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A Perspective From Provincial Hospital
Chatchai Kraysubun
Emergency Department
Chaophayaabhaibhubejhr Hospital
Prachinburi Province
Model of Clinical Practice of Emergency
Medicine
Obstacles VS. challenge
From Routine to Research
Clinician
Administrator
Researcher
◦ Evidence-based medicine
◦ Interpretation of medical literature
◦ Performance of research
“A study in search for factsfacts or new new
knowledge knowledge using the reliable and valid
methodology”
-Tertiary care hospital
-Admission rate = 88%
How we service?
◦ 1 EP or 1 intern doctor per shift
◦ 4-5 Nurses per shift
◦ 1 EMT-B, 2 EMT-I per shift
ED crowdingED crowding EMSEMS
“Clearing the crowd”
◦ Spend the time for managing patient
◦ Tired and Exhausted
◦ Research is the furthest thing on their mind
Average EP spend > 40-56 hr/week in patient care activities
Limitation of resource and ability to organize data
Positive features Difficulties
Large numbers of patients
Wide range of clinical
conditions
Early access to acute illness
Potential for epidemiological
studies
Studying non-emergency
illness Performing laboratory
research Obtaining research grants Finding a project supervisor Continuing studies “out of
hours” Defining entry criteria in
prospective studies
Is it possible to do the research in provincial
hospital ?
Can EP perform the research even in the
limitation of the resource?
Can EP have enough time to do the
research ?
No exactly definition
Continuous development of
the organization towards the
goal
Strengthen the care of patient
for excellent services
PDCA(Plan-Do-Check-Act)
Prof . Vicharn Panich
Development of leadership
Innovation supported by evidence base
Win-Win situation for all levels of personnel
Teamwork
Knowledge management
1. I have the collected data, but I don’t but I don’t
have the research questionhave the research question 2. I have the project, but I’ve not started yet 3. I’m very interesting in research, but I but I
don’t know how to startdon’t know how to start 4. I’m interesting in research, but I’m not but I’m not
sure I can do it sure I can do it 5. I don’t like it and I don’t want to do
Examine everyday standard work and ask “ How can I improve it?”
Review literature to find the room for question
Reduplicate and application of the study Talk with people who are interested in
research
Step 1: Help me please !!!!
Comparison protocol checklist
Research in EM is the challengechallenge
Research is the tool of development
◦ People development
◦ Process of work development
◦ Place development
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