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