1 Jitrada Deawpha Thanamat Bunpanya Natthida Malathong

2 The Geography of ChiangSaen district in has located in Chiang Rai province the north of Chiang Rai province. It has four directions ; - North ; Mae Sai district and Laos PDR - East ; Bor kaew district, Laos PDR and Chiang Khong district - South ; Chiang Khong, Doi Luang and Mae Chan district - West ; Mae Chan and Mae Sai district Source: Chiangsaen hospital, Chiang Rai province, Thailand

3 Locate : Location at 104 Moo 6 Wiang sub- district, Chiangsaen district, Chiang Rai Province Primary & Secondary care level Hospital size : 60 beds Hospital Staff : 229 persons Department : 10 Department

 Chiangsaen hospital are a quality hospital to provide a good service, bring the community and borderland health system through a dedicated health and social network association, satisfied and customer, and healthy people. Provider is valuable and goodness. เราจะเป็นโรงพยาบาลคุณภาพ มุ่งบริการดี สร้างระบบสุขภาพชุมชนและ ระบบสุขภาพชายแดนที่เข้มแข็ง ด้วยหลักสุขภาพพอเพียงร่วมกับภาคี เครือข่ายและ ภาคประชาสังคม เพื่อให้ผู้รับบริการปลอดภัย พึงพอใจ ประชาชนมีสุขภาวะ ผู้ให้บริการมีคุณค่า ความดีงามและความสุข 4 Source: Chiangsaen hospital, Chiang Rai province, Thailand

5 1. To provide a good service system through the professional and integrating the holistic. 2. To bring the community and borderland health system through a dedicated health and social network association 3. To improve a quality, value, goodness, and happiness of staff by a good governance and self-sufficiency in Chiangsaen is the organization of learning. 1. สร้างระบบบริการที่ดี ตามมาตรฐานวิชาชีพ อย่างผสมผสานและเป็นองค์ รวม 2. สร้างระบบสุขภาพชุมชนและระบบสุขภาพชายแดน ที่เข้มแข็ง ร่วมกับภาค เครือข่ายและภาคประชาสังคม 3. สร้างเสริมบุคลากรให้มีคุณภาพ มีคุณค่า ความดีงาม และมีความสุข ยึด หลักธรรมาภิบาลและความพอเพียงในการดำเนินชีวิตสร้างโรงพยาบาลเชียง แสนให้เป็นองค์กรแห่งการเรียนรู้ Source: Chiangsaen hospital, Chiang Rai province, Thailand

6 N = 46,631 Source: Chiangsaen hospital, Chiang Rai province, Thailand

7

8 DaysClinic Service Monday -ANC -HT -Addiction -Physical Therapy -Thai traditional medicine Tuesday -TB -Anti-HIV drug -COPD -Addiction -Physical Therapy -Thai traditional medicine Wednesday -DM -Family Planning -Addiction -Physical Therapy -Thai traditional medicine Thursday -DM -Addiction -Physical Therapy -Thai traditional medicine Friday -HT -Addiction -Physical Therapy -Thai traditional medicine Every 2 nd Thursday of month Well baby Clinic, Immunization Source: Chiangsaen hospital, Chiang Rai province, Thailand

9 N = 87,116

10 Source: Chiangsaen hospital, Chiang Rai province, Thailand

11 Source: Chiangsaen hospital, Chiang Rai province, Thailand

12 Source: Chiangsaen hospital, Chiang Rai province, Thailand

13 Source: Chiangsaen hospital, Chiang Rai province, Thailand

14 Registration Vital sign & Screening Old patient : ID card New patient : Record profile + ID card Emergency room -Accident with in 24 hour -Blood pressure is too high Out patient department -General health service -Counseling -X-Ray Health promotion -ANC -Family Planning -Well Baby Clinic -Immuniz ation -Physical therapy -Thai Tradition Appointments -NCD clinic -HIV clinic -TB clinic -Addiction Disease prevention and control clinic -Vaccinatio n -New TB case -Dog bite Source: Chiangsaen hospital, Chiang Rai province, Thailand

15 Visit/Case Year Source: Chiangsaen hospital, Chiang Rai province, Thailand

16 yea r Visit Source: Chiangsaen hospital, Chiang Rai province, Thailand

17 year Percentage Source: Chiangsaen hospital, Chiang Rai province, Thailand

18 year Visit Source: Chiangsaen hospital, Chiang Rai province, Thailand

year Morbidity rate 19 Source: Chiangsaen hospital, Chiang Rai province, Thailand

20 Percentage Source: Chiangsaen hospital, Chiang Rai province, Thailand

21 Father & Mother school Blood test Urine Test Dental Care Palpation and measure high of fundus Fetal Heart Sound

22 Child development, observed and practiced for Immunization in responsibility area

23

24 Health screening & Visit elderly home Home visits the disabled

25

26

27 Infectious waste General waste

28 infectious waste way Food and equipment sterile

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THE EFFECTIVENESS OF INNOVATION “CALENDAR BAG” FOR COMPLETE DRUG COURSE IN TB PATIENT ON TREATMENT IN CHIANGSAEN HOSPITAL CHIANG RAI PROVINCE ( ประสิทธิผลของนวัตกรรม “ ปฏิทินกิน ยา ถุงผ้ากันลืม ” เพื่อให้ผู้ป่วยวัณโรคที่รักษาในช่วง กินยาได้ครบในโรงพยาบาลเชียงแสน จังหวัด เชียงราย ) 30

Source: Chiangsaen hospital, Chiang Rai province, Thailand Morbidity rate 31

Results of treatment TB in PROBLEM Source: Chiangsaen hospital, Chiang Rai province, Thailand 32

PROBLEM Percentage Source: Chiangsaen hospital, Chiang Rai province, Thailand 33

22 Peoples of TB patient on treatment have take corrected drug 4 peoples from TB registration is 18.1% PROBLEM 34

PROBLEM Source: Chiangsaen hospital, Chiang Rai province, Thailand 35

Research Question Research Hypothesis  Did the innovation “Calendar bag” enhance the percentage of complete drug course?  The innovation “Calendar bag” makes complete drug course of TB patients. 36 Objectives 1. To complete drug course of treatment in TB patient. 2. To development of innovation “Calendar bag”

Target group  TB patient on treatment in from registration in TB clinic.  Criteria : The registries in TB clinic to consent Questionnaire and participant of intervention. Included : Patient consent with Questionnaire and participant of intervention. (22 peoples) Excluded : 8 peoples 37 Study design & Statistic

Methodology TB patient on treatment in (30 persons) Measure after 2 week Provide innovation “Calendar bag” Measure satisfaction of innovation “Calendar bag” Data from registration in TB clinic Questionnaire of satisfaction 38 Exclude (8 persons) -Transfer out (2) -Cure (2) -Work in other province (1) -Closer patient (2) -Admission (1) Included (22 persons) - On treatment - Consent 22 persons Count the number of sachets and look in the checkbo ok

Calendar Bag 39

40

 Gender  Age  Education 41 FrequencyPercentValid PercentCumulative Percent ValidMale Fem ale Total FrequencyPercentValid Percent Cumulative Percent Valid15-60 years More than 60 years Total Result Frequenc yPercentValid Percent Cumulative Percent Valid No education Primary education Total

Result Percentage 42

NoQuestion Tot al averag e Level of satisfac tion SD 1 Calendar bags are convenient to use The most Calendar bags can improve the behavior of taking medicine Good calendar bags have the beautiful patterns for usage The most calendar bags use sufficient resources and effective Good This innovation is applicable and help patient to take medicine for the full course The most Total The most Result 43

 TB's patients have complete course of treatment.  To reduce the workload of care for the patient's family.  Patient can take drug easily and convenient.  The effectiveness of innovation “Calendar bag” can evaluate from sputum and chest X-RAY. The measure of 2 month and 5 month  The hospital to be continues and sustainable project. Recommendation Limitation of study 1.Elderly person 2.Foreigner person 3.People who are not receive an education. Expected Outcome 44

 Chiangsaen Hospital  Saran Intawan (Professor of Chiangsaen Hospital)  Petcharee Manasuk (Professor of Chiangsaen Hospital)  Chareerat Fongnuan (Responsible department of TB clinic) Acknowledgement 45

46 ลุงหนาใจ้ กระเป๋าแกนนี่ แล้วดีแต๊ๆเลย ใจ้แล้วบ่ ลืมกิ๋นยาเลย ผ่อไปตี้ฝาผนัง บ้านหันละเตือน ใจ๋ตลอด ดีแต๊ๆ เลย