Teamwork Skills and Learning Organization Affecting the Implementation of Primary Care Service Standard by Director of Sub-District Health Promoting Hospitals in Nakhonratchasima Province

Abstract

This study employed a descriptive cross-sectional research design with the objective of examining teamwork skills and learning organization affecting the implementation of primary care unit service standard by director of sub-district health promoting hospitals in Nakhon Ratchasima Province. The study population consisted of 348 directors of Subdistrict Health Promoting Hospitals in Nakhon Ratchasima Province. Stratified random sampling was employed to select a sample size of 128 participants. A total of 123 questionnaires were returned, yielding a response rate of 96.09%. Therefore, 123 participants were included in the analysis for this study.The research instruments included a structured questionnaire. Content validity was assessed by three experts, with all items achieving an item–objective congruence (IOC) index greater than 0.50. The reliability of the questionnaire was high, with a Cronbach’s alpha coefficient of 0.98 and in-depth interview guidelines for qualitative data collection from 13 key informants. Data were analyzed using descriptive and inferential statistics were employed using Pearson’s correlation coefficient to examine the relationships between teamwork skills and learning organization, and the performance based on primary care service standards of directors of Subdistrict Health Promoting Hospitals in Nakhon Ratchasima Province. In addition, Stepwise Multiple Linear Regression analysis was conducted to determine the effects of teamwork skills and learning organization on the performance according to the primary care service standards of these directors. with the level of significance set at 0.05.The results revealed that the overall levels of teamwork skills, learning organization characteristics, and performance according to the Primary Care Unit Standards among SHPH directors in Nakhon Ratchasima Province were at a high level with averages of 4.09 (S.D.= 0.42), 4.02 (S.D.= 0.41) and 4.17 (S.D.= 0.41), respectively. Five variables composed of three dimensions of teamwork skills; shared responsibility skills, problem-solving skills, and interpersonal relationship skills and two dimensions of learning organization; systems thinking and shared vision were effected and to jointly predict the performance of Primary Care Unit Standards. These factors accounted for 73.1% of the variance in performance (R² = 0.731, p-value< 0.001). This study identified several key challenges among directors of Subdistrict Health Promoting Hospitals, including limitations in systems thinking (71.43%), shared vision communication (68.25%), and teamwork in terms of shared responsibility (65.08%). These issues adversely affected data utilization, goal setting, and problem-solving effectiveness (61.90%), as well as interpersonal relationships (60.32%). To address these challenges, it is recommended to enhance systems thinking skills, promote participatory leadership, strengthen team-based working mechanisms, encourage evidence-based data utilization, and foster a supportive learning organization environment. Findings from the in-depth interviews indicate that digital communication systems should be strengthened, along with the promotion of experiential learning approaches. In addition, a non-blaming team culture and the use of systematic analytical tools should be fostered. These strategies are essential to enhance the effectiveness of primary care service delivery in accordance with established standards and to ensure alignment with local contextual conditions.