Officer, Professional Level Bureau Of Health Promotion, Department of Health

Abstract The research study on the Development of Thailand Health Promoting Hospital (HPH) Standard to Health Promoting Hospital National Quality Award (HPHNQA) had set up the objective to develop the guideline and procedure of hospital self - assessment by mean of Health Promoting Hospital National Quality Award : HPHNQA Standard, There were 16 hospitals under the project divided into 4 clusters. There were 2 phases for action. The first phase was to review and benchmark the several criteria standard on hospitals development and had appointed the Standard of Health Care Criteria for Performance Excellence (Malcolm Baldrige National Quality Award : MBNQA) to benchmark with the standard criteria on HPH and developed the standard criteria of HPHNQA. The second phase was the period of proceeding of standard criteria of HPHNQA as a tool for hospital self - assessment and defining of opportunity for improvement. Furthermore, the staff from 16 hospitals had been trained as an internal surveyor to work with this standard. After 6 months of trial, the standard criteria of HPHNQA had been finalized and using as a tool for hospital development. The result from the study, finding that the highest of mean score (37.6%) is the second category (strategic planning). the later (36.5%) is the first category (Leadership) and the lowest of mean score (28.6 %) is the seventh category (outcome). Nevertheless, it found that the development of HPH to HPHNQA would be more beneficial for hospital to develop themselves as a health Promoting Hospital depending on several factors for example hospital policy and action, working by multidisciplinary team, clarify of concept and procedure etc. Recommendation for further action, were staff development (regional) as a coaching team for hospital development, guideline for hospital action, development of surveyor at regional, national level and distribution of standard criteria for hospitals for self-assessment themselves for further action on health promotion outcome.

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011

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«‘∏’°“√»÷°…“ °“√»÷°…“«‘®—¬·≈–æ—≤π“ (Research and Development) π’¥È ”‡π‘π°“√√–À«à“ß ‡¥◊Õπµÿ≈“§¡ 2550- °—𬓬π 2552 ª√–™“°√∑’Ë»÷°…“ §◊Õ ‚√ß欓∫“≈ ¢Õß√—∞°≈ÿࡵ—«Õ¬à“ß ‡≈◊Õ°‚√ß欓∫“≈∑—Ë«‰ª ‚√ß æ¬“∫“≈™ÿ¡™π ‚√ß欓∫“≈¢Õß°√¡Õπ“¡—¬ ·≈– ‚√ß欓∫“≈ — ß °— ¥ °√–∑√«ß°≈“‚À¡∑’Ë   ¡— § √„® ®”π«π ‰¡àπâÕ¬°«à“ 16 ·Ààß ·≈–µâÕ߇ªìπ‚√ß æ¬“∫“≈∑’ˉ¥â√—∫°“√√—∫√Õß HPH ¡“·≈â« ‡§√◊ËÕß¡◊Õ∑’Ë„™â„π°“√«‘®—¬ 1. °“√𔇰≥±å√“ß«—≈§ÿ≥¿“æ¥â“π ÿ¢¿“æ (Health Care Criteria for Performance Excellence : The Malcolm Baldrige National Quality Award : MBNQA) ª√–°Õ∫¥â«¬ 7 À¡«¥ 18 À—«¢âÕ 32 ª√–‡¥Áπæ‘®“√≥“ 84 §”∂“¡ ·≈–¡“µ√∞“π‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ ª√–°Õ∫ ¥â«¬ 7 Õߧåª√–°Õ∫ 25 À—«¢âÕ ¡“‡∑’¬∫‡§’¬ß ¥â “ π°√Õ∫·π«§‘ ¥ ·≈–·π«ªØ‘ ∫— µ‘ æ— ≤ 𓇪ì π ‡°≥±å‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“栟৫“¡‡ªìπ‡≈‘» ·∫∫°â“«°√–‚¥¥ (Health Promoting Hospital National Quality Award : HPHNQA) ‡æ◊ËÕ ‡ªì π ·π«§”∂“¡„π°“√ª√–‡¡‘ π µπ‡ÕߢÕß‚√ß æ¬“∫“≈ (Self Assessment) ®”π«π 7 À¡«¥ ‚¥¬¡’§–·ππ‡µÁ¡ 1,000 §–·ππ ·≈–°”Àπ¥ §–·ππ√“¬À¡«¥∑’Ë   Õ¥§≈â Õ ß°— ∫ °“√‡ªì π ‚√ß æ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ °“√ª√–‡¡‘π„™â√“¬À¡«¥ 1-6 ‡ªìπ°“√ª√–‡¡‘π°√–∫«π°“√µ“¡·π«∑“ß

ADLI (Approach - Development - Learning - Integration) à « πÀ¡«¥ 7 ‡ªì π °“√ ª√–‡¡‘πº≈≈—æ∏嵓¡·π«∑“ß LeTCI 2. ·∫∫√“¬ß“π°“√ª√–‡¡‘πµπ‡Õßµ“¡ ¡“µ√∞“π HPHNQA ‡æ◊ÕË «‘‡§√“–ÀåÀ“®ÿ¥·¢Áß ·≈– ‚Õ°“ „π°“√æ—≤π“ (Opportunity for Improvement : OFI) ¢—ÈπµÕπ°“√»÷°…“«‘®—¬ ¢—ÈπµÕπ∑’Ë 1 °“√®—¥°“√ª√–™ÿ¡·≈–°“√  ◊ËÕ “√Õ¬à“߉¡à‡ªìπ∑“ß°“√√–À«à“ߧ≥–ºŸâ«‘®—¬·≈– ‚√ß欓∫“≈∑’Ë ¡—§√‡¢â“√à«¡‚§√ß°“√ ‡æ◊ËÕæ—≤π“ ‡°≥±å  Ÿà § «“¡‡ªì π ‡≈‘ » ‚¥¬°“√‡∑’ ¬ ∫‡§’ ¬ ßπ” ‡Õ° “√‡°≥±å√“ß«—≈§ÿ≥¿“æµà“ßÊ ‰¥â·°à The Malcolm Baldrige National Quality Award : MBNQA / Health Care, Public Management Quality Award (PMQA), Thailand Quality Award (TQA), Hospital Accreditation (HA) ¡“»÷ ° …“·π«§‘ ¥ ·π«§”∂“¡·≈–‡∑’ ¬ ∫‡§’ ¬ ß ¡“µ√∞“π MBNQA °—∫¡“µ√∞“π‚√ß欓∫“≈ àß ‡ √‘¡ ÿ¢¿“æ (HPH) ‡ªìπ‡°≥±å°“√æ—≤π“‚√ß æ¬“∫“≈ à ß ‡ √‘ ¡  ÿ ¢ ¿“æ Ÿà § «“¡‡ªì π ‡≈‘ » (HPHNQA) ¢—ÈπµÕπ∑’Ë 2 °“√æ— ≤ π“·∫∫ª√–‡¡‘ π µπ‡Õß (Self Assessment) ‚¥¬∑’¡ºŸâ«‘®—¬ ºŸâ ‡™’ˬ«™“≠¥â“π°“√ª√–‡¡‘π ·≈–ºŸâ·∑π®“°‚√ß æ¬“∫“≈∑’Ë ¡—§√„®‡¢â“√à«¡‚§√ß°“√ ¢—ÈπµÕπ∑’Ë 3 ‡ª√’ ¬ ∫‡∑’ ¬ ∫·≈–«‘ ‡ §√“–Àå §«“¡·µ°µà“ß (Gap Analysis) ‚¥¬°“√®—¥‡«∑’ ·≈°‡ª≈’ˬπ‡√’¬π√Ÿâ ‡æ◊ËÕ𔇠πÕº≈°“√ª√–‡¡‘π µπ‡Õß (Self-Assessment) ·≈–°“√æ— ≤ π“ ª√—∫ª√ÿßµπ‡Õß À“ Best Practice ·≈–ªí®®—¬ §«“¡ ”‡√Á® »÷°…“‡ª√’¬∫‡∑’¬∫ (Benchmarking) §«“¡·µ°µà“ß ·≈–·≈°‡ª≈’ˬπ‡√’¬π√Ÿâ√–À«à“ß‚√ß æ¬“∫“≈ ‡æ◊ÕË  π—∫ πÿπ™à«¬‡À≈◊Õ´÷ßË °—π·≈–°—π √«¡

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∫ ∑ «‘ ∑ ¬ “ ° “ √ ∑—Èß°“√‡¬’ˬ¡µ‘¥µ“¡/ π—∫ πÿπ®“°∑’¡ß“π à«π °≈“ß ¢—ÈπµÕπ∑’Ë 4 °“√ª√—∫ª√ÿß‚√ß欓∫“≈ Ÿà §«“¡‡ªìπ‡≈‘» ‚√ß欓∫“≈¡’°“√æ—≤π“µπ‡Õß ·≈– ª√—∫ª√ÿßµ“¡·ºπæ—≤π“·≈–·π«ªØ‘∫—µ‘∑’Ë¥’ (Best Practice) ‚¥¬‚√ß欓∫“≈π”®ÿ¥ÕàÕπ·≈–®ÿ¥·¢Áß ¡“«‘‡§√“–Àå·≈–°”Àπ¥·ºπß“π°‘®°√√¡ ‡æ◊ËÕ°“√ ¥”‡π‘πß“π

º≈°“√»÷°…“ ¡’‚√ß欓∫“≈‡¢â“√à«¡°“√«‘®—¬·≈–æ—≤π“π’È 16 ‚√ß欓∫“≈ „π¿“§‡Àπ◊Õ ¿“§°≈“ß ·≈– ¿“§µ–«— π ÕÕ°‡©’ ¬ ߇Àπ◊ Õ à « π„À≠à ‡ ªì π ‚√ß æ¬“∫“≈™ÿ¡™π ·≈–¡’‚√ß欓∫“≈ —ß°—¥°√¡Õπ“¡—¬ 5 ·Ààß ·≈–‚√ß欓∫“≈ —ß°—¥°√–∑√«ß°≈“‚À¡ 3 ·Ààß ¥—ßµ“√“ß∑’Ë 1 µ“√“ß∑’Ë 1 ≈—°…≥–¢Õß‚√ß欓∫“≈∑’√Ë «à ¡»÷°…“ ≈—°…≥–

®”π«π

¿“§ ‡Àπ◊Õ °≈“ß µ–«—πÕÕ°‡©’¬ß‡Àπ◊Õ ª√–‡¿∑ √æ™. √æ». ‚√ß欓∫“≈ —ß°—¥°√¡Õπ“¡—¬ ‚√ß欓∫“≈ —ß°—¥°√–∑√«ß°≈“‚À¡

3 ·Ààß 9 ·Ààß 6 ·Ààß 7 ·Ààß 1 ·Ààß 5 ·Ààß 3 ·Ààß

®“°¢—ÈπµÕππ’È ‰¥â‡°≥±å√“ß«—≈§ÿ≥¿“æ‚√ß æ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ·Ààß™“µ‘ (Health Promoting Hospital National Quality Award : HPHNQA) ª√–°Õ∫¥â«¬ Õߧåª√–°Õ∫ 7 À¡«¥ 19 À—«¢âÕ 32 ª√–‡¥Áπæ‘®“√≥“ 88 §”∂“¡À≈—° 102 ¡°√“§¡ - ¡’π“§¡ 2554 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

160 §”∂“¡¬àÕ¬ ‚¥¬„™â«‘∏’ª√–‡¡‘π¥â«¬°“√„™â §–·ππ 1,000 ‡µÁ¡ ¥—ßµ“√“ß∑’Ë 2 ¢—È π µÕπ∑’Ë 2 ∑’ ¡ ‚√ß欓∫“≈¡’ ° “√ ª√–‡¡‘πµπ‡Õßµ“¡¡“µ√∞“π HPHNQA ´÷Ëß ∑¥≈Õß„™â·∫∫ª√–‡¡‘π HPHNQA ‡¡◊ËÕæ∫ªí≠ À“π”¡“ª√—∫·°â·≈–𔉪„™âª√–‡¡‘π´È” 3 §√—ßÈ ®π ¡“µ√∞“π¡’ § «“¡‡∑’Ë ¬ ßµ√ß ·∫∫ª√–‡¡‘ π ·∫à ß ‡ªìπ°“√ª√–‡¡‘π°√–∫«π°“√µ“¡‡°≥±å À¡«¥ 16 „™â°“√ª√–‡¡‘π 4 ¡ÿ¡¡Õß §◊Õ Approach : A, Deployment : D, Learning : L, and Integration : I (ADLI) à«π°“√ª√–‡¡‘πº≈≈—æ∏åÀ¡«¥ 7 „™â°“√ª√–‡¡‘π 4 ¡ÿ¡¡Õß §◊Õ Level: L, Trends: T, Comparisons : C, and Integration: I (LeTCI) ®“°·∫∫ª√–‡¡‘ π π’È ‚√ß欓∫“≈  “¡“√∂§âπÀ“®ÿ¥ÕàÕπ ®ÿ¥·¢Áß ·≈–„À⧖·ππº≈ °“√¥”‡π‘πß“π¢Õßµπ‡Õ߉¥â º≈°“√ª√–‡¡‘π §√—Èß ∑’Ë 3 æ∫«à“ À¡«¥ 2 °“√«“ß·ºπ°≈¬ÿ∑∏å ‡ªìπ À¡«¥∑’Ë‚√ß欓∫“≈ à«π„À≠àª√–‡¡‘πµπ‡Õ߉¥â §–·ππ Ÿß ÿ¥ √âÕ¬≈– 45.3 √Õß≈ß¡“ §◊Õ À¡«¥ 1 °“√π”‚√ß欓∫“≈ √âÕ¬≈– 36.5 À¡«¥ 3 °“√¡ÿàß ‡πâπºŸâ√—∫∫√‘°“√ ≠“µ‘ ™ÿ¡™π æ—π∏¡‘µ√ ¿“§’‡§√◊Õ ¢à“¬ ·≈–°“√µ≈“¥ √âÕ¬≈– 36.4 À¡«¥ 4 °“√«—¥ «‘‡§√“–Àå ·≈–°“√®—¥°“√§«“¡√Ÿâ √âÕ¬≈– 36.3 À¡«¥ 5 °“√¡ÿà߇πâπ∫ÿ§≈“°√ √âÕ¬≈– 35.8 À¡«¥ 6 °“√ ®—¥°“√°√–∫«π°“√ √âÕ¬≈– 35.4 ·≈–À¡«¥∑’ˉ¥â √—∫§–·ππµË” ÿ¥ §◊Õ À¡«¥ 7 º≈≈—æ∏å ¢—È π µÕπ∑’Ë 3 À≈— ß ®“°‚√ß欓∫“≈ ª√–‡¡‘πµπ‡Õß·≈â« ºŸâ«‘®—¬®÷ß®—¥‡«∑’·≈°‡ª≈’ˬπ ‡√’¬π√Ÿâ°“√ª√–‡¡‘πµπ‡ÕߢÕß‚√ß欓∫“≈µà“ß Ê √«¡∑—Èߪí≠À“Õÿª √√§ ®“°°“√‡«∑’π’È æ∫«à“ ‚√ß æ¬“∫“≈‰¥â¡’°“√‡√’¬π√Ÿâ ·≈–¡’°“√¥”‡π‘πß“πµ“¡ ¢—ÈπµÕπ¢Õß°“√»÷°…“§√∫∑ÿ°¢—ÈπµÕπ µ—Èß·µà°“√ ª√–‡¡‘πµπ‡Õß ·≈–„À⧖·ππ°“√«‘‡§√“–Àå OFI °“√∑”·ºπæ—≤π“Õߧå°√ ¡’ best practice ·≈–


‚§√ß°“√»÷°…“«‘®—¬°“√æ—≤π“‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“栟৫“¡‡ªìπ‡≈‘»œ

µ“√“ß∑’Ë 2 µ“√“߇ª√’¬∫‡∑’¬∫¡“µ√∞“π§ÿ≥¿“æ‚√ß欓∫“≈µ“¡¡“µ√∞“π HPH, MBNQA, HPHNQA ¡“µ√∞“π HPH

1. °“√π”Õߧå°√ 2. °“√®— ¥ √√∑√— æ ¬“°√ · ≈ – ° “ √ æ— ≤ π “ ∑√—欓°√∫ÿ§§≈ 3. °“√®—¥°“√ ‘Ëß·«¥≈âÕ¡∑’Ë ‡Õ◊È Õ µà Õ °“√¥”‡π‘ π ß“π ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢ ¿“æ 4. 5.

6. 7.

·π«∑“ß °“√„Àâ §–·ππ

√–¥—∫ 1 æÕ„™â

¡“µ√∞“π MBNQA

§–·ππ ¡“µ√∞“π HPHNQA §–·ππ

1. °“√π”Õߧå°√ 2. °“√«“ß·ºπ°≈¬ÿ∑∏å

120 1. °“√π”Õߧå°√ 85 2. °“√«“ß·ºπ°≈¬ÿ∑∏å

120 80

3. °“√¡ÿà߇πâπºŸâ√—∫∫√‘°“√ ≈Ÿ ° §â “ Õ◊Ë π Ê ·≈–°“√ µ≈“¥

85 3. °“√¡ÿà ß ‡πâ π ∫ÿ § ≈“°√ºŸâ ¡’ à«π‰¥â‡ ’¬ ºŸâ√—∫∫√‘°“√ ·≈–≠“µ‘ ¿“§’‡§√◊Õ¢à“¬ ª√–™“™π„π™ÿ¡™π·≈– °“√µ≈“¥ 90 4. °“√«—¥«‘‡§√“–Àå·≈–°“√ ®—¥°“√§«“¡√Ÿâ 85 5. °“√¡ÿà߇πâπ∫ÿ§≈“°√∑’Ë„Àâ ∫√‘°“√

100

√–¥—∫ 2 ‡√‘¡Ë °“√ à ß ‡ √‘ ¡  ÿ ¢ ¿“æ ‡ª≈’ˬπ·ª≈ß 4. °“√«—¥«‘‡§√“–Àå ·≈– ¥’¢÷Èπ °“√®—¥°“√§«“¡√Ÿâ  ”À√—∫∫ÿ§≈“°√ 5. °“√¡ÿà ß ‡πâ π ∑√— æ ¬“°√ °“√ à ß ‡ √‘ ¡  ÿ ¢ ¿“æ ∫ÿ§§≈  ”À√—∫ºŸâ√—∫∫√‘°“√·≈– √–¥—∫ 3 §√Õ∫§√—«∑’Ë¡“√—∫∫√‘°“√ ¡’·π«‚πâ¡∑’¥Ë ’ „π area  ”§—≠ ∑’Ë‚√ß欓∫“≈ 6. °“√®—¥°“√°√–∫«π°“√ 85 6. °“√®—¥°“√°√–∫«π°“√ °“√ à ß ‡ √‘ ¡  ÿ ¢ ¿“æ„π ™ÿ¡™π 450 7. º≈≈—æ∏å º ≈ ≈— æ ∏å ¢ Õ ß √–¥—∫ 4 7. º≈≈—æ∏å °√–∫«π°“√ à߇ √‘¡ ÿ¢ ¡’º≈≈—æ∏å∑’Ë¥’ ¿“æ „π area  ”§—≠ - ∫ÿ§≈“°√ - ºŸ√â ∫— ∫√‘°“√ √–¥—∫ 5 - ™ÿ¡™π ¥’‡≈‘» 1,000

‡¢’¬π√“¬ß“π 6 ·Ààß ∑”∑ÿ°¢—ÈπµÕπ·µà¢“¥°“√ ‡¢’¬π√“¬ß“π 6 ·Ààß ∑”¢—ÈπµÕπ‡¥’¬« 1 ·Ààß ·≈– ‰¡à àß√“¬ß“π°“√ª√–‡¡‘πµπ‡Õß 3 ·Ààß ®“°º≈ °“√ª√–™ÿ¡∑”„Àâ‚√ß欓∫“≈π” ‘Ëß∑’ˉ¥â®“°°“√ ‡√’¬π√Ÿâ‰ªª√—∫æ—≤π“µπ‡Õß ¢—πÈ µÕπ∑’Ë 4 ®–µâÕߥ”‡π‘π°“√µàÕ„π√–¬–∑’Ë

80 100

110 400

1,000

2 ¢Õß°“√«‘®—¬ ªí®®—¬§«“¡ ”‡√Á® ·≈–¢âÕ‡ πÕ ·π–®“°°“√¥”‡π‘πß“π ®“°°“√®—¥‡«∑’ ¡— ¡π“ ·≈– °“√‡¬’¬Ë ¡‡æ◊ÕË æ—≤π“ ®“°º≈°“√¥”‡π‘πß“π¥—ß°≈à“«  “¡“√∂®”·π°§«“¡ ”‡√Á®¢Õß‚√ß欓∫“≈‰¥â‡ªìπ 3 °≈ÿà¡ ·≈– √ÿªªí®®—¬§«“¡ ”‡√Á® ¥—ßπ’È °≈ÿà¡∑’Ë 1 ‡ªìπ°≈ÿà¡∑’Ë¡’º≈ß“πÕ¬Ÿà„π√–¥—∫¥’

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011

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∫ ∑ «‘ ∑ ¬ “ ° “ √ ¥”‡π‘π°“√§√∫∑ÿ°¢—ÈπµÕπ ¡’°“√æ—≤π“ª√—∫ª√ÿß √Ÿª·∫∫ °√–∫«π°“√¥”‡π‘πß“π à߇ √‘¡ ÿ¢¿“æ „π‚√ß欓∫“≈·≈–™ÿ¡™π ®π‡°‘¥π«—µ°√√¡°“√  à߇ √‘¡ ÿ¢¿“æ ‡™àπ ¡’°“√∑”ß“π∑’ˇªìπ∑’¡®“° ∫ÿ§≈“°√∑ÿ°√–¥—∫ ·≈–∑ÿ° “¢“«‘™“™’æ ‡°‘¥®“° °“√∑’˺Ÿâ∫√‘À“√„À⧫“¡ ”§—≠ ¡’°“√°”Àπ¥‡ªÑ“ À¡“¬™—¥‡®π ¡’ºŸâ√—∫º‘¥™Õ∫À≈—° ¡’°“√∑”ß“π ‡ªìπ∑’¡ ·≈–¡’‚§√ß √â“ß°“√ªØ‘∫—µ‘ß“π∑’ˇÕ◊ÈÕµàÕ °“√¥”‡π‘πß“π ∑’¡π”¡’§«“¡‡¢â“„®¡“µ√∞“π¥â“π §ÿ≥¿“æµà“ßÊ·≈–𔉪 Ÿà°“√ªØ‘∫—µ‘‰¥â ·≈–¡’∑’¡  π—∫ πÿπ∑’ˇ¢â¡·¢Áß®“°»Ÿπ¬åÕπ“¡—¬‡¢µ °≈ÿà¡∑’Ë 2 ‡ªìπ°≈ÿà¡∑’Ë¡’º≈ß“πÕ¬Ÿà„π√–¥—∫ ª“π°≈“ß „À⧫“¡√à«¡¡◊Õ„π°“√‡√’¬π√Ÿâµ≈Õ¥°“√ «‘®—¬ ·µàªØ‘∫—µ‘ß“π‰¡à§√∫∂â«π°√–∫«π°“√«‘®—¬ ºŸâ∫√‘À“√„À⧫“¡ ”§—≠·≈– π—∫ πÿπ ·µàºŸâ√—∫º‘¥ ™Õ∫À≈—°¡’°“√‡ª≈’ˬπ·ª≈ßµ—«∫ÿ§§≈ ¢“¥§«“¡ √à«¡¡◊Õ„π√–À«à“ߺŸâªØ‘∫—µ‘ß“π ·≈–°“√∑”ß“π ‡ªìπ∑’¡¬—߉¡à™—¥‡®π °≈ÿà¡∑’Ë 3 °≈ÿà ¡ ∑’Ë ¡’ º ≈°“√¥”‡π‘ π ß“π √–¥—∫πâÕ¬ ‡π◊ËÕß®“°¢âÕ®”°—¥∫“ßÕ¬à“ß∑—Èß„π√–¥—∫ Õß§å ° √ √–¥— ∫ ∫ÿ § ≈“°√ Õ— π ‡π◊Ë Õ ß¡“®“° ‚√ß æ¬“∫“≈µâ Õ ß√— ∫ ¿“√–°“√¥”‡π‘ π °“√µ“¡ ¡“µ√∞“πµà“ßÊ ‡æ◊ËÕ°“√æ—≤π“‚√ß欓∫“≈ ·≈– ¡’°“√°”Àπ¥ºŸâ√—∫º‘¥™Õ∫·∫àß·¬°µ“¡¡“µ√∞“π ¢“¥°“√∑”§«“¡‡¢â“„®„π‡√◊ËÕߢÕß¡“µ√∞“π∫“ß ¡“µ√∞“π∑’ Ë “¡“√∂∫Ÿ√≥“°“√°—π‰¥â ¢“¥°“√‡√’¬π√Ÿâ ·≈–§«“¡µàÕ‡π◊ÕË ß ·≈–ºŸªâ Ø‘∫µ— ß‘ “𧑥«à“ ¡“µ√∞“π µà“ßÊ ‡ªìπ¿“√–ß“π¢ÕߺŸâªØ‘∫—µ‘ß“π ¢—ÈπµÕπ∑’Ë 4 ·ºπªØ‘∫—µ‘ß“πµ“¡‚Õ°“  æ—≤π“ (Opportunity for Improvement : OFI) æ∫«à “ ∫“ß‚√ß欓∫“≈ “¡“√∂¥”‡π‘ π °“√µ“¡ ·ºπ∑’Ë°”À𥉥â 3 ·Ààß ¡’°“√®—¥∑”°‘®°√√¡ ‚§√ß°“√®π‡°‘¥‡ªìπ best practice ∑’Ë “¡“√∂ ª√–‡¡‘ π º≈ ”‡√Á ® ‰¥â ·µà ∫ “ß·Àà ß ‰¡à   “¡“√∂ 104 ¡°√“§¡ - ¡’π“§¡ 2554 °√¡Õπ“¡—¬

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¥”‡π‘π°“√‰¥â·µàµâÕß√Õß∫ª√–¡“≥ ∫“ß·ÀàßÕ¬Ÿà √–À«à“ß°“√¥”‡π‘πß“π

Õ¿‘ª√“¬º≈ / ¢âÕ‡ πÕ·π– ®“°°“√¥”‡π‘πß“π‚§√ß°“√¥—ß°≈à“«‰¥â¡’ °“√æ—≤𓇰≥±å‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ ‡ªìπ ‡°≥±å¡“µ√∞“π‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ‚¥¬ °“√‡∑’¬∫‡§’¬ß‡°≥±å√“ß«—≈§ÿ≥¿“æ (Health Promoting Hospital National Quality Award : HPHNQA) ‚¥¬¡’‚§√ß √â“ߢÕß 7 Õߧåª√–°Õ∫ ‡¥‘¡ ¡’°“√‡πâπ°√–∫«π°“√§ÿ≥¿“æ ®“° ¡“µ√∞“π √“ß«—≈§ÿ≥¿“æ·Ààß™“µ‘ (Health Care Criteria for Performance Excellence : The Malcolm Baldrige National Quality Award : MBNQA) ‡πâπ°“√„Àâ∫√‘°“√¥â“π√—°…“欓∫“≈·°à≈°Ÿ §â“ À√◊Õ ºŸâªÉ«¬ ·µà HPHNQA ‡πâπ°“√„Àâ∫√‘°“√¥â“π°“√  à߇ √‘¡ ÿ¢¿“æ ·≈–ªÑÕß°—π‚√§∑’°Ë ≈ÿ¡à ‡ªÑ“À¡“¬ §◊Õ ºŸâ √— ∫ ∫√‘ ° “√ À√◊ Õ ºŸâ ªÉ « ¬ √«¡∂÷ ß ≠“µ‘ ·≈– §√Õ∫§√—«¢ÕߺŸ√â ∫— ∫√‘°“√ ∫ÿ§≈“°√¢Õß‚√ß欓∫“≈ ·≈–ª√–™“™π„π™ÿ¡™π¥â«¬ πÕ°®“°π’Ȭ—ß√«¡∂÷ß °“√®— ¥ °“√¥â “ π ‘Ë ß ·«¥≈â Õ ¡∑“ß°“¬¿“æ  ‘Ë ß ·«¥≈âÕ¡∑“ß —ߧ¡ ·≈– ‘Ëß·«¥≈âÕ¡∑’ˇÕ◊ÈÕµàÕ°“√  à߇ √‘¡ ÿ¢¿“æ √«¡∑—ßÈ ‡°≥±å°“√„À⧖·ππ HPH ®“°‡¥‘¡∑’„Ë À⇪ìπ°“√®—¥√–¥—∫ ®“°√–¥—∫ 1 ∂÷ß √–¥—∫ 5 ‡ªìπ°“√„À⧖·ππ (Scoring) ·∑π´÷Ëß®–‡ªìπ «‘∏°’ “√∑’ªË √–‡¡‘π„π√“¬≈–‡Õ’¬¥¢Õß°“√¥”‡π‘πß“π §◊ Õ §–·ππ‡µÁ ¡ 1,000 §–·ππ  ”À√— ∫ °“√ ª√–‡¡‘πµπ‡Õß (Self Assessment) æ∫«à“ §–·ππ „πÀ¡«¥°√–∫«π°“√ 1-6 ‡ªìπ°“√„À⧖·ππ·∫∫ ADLI ‚√ß欓∫“≈¡’°“√ª√–‡¡‘πµπ‡Õß 3 §√—ßÈ „π §√—Èß·√° æ∫«à“  “¡“√∂ª√–‡¡‘π‰¥â A ·≈– D ·µà ‰¡à “¡“√∂𔉪 Ÿà L ·≈– I ‰¥â·µà ‡¡◊ËÕ¡’°“√ ∑”§«“¡‡¢â “ „®‡°≥±å «‘ ∏’ ° “√ªØ‘ ∫— µ‘ ·≈–°“√ æ—≤π“µπ‡Õß ‚√ß欓∫“≈ “¡“√∂ª√–‡¡‘π‰¥â„°≈â


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‡§’¬ß°—∫°“√ªØ‘∫—µ‘ß“π‰¥â¡“°¢÷Èπ §–·ππ‚¥¬ ‡©≈’ˬլŸà∑’Ë 338 §–·ππ ‚√ß欓∫“≈„À⧖·ππ„π À¡«¥ 2 °“√«“ß·ºπ°≈¬ÿ∑∏剥⧖·ππ¡“°∑’Ë ÿ¥ ·≈–À¡«¥ 7 º≈≈— æ ∏å ¢ Õß°“√¥”‡π‘ π ß“π‰¥â §–·πππâÕ¬∑’Ë ÿ¥ ®“°°“√ª√–‡¡‘πµπ‡Õߥ—ß°≈à“« ∑”„Àâ ‚ √ß欓∫“≈ “¡“√∂§â π À“®ÿ ¥ Õà Õ π¢Õß µπ‡Õ߉¥â · ≈–𔉪 Ÿà ‚ Õ°“ °“√æ— ≤ π“ ‡æ◊Ë Õ °”À𥇪ìπ·ºπæ—≤π“Õߧå°√µàÕ‰ª‰¥â √«¡∑—Èß °“√§âπÀ“®ÿ¥·¢Áß∑’Ë𔉪 Ÿà°“√æ—≤𓇪ìπ Best Practice ‰¥â ‚√ß欓∫“≈∑’ˇ¢â“√à«¡‚§√ß°“√ ¡’ ‚Õ°“ ‡√’ ¬ π√Ÿâ √à « ¡°— π ·≈°‡ª≈’Ë ¬ 𧫓¡§‘ ¥ ª√– ∫°“√≥å ·≈–𔉪æ—≤π“„π‚√ß欓∫“≈ ¢Õßµπ‡Õ߉¥â ®“°°“√®”·π°°≈ÿà¡‚√ß欓∫“≈∑’Ë √à«¡¥”‡π‘πß“π æ∫«à“ ‚√ß欓∫“≈∑’ËÕ¬Ÿà„π°≈ÿà¡ º≈°“√¥”‡π‘πß“π¥’ ¡’ªí®®—¬ ”§—≠§◊Õ π‚¬∫“¬∑’Ë ™—¥‡®π °“√ π—∫ πÿπ·≈– à߇ √‘¡®“°ºŸ∫â √‘À“√ °“√ √à«¡¡◊Õ®“°∑’¡ß“π ºŸâ‡™’ˬ«™“≠„Àâ°“√ π—∫ πÿπ «‘™“°“√ ºŸâ√—∫º‘¥™Õ∫ß“π ∫ÿ§≈“°√¡’§«“¡¡ÿàß¡—Ëπ ∑’¡ß“π‡¢â“„®°“√ªØ‘∫—µ‘ß“π‡æ◊ËÕ°“√æ—≤π“Õߧå°√  à߇ √‘¡ ÿ¢¿“æ ¡“µ√∞“π¥—ß°≈à“«®–µâÕß¡’°“√ »÷ ° …“«‘ ®— ¬ µà Õ ‡π◊Ë Õ ß„π√–¬–∑’Ë 2 ‡æ◊Ë Õ „Àâ ‚ √ß æ¬“∫“≈ “¡“√∂æ—≤π“µπ‡Õ߇ªìπ‚√ß欓∫“≈ àß ‡ √‘¡ ÿ¢¿“æ§ÿ≥¿“æ∑’ˇ∑’¬∫‡§’¬ß√–¥—∫ “°≈

¢âÕ‡ πÕ·π–‡æ◊ËÕ°“√æ—≤π“ 1. æ—≤π“∑’¡ß“π√–¥—∫‡¢µ (»Ÿπ¬åÕπ“¡—¬ ‡¢µ„π°“√‡ªìπæ’ˇ≈’Ȭ߷≈–∑’˪√÷°…“‚√ß欓∫“≈„π æ◊πÈ ∑’)Ë 2. ®—¥∑”§Ÿà¡◊Õ°“√¥”‡π‘πß“π‡æ◊ËÕæ—≤π“ ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ Ÿà°“√‡ªìπ‚√ß欓∫“≈  à߇ √‘¡ ÿ¢¿“懰≥±å√“ß«—≈§ÿ≥¿“æ√–¥—∫™“µ‘ (HPHNQA) 3. æ— ≤ π“∑’ ¡ æ— ≤ π“·≈–‡¬’Ë ¬ ¡ª√–‡¡‘ π (Surveyor) √–¥—∫‡¢µ ·≈–√–¥—∫™“µ‘ ‡æ◊ËÕ°“√ ª√–‡¡‘π·≈–√—∫√Õß 4. º≈— ° ¥— π „Àâ ° √–∑√«ß “∏“√≥ ÿ ¢  π— ∫  πÿ π ¡“µ√∞“π‡°≥±å √ “ß«— ≈ §ÿ ≥ ¿“æ‚√ß æ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ√–¥—∫™“µ‘ 5. °“√‡º¬·æ√৫“¡√Ÿâ §«“¡‡¢â“„® „Àâ‚√ß æ¬“∫“≈µà“ßÊ ∑’Ë π„® ¡—§√ª√–‡¡‘πµπ‡Õß„π √–¬–·√° ‡æ◊ËÕ„À⇰‘¥°“√«—¥º≈°“√ à߇ √‘¡ ÿ¢ ¿“æ∑’Ë¡’§«“¡‡ªìπº≈≈—æ∏凙‘ߪ√–®—°…剥â 6. °“√ π— ∫  πÿ π °“√»÷ ° …“«‘ ®— ¬ °“√  π—∫ πÿπ°“√»÷°…“«‘®—¬‚§√ß°“√µàÕ‡π◊ËÕß ‡æ◊ËÕ„Àâ ‰¥â¢âÕ √ÿª·≈–«‘∏’°“√∑’Ë𔉪 Ÿà°“√ªØ‘∫—µ‘ ‡æ◊ËÕ §ÿ≥¿“æ¢Õß‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ

‡Õ° “√Õâ“ßÕ‘ß 1. ”π—° à߇ √‘¡ ÿ¢¿“æ °√¡Õπ“¡—¬. §Ÿà¡◊Õ°“√ª√–‡¡‘π„π‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ. °√¡Õπ“¡—¬ °√–∑√«ß “∏“√≥ ÿ¢, ππ∑∫ÿ√’;2546 2. ”π—°ß“π§≥–°√√¡°“√æ—≤π“√–∫∫√“™°“√ ( ”π—°ß“π °.æ.√.). °“√æ—≤π“§ÿ≥¿“æ°“√∫√‘À“√®—¥°“√¿“§√—∞ ‡°≥±å§ÿ≥¿“æ °“√∫√‘À“√®—¥°“√¿“§√—∞ æ.». 2550. ¿“√°‘®°“√∫√‘À“√°“√‡ª≈’ˬπ·ª≈ß·≈–π«—µ°√√¡  ”π—°ß“π °.æ.√., °√ÿ߇∑æœ;2549 3. ∂“∫—π‡æ‘Ë¡º≈º≈‘µ·Ààß™“µ‘. ‡°≥±å√“ß«—≈§ÿ≥¿“æ·Ààß™“µ‘‡æ◊ËÕÕߧå°√∑’ˇªìπ‡≈‘» (Thailand Quality Award 2550). ∫√‘…—∑®‘ π«—≤πå ‡ÕÁ°‡æ√  ®”°—¥, °√ÿ߇∑æœ;2550 4. ∂“∫—πæ—≤π“·≈–√—∫√Õߧÿ≥¿“æ‚√ß欓∫“≈. ¡“µ√∞“π‚√ß欓∫“≈·≈–∫√‘°“√ ÿ¢¿“æ ©∫—∫‡©≈‘¡æ√–‡°’¬√µ‘©≈Õß ‘√‘√“™  ¡∫—µ‘§√∫ 60 ªï.  ∂“∫—πæ—≤π“·≈–√—∫√Õߧÿ≥¿“æ‚√ß欓∫“≈ (æ.√.æ.), ππ∑∫ÿ√’;2551 5. ”π—°æ—≤π“√–∫∫∫√‘°“√ ÿ¢¿“æ °√¡ π—∫ πÿπ∫√‘°“√ ÿ¢¿“æ °√–∑√«ß “∏“√≥ ÿ¢. ¡“µ√∞“π∫√‘°“√ “∏“√≥ ÿ¢. ‚√ßæ‘¡æå ™ÿ¡™π À°√≥å°“√‡°…µ√·Ààߪ√–‡∑»‰∑¬ ®”°—¥, °√ÿ߇∑æœ;2550 6. ”π—°ß“π°“√欓∫“≈ °√¡°“√·æ∑¬å °√–∑√«ß “∏“√≥ ÿ¢. ‡°≥±å§ÿ≥¿“æ°“√ªØ‘∫—µ‘°“√欓∫“≈∑’ˇªìπ‡≈‘». ∫√‘…—∑ “¡ ‡®√‘≠æ“≥‘™¬å (°√ÿ߇∑æ) ®”°—¥. °√ÿ߇∑æœ;2549 7.Baldrige National Quality Program. Criteria for Performance Excellence 2008. National Institute of Standard and Technology. Technology Administration. Department of Commerce. U.S.A. THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH J a n u a ry - M a r c h 2011

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HEALTH_Vol34No1_09  

∫∑§— ¥ ¬à Õ 98 ∫ ∑ «‘ ∑ ¬ “ ° “ √ °√¡Õπ“¡— ¬ à ß ‡ √‘ ¡ „Àâ § π‰∑¬ ÿ ¢ ¿“楒 ¡°√“§¡ - ¡’π“§¡ 2554 Abstract 99 THAILAND JOURNAL OF HEALTH PRO...