02. dr. nico patcentercare

8/20/2019 02. Dr. Nico PatCenterCare

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CURRICULUM VITAECURRICULUM VITAENamaNama : Dr. Nico A. Lumenta, K.Nefro, MM: Dr. Nico A. Lumenta, K.Nefro, MMLahirLahir : Magelang, 5 Nov 1943: Magelang, 5 Nov 1943StatusStatus : Menikah, 1 anak: Menikah, 1 anak

Alamat Alamat : Jl.: Jl. Kayu Mas I/4, Pulo Mas,Jkt TimurKayu Mas I/4, Pulo Mas,Jkt TimurPendidikanPendidikan : Dokter, 1970, FK.UKI, Jakarta: Dokter, 1970, FK.UKI, Jakarta

•• Konsultan Nefrologi (GinjalKonsultan Nefrologi (Ginjal--Hipertensi) 1982, Pernefri (PerhimpunanHipertensi) 1982, Pernefri (PerhimpunanNefrologi Indonesia)Nefrologi Indonesia)

•• Magister Manajemen, 1994, Sekolah Tinggi Manajemen PPM, Jkt.Magister Manajemen, 1994, Sekolah Tinggi Manajemen PPM, Jkt.JabatanJabatan RSRS :: RS Mediros : Ketua Komite MedisRS Mediros : Ketua Komite Medis, Koordinator KSM PD.Ginjal, Koordinator KSM PD.Ginjal--HipertensiHipertensiOrganisasiOrganisasi::

•• Ketua KKPKetua KKP--RS (Komite Keselamatan Pasien Rumah Sakit)RS (Komite Keselamatan Pasien Rumah Sakit)--PERSI 05PERSI 05•• --

,,Surveior / Pembimbing AkreditasiSurveior / Pembimbing Akreditasi

•• Pengurus PERSI Pusat, Ketua Kompartemen Khusus, 2009Pengurus PERSI Pusat, Ketua Kompartemen Khusus, 2009--20122012•• Member Advisory Council Asia Pacific, Joint Commission International, 2009Member Advisory Council Asia Pacific, Joint Commission International, 2009, 2010, 2010•• PPJ SubPokjaJ SubPokja Model Akreditasi Baru, Pokja Penyempurnaan Akreditasi RS, DitJen BinaModel Akreditasi Baru, Pokja Penyempurnaan Akreditasi RS, DitJen Bina Yan Yan Med, 2010Med, 2010--20112011

PenghargaanPenghargaan:: Kadarman Award 2007 (untuk Patient Safety), Sekolah Tinggi Manajemen PPMKadarman Award 2007 (untuk Patient Safety), Sekolah Tinggi Manajemen PPMLainLain--lainlain ::

•• Sekretaris Jendral PERSI PusatSekretaris Jendral PERSI Pusat 1988–1990, 1990–1993, 1993–1996•• Direktur Ketua RS.PGI.Cikini, Jakarta, 1983Direktur Ketua RS.PGI.Cikini, Jakarta, 1983 –– 19931993•• Dekan Fakultas Kedokteran UKI, 1988Dekan Fakultas Kedokteran UKI, 1988 – – 19911991•• Kepala Bagian Ilmu Penyakit Dalam FK Kepala Bagian Ilmu Penyakit Dalam FK--UKI, Jakarta, 1992UKI, Jakarta, 1992 -- 19951995•• Kepala Renal Unit (Unit Ginjal) RS.PGI Cikini, 1973Kepala Renal Unit (Unit Ginjal) RS.PGI Cikini, 1973 –– 19811981


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PatientCentered Care Fokus Pasien

Standar Akreditasi RSpd badan Internasional

Quality & Safety

of Patient Care

NB. Mulai digunakan juga istilah :

“Patient – Family Centered Care”


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Balint and colleagues introduced the

term patient-centered medicine in 1969.

The term patient-centered care was

coined by Harvey Picker (Picker

Institute, 1988)

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1915-2008


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• Patient centredness is becoming a widely used, but poorlyunderstood, concept in medical practice. It may be most commonlyunderstood for what it is not—technology centred, doctor centred,hospital centred, disease centred.

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Konsep ‘Patient centredness’ dalam praktek medis makin luasdigunakan, tapi masih sangat kurang dipahami. Umumnya dipahamisebagai : berpusat pada teknologi, berpusat pada dokter, berpusat

pada RS atau berpusat pada penyakit, padahal bukan demikian.

(Stewart, M. : Towads a global defini tion

of patient centred care, Editorial BMJ 322 : 444, 2001)


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• For well over a decade, there has been growing recogni tion of the enormousbenefits patient- and family-centered care offers to health care providers,patients, and families in all areas of health care.

• As hospi tals, ........ st rugg le with issues related to quali ty, safety, HIPAAcompliance, workforce capacity, the use of technology, the need to renovate orbuild new facilit ies, and cost control, .......

• they are recognizing that patient- and family-centered approaches and theperspectives of patients and families are essential to their efforts.

• Selama lebih dari satu dekade, terjadi pertumbuhan atas pengakuan thdbe itu besarn a manfaat asuhan ‘ atient- and-famil -centered care’

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ditawarkan kepada para PPK, pasien, dan keluarga dalam semua saranapelayanan kesehatan

• Saat RS, .... berjuang dengan isu2 yang berhubungan dengan mutu,safety /keselamatan, memenuhi persyaratan HIPAA, kapasitas tenagakerja, penggunaan teknologi, kebutuhan untuk merenovasi ataumembangun fasilitas baru, dan kendali biaya, ...

• mereka mengakui bahwa pendekatan ‘patient- and family-centered’ danperspektif t tg pasien & keluarga adalah penting dlm upaya mereka

Advancing the Practice of Patient-and Family- Centered Care,

Institute for Family-Centered Care, 2008


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• Bringing the perspectives of patients and families directly into the planning,delivery, and evaluation of health care, and thereby improving its quality andsafety is what patient- and family-centered care is all about.

• Studies increasingly show that when health care administrators / providers, andpatients & families work in partnership, the quality and safety of health care rise,costs decrease, and provider and patient satisfaction increase.

• Memasukkan perspektif ttg pasien & keluarga langsung ke dalamperencanaan, pemberian dan evaluasi dari yan kes/RS, sehingga

meningkatkan mutu dan keselamatan, itulah patient- and family-

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centered car .• Penelit ian menunjukkan bahwa bila para administrator / PPK,

bermitra dengan pasien & keluarga, maka mutu dan safety daripelayanan kesehatan akan meningkat, biaya menurun, dankepuasan provider maupun pasien akan meningkat.

(Advancing the Practice of Patient-and Family- Centered Care,

Institute for Family-Centered Care, 2008 )

• Dari mana PCC lahir ?“Patient Safety”


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(Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building

a safer health system. Washington, D.C.: National Academy Press, 2000.)

RS - RS AE(>50% krn

ME)

Mati PasienRS di US

: Admisi

Pasien

tsb

:Mati sb

Mati sb

lain

TO ERR IS HUMANTO ERR IS HUMAN

Building a Safer Health SystemBuilding a Safer Health System

LaporanLaporan

Institute of MedicineInstitute of Medicine -- IOMIOM

/year (Extrapolasi)

Di

Colorado

&Utah(1992)

2.9 % 6.6 %

33.6 juta

44,000

-

98,000

!!!

Estimasibiaya: $17 -

$50 milyar

- KLL :

43,458

-Cancer :

42,297

- AIDS :

16,516

Di New

York(1984)

3.7 % 13.6 %


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(98.000 pasien mati / tahun)

“JUM BO JET UNITS”

D A L A M 1 TAHUN

S E T I A P H A R I

1 PESAWAT J UMBO J ET

BERPENUMPANG 268 ORANG

J A T U H !!!

(.....and die .....!!)


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Definisi IOM – Institute of Medicine : patient-centered care as “ care that is

respectful of and responsive to individual patient preferences, needs andvalues, and ensuring that patient values guide all clinical decisions.”

‘Patient-centered care’ sebagai “ asuhan yang menghormati dan responsifterhadap pilihan, kebutuhan dan nilai-nilai pribadi pasien. Serta memastikanbahwa nilai-nilai pasien menjadi panduan bagi semua keputusan klinis”

Picker Institute : ‘

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. , , .Coordination and integration of care, 3. Information communication andeducation, 4. Physical comfort, 5. Emotional support and alleviation offear and anxiety, 6. Involvement of family and friends, 7. Continui ty of

care and smooth transition, 8. Access to Care1.Hormati nilai2, pilihan dan kebutuhan yg diutarakan oleh pasien; 2.Koordinasi dan integrasi asuhan; 3.Informasi, komunikasi dan edukasi; 4.Kenyamanan fisik; 5. Dukungan emosional dan penurunan rasa takut &kecemasan; 6. Keterlibatan keluarga dan teman2; 7. Asuhan yang

berkelanjutan dan transisi yang lancar; 8. Akses thd pelayanan.


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NHC – National Health Council :Patients and their famities manage their heatth care in partnership with a

coordinated health care team that recognizes, respects and acts upon their goals,

needs, values, preferences, cultural wishes, and/or other factors identified bypatients and their famities.Patients and their famities receive evidenced-based, cost-effective quality care that

maximizes health, alleviates discomfort and is safe and free from avoidable errors.Patients and their families have the ability to obtain and understand health

information and services, and make appropr iate heatth decisions. (NHC, 2004)

Pasien & keluar a men atur asuhan kes mereka bermitra d n suatu tim an

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kes yg diakui, yg menghormati dan bertindak utk tujuan, kebutuhan, nilai2,pilihan serta harapan budaya mereka, dan/atau faktor-faktor lain ygdiidentifikasi oleh pasien & keluarga.

Pasien & keluarga menerima asuhan berbasis-bukti dan dgn mutu yg efektif-biaya yg memaksimalkan kesehatan, menurunkan rasa tidak nyaman danaman serta bebas dari error yg bisa dicegah

Pasien & keluarga mempunyai kemampuan utk memperoleh dan memahamiinformasi maupun yan kes, dan mbuat kebutusan kesehatan yg tepat (NHC,2004)


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Australian Commission on Safety and Quality in Health Care(ACSQHC) :Patient-centred care is: ‘ is an innovative approach to theplanning, delivery, and evaluation of health care that is groundedin mutually beneficial partnerships among health care providers,patients, and families. Patient- and family-centered care appliesto patients of all ages, and it may be practiced in any health care

setting.

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Patient-centred care (PCC) adalah : ‘suatu pendekatan inovatifterhadap perencanaan, pemberian, dan evaluasi atas yan kes ygdidasarkan pada kemitraan yg saling menguntungkan antar PPK,

pasien & keluarga. PCC diterapkan kepada pasien dari segalakelompok usia, dan bisa dipraktekkan dalam setiap bentuk playanankesehatan


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IAPO – International Alliance of Patients’ Organizations :1. A collaborative effort consisting of patients, patients' families, friends, the

doctors and other health professionals...achieved through acomprehensive system of patient education where patients and the healthcare professionals collaborate as a team, share knowledge and worktoward the common goals of optimum healing and recovery.(Grin, 1994)

2. A construct that advocates simplifying the care at the bedside in the acute

care setting by focusing on the expected outcomes for the patient rather

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. ,1997).

3. Health care that is closely congruent with and responsive to patients'wants, needs, and preferences. (Laine & Davidoff , 1996).

4. Placing patients at the center of the system af care and developing goodservices that revolve around them (Mallett , 1996).

1. Suatu upaya kolaboratif yg terdiri dari pasien, keluarga, teman2,para dokter dan profesional kesehatan lain .............


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1. Suatu upaya kolaboratif yg terdiri dari pasien, keluarga, teman2,

para dokter dan profesional kesehatan lain ... tercapai melaluisuatu sis tem edukasi pasien yg komprehensif dimana para pasiendan profesional yan kes yg bekerjasama sbg suatu tim, salingberbagi pengetahuan dan pekerjaan kearah tujuan yg sama yaitupenyembuhan dan pemulihan yg optimum (Grin, 1994)

2. Suatu bentuk yg menyokong penyederhanaan yan ‘bedside’ pada

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saat yan akut dgn cara memusatkan thd hasil yg diharapkan bagipasien daripada thd kemajemukan tugas dari setiap bagian(Johnston & Cooper, 1997)

3. Yan kes yg sangat erat dan responsif thd keinginan, kebutuhandan pi lihan pasien (Laine & Davidoff , 1996)

4. Menempatkan pasien pada pusat dari sistem asuhan danmengembangkan yan yg baik disekitar pasien (Mallett, 1996)


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What is “ Patient-Centered Care” ?

the essential theme is the importance of delivering healthcare in a

manner that works best for patients.

providers partner with patients and their family members to

identify and satisfy the full range of patient needs and preferences.

Hospital recognize that :

A patient is an individual to be cared for,

not a medical condition to be treated.

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“Personalization of Care”

tema esensial adalah pentingnya memberikan yan kes dgn cara ygterbaik bagi para pasien

para PPK bermitra dgn pasien dan anggota keluarga mereka ukmengetahui dan sedapat mungkin memenuhi kebutuhan dan pilihanpasien

Rumah sakit mengakui bahwa : (tsb diatas)


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What is “Patient-Centered Care”?1. Each patient is a unique person, with diverse needs.

2. Patients are partners and have knowledge and expertise that isessential to their care.3. Patients’ family and friends are also partners.4. Access to understandable health information is essential to

empower patients to participate in their care

5. The opportunity to make decisions is essential to the well-being of

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.6. Each staff member is a caregiver, whose role is to meet the needs

of each patient, and staff members can meet those needs moreeffectively if the organization supports staff members in achieving

their highest professional aspirations, as well as their personalgoals.

7. Patient-centered care is the core of a high quality health caresystem and a necessary foundation for safe, effective, efficient,timely, and equitable care.


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1. Setiap pasien adalah manusia yg unik, dgn berbagai kebutuhan ygberbeda

2. Pasien adalah mitra dan mempunyai pengetahuan serta keahlian ygpenting bagi asuhan mereka

3. Keluarga dan teman pasien juga merupakan mitra4. Akses thd informasi kes yg bisa dimengerti adalah penting dlm

memberdayakan pasien utk berpartisipadi d lm asuhan mereka.5. Kesempatan utk membuat keputusan adalah penting bagi keadaan

What is “Patient-Centered Care”?

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sehat pasien6. Setiap anggota staf adalah pemberi layanan, yg perannya adalah utk

memenuhi kebutuhan setiap pasien, dan anggota staf dapat

memenuhi kebutuhan tsb secara lebih efektif bila RS mendukungmereka dlm mencapai aspirasi profesional, maupun tu juan pibadimereka yg tertinggi.

7. Patient-centered care adalah inti dari sistem Yan Kes yg bermututinggi dan suatu dasar yang penting bagi pelayanan yg aman, efektif,

efisien, tepat waktu, dan equitable.


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What are the Core Concepts of Patient- and

Family-Centered Care?1. Dignity and Respect. Health care practitioners listen to and honor

patient and family perspectives and choices. Patient and family

knowledge, values, beliefs and cultural backgrounds are incorporated

into the planning and delivery of care.

2. Information Sharing. Health care practitioners communicate and share

complete and unbiased information with patients and families in ways

that are affirming and useful. Patients and families receive timely,

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,

care and decision-making.

3. Participation. Patients and families are encouraged and supported in

participating in care and decision-making at the level they choose.

4. Collaborat ion. Patients and families are also included on an institution-wide basis. Health care leaders collaborate with patients and families in

policy and program development, implementation, and evaluation; in

health care facility design; and in professional education, as well as in

the delivery of care.

Partnering with Patients and Families to Design a Patient and Family-Centered Health Care System.

Johnson, B et al. Institute for Family-Centered Care 2008


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What are the Core Concepts of Patient- and Family-Centered Care?

1. Martabat dan Rasa hormat. Praktisi yan kes mendengarkan danmenghormati pandangan dan pil ihan pasien & keluarga. Pengetahuan,nilai-nilai, kepercayaan dan latar belakang kultural pasien & keluargadimasukkan dlm perencanaan dan pemberian yan kes

2. Berbagi informasi. Praktisi yan kes mengkomunikasikan dan berbagiinformasi secara lengkap dan tdk menyimpang/bias dgn pasien & keluargadgn cara menguatkan (affirming) dan berguna. Pasien & keluarga

menerima informasi secara tepat waktu, lengkap, dan akurat agar

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erpar s pas secara e e m asu an an pem ua an epu usan.3. Partisipasi. Pasien & keluarga didorong dan didukung utk berpartisipasi

dlm asuhan dan pengambilan keputusan pada tingkat yg mereka pilih4. Kolaborasi / kerjasama. Pasien & keluarga juga dimasukkan dlm institusi

secara luas. Pimpinan yan kes bekerjasama dgn pasien & keluarga dlmpengembangan, implementasi dan evaluasi kebijakan dan program; dlmrancangan fasilitas yan kes; dan dlm edukasi profesional, serta dalampemberian pelayanan.

Partnering with Patients and Families to Design a Patient and Family-Centered Health Care System.

Johnson, B et al. Institute for Family-Centered Care 2008


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WHO General Principles of Good Chronic Care (2003)

1. Develop a treatment partnership with your patient2. Focus on your patient's concerns and priorities

3. Use the 5 A's: Assess, Advise, Agree, Assist, Arrange

4. Educate patient on disease and support patient self-management

5. Or anize roact ive follow-u

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6. Involve "expert patients," peer educators and support staff inyour health facility

7. Link the patient to community-based resources and support

8. Use written information - registers, Treatment Plan, treatmentcards and written information for patients - to document,monitor, and remind

9. Work as a clinical team

10. Assure continuity of care


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WHO General Principles of Good Chronic Care (2003)

1. Kembangkan suatu kemitraan pengobatan dgn pasien Anda

2. Fokus pada masalah dan prioritas pasien Anda3. Gunakan 5 A’s : Assess (periksa), Advise (nasehat), Agree

(setuju), Assist (bantu), Arrange (atur)4. Didik pasien ttg penyakit dan dukung pengelolaan mandiri

pasien

5. Atur tindak-lanjut yg proaktif

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6. Libatkan “ pasien yg ahli”, peer pendidik dan dukung staf Anda7. Hubungkan pasien dgn sumber-sumber dan dukungan

berbasis komunitas8. Gunakan informasi tertulis – pendaftaran, Rencana

Pengobatan, kartu berobat dan informasi tertul is bagi pasien –sbg dokumen, monitor/pemantau, dan pengingat

9. Bekerja sebagai tim klinis10. Pastikan kontinuitas asuhan


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Traditional model in health

care, the physician has been

the central unit in the

health care model.

A more modern approach to

health care is now being quickly

implemented in many hospitals

around the world: the

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.

This model has shifted all of

the health care providers

AROUND the PATIENT

focusing on PATIENT-

CENTERED CARE.

In addition, they are all of

equal importance when it comes

to each health care

professional’s contr ibution to

the patient and the team.


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Pada Model tradisional dalamyan kes, dokter merupakan unit

sentral/pusat dalam model yan kes

Pedekatan yg lebih modern dlmyan kes sekarang, di terapkan dgncepat di banyak RS di seluruhdunia, model tim interdisiplin :

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model ini telah menggeser

semua PPK menjadi disekitarpasien berfokus pada PCC

Sbg tambahan, mereka semuasama pentingnya bila tiba padakontribusi setiap profesional yankes tthd pasien dan tim


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1. The traditional model calls for patients and families to give

blind obedience to the expertise of paternalistic health care

professionals. The patient- and family-centered model calls

for an equal partnership.

2. What is difficult for many to appreciate is that for the most

part today’s health systems do not foster collaboration

among patients, families and caregivers

3. The hard part is understanding that the shift to patient- andfamil -centered care is a fundamental chan e in how ou

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manage your hospital. The concepts of patient- and family-

centered care are woven into the infrastructure of your

organization—in strategic plans, vision and values, facility

design, patterns of care, information-sharing processes,

family support, charting and documentation, human

resources management, professional education, and quality

and safety improvement processes. The key is to partner

with patients and families who are trained as formal advisers.

Sodomka, P : Engaging Patients & Fam: A High Leverage Tool for Healthcare Leaders,

AHA Quality Update, 2006


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1. Pada Model tradisional pasien & keluarga (“dibangun” ) patuh tanpasyarat kpd expertise dari para pofesional yan kes yg paternalistik.

Sedangkan pada model ‘patient- and family-centered’ diberlakukankemitraan yg setara.2. Dalam sistem yan kes masa kini, masih sulit bagi banyak orang utk

menghargai dan mengembangkan kolaborasi antar PPK dan pasien – keluarga.

3. Bgn yg sulit adalah memahami bhw pergeseran ke ‘patient- and’

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cara mengelola RS. Konsep ‘PFCC’ terjalin ke dalam infrastrukturorganisasi RS, dalam rencana stratejik, vis i dan nilai-nilai, rancangbangun fasilitas, pola yan, proses berbagi-informasi, dukungan

keluarga, pemetaan dan dokumentasi, pengelolaan SDM, edukasiprofesional, dan proses peningkatan mutu serta keselamatan. Ygpenting adalah bermitra dgn pasien & keluarga yg terlatih sbgpenasehat formal.

Sodomka, P : Engaging Patients & Fam: A High Leverage Tool for Healthcare Leaders,



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Partnering with Patients and Families to Design a Patient and Family-Centered Health Care

System. Johnson, B et al. Institute for Family-Centered Care 2008


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"Medical Excellence Model" merupakan pengembangan dari interdisciplinary team model.

Theclinical team of expert physicians and nurses who work togetherin an integrated manner, assessing patient needs, ordering tests,

planning treatments, scheduling surgeries, monitoring progress and

planning for early discharge to home.

The pillars of this model include

1. Clinical governance

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. re en a ng an c nca prv egng o p yscans nurses

3. Use of standardized, evidenced based protocols

4. Patient and Staff Safety

5. Infection control

6. A culture of audit and continuous professional development




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"Medical Excellence Model" / “ Model keunggulan medis” Merupakan pengembangan dari model tim interdisipl in

Tim klinis dari para dokter dan perawat ahli yg bekerja bersama dgncara yg terintegrasi, memeriksa kebutuhan pasien, memerintahkanpemeriksaan, merencanakan pengobatan, menjadwalkan operasi /pembedahan, memonitor kemajuan dan merencanakan pasien pulangcepat ke rumah

Pilar dari model ini termask Clinical governance / Tata kelola klinis

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Kredensialing dan pemberikan kewenangan klinis kpd para dokterdan perawat

Penggunaan protokol yg terstandar dan berbasis bukti Keselamatan Pasien dan Staf

Pengendalian infeksi Suatu budaya yg dewasa dan pengembangan profesional secara

berkesinambungan




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TheMCG Health System in Augusta, Georgia.MemberUniversity HealthSystem Consortium

29Partnering with Patients and Families to Design a Patient and

Family-Centered Health Care System. Johnson, B et al. Institute for Family-Centered Care 2008


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Patient's Responsibilities (“Pasien tidak (“Pasien tidak diatas segalanya”) diatas segalanya”)

SHOULD :

1. provide accurate and complete information concerning present

complaints, past medical history, hospitalizations, medications andother matters relating to the patient's health.

2. Follow the treatment plan advised by the Physician including the

instructions of nurses and other health professionals as they carry

out the Physician's orders.

3. Treat hospital staff and other patients with dignity & respect and not

to conduct any activity that will disrupt the work of the hospital.

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4. Respect the privacy of others and the property of the hospital

5. not bring alcohol, unauthorized drugs or weapons into the hosp.

6. respect that the hospital is a non smoking zone

7. follow visiting hours of the hospital

8. leave valuables at home and bring only those items necessary during

hospital stay

9. assure that the financial obligations of Patient's care are fulfilled as per the

hospital policy

10. be responsible for their own actions if they refuse treatment or their

physician's advice


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Patient 's Responsibil ities / Tanggung Jawab PasienWAJIB :1. memberikan informasi yg akurat dan lengkap ttg keluhan sakit sekarang,

riwayat medis yg lalu, hospitalisasi, medikasi/pengobatan dan hal-hal lain ygberkaitan dgn kes pasien.2. Mengikuti rencana pengobatan yg diadviskan oleh Dr termasuk instruksi

para perawat dan profesional kes yg lain sesuai perintah Dr 3. Memperlakukan staf RS dan pasien lain dgn bermartabat dan hormat serta

tidak melakukan tindakan yg akan mengganggu pekerjaan RS4. Menghormati privasi orang lain dan barang milik RS

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5. Tidak mbawa alkohol, obat2 yg tdk mendpt persetujuan atau senjata ke dlmRS

6. Menghormati bahwa RS adalah area bebas rokok7. Mematuhi jam kunjungan dari RS

8. Meninggalkan barang berharga di rumah dan membawa hanya barang-barang yg penting selama tinggal di RS

9. Memastikan bahwa kewajiban finansial atas asuhan pasien dipenuhisebagaimana kebijakan RS

10. Bertangg-jwb atas tindakan2nya sendir i bi la mereka menolak pengobatan

atau advis Dr nya


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Declaration on Patient-Centred HealthcarePatient-centred healthcare is the way to a fair and cost-

effective healthcare systemIAPO, International Alliance of Patients’ Organizations, 2006

1. Health systems in all world regions are under pressure and

cannot cope if they continue to focus on diseases rather than

patients;

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.

their treatments, make behavioural changes and self-manage.

3. Patient-centred healthcare may be the most cost-effective way to

improve health outcomes for patients.

4. Patients’, families’ and carers’ priorities are different in everycountry and in every disease area, but from this diversity we have

some common priori ties. To achieve patient-centred healthcare

we believe that healthcare must be based on the following Five

Principles:


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a. Respect

respects their unique needs, preferences and values,

as well as their autonomy and independence.b. Choice and empowerment

Patients have a right and responsibility to participate, as a partner

in making healthcare decisions that affect their lives. .

c. Patient involvement in health policy

Patients and patients’ organizations deserve to share the

responsibility of healthcare policy-making.

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.

Patients must have access to the healthcare services warranted

by their condition.

This includes access to safe, quality and appropriate services,

treatments, preventive care and health promotion activities.

e. Information Accurate, relevant and comprehensive information is essential to

enable patients and carers to make informed decisions about

healthcare treatment and living with their condition.


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Declaration on Patient-Centred HealthcarePatient-centred healthcare is the way to a fair and cost-

effective healthcare systemIAPO, International Alliance of Patients’ Organizations, 2006

1. Sistem kes di semua bagian dunia ada dibawah tekanan dan tdk dptmengatasinya bila mereka terus memusatkan perhatian pd penyakit dan

bukannya kepada pasien;

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.melekat thd pengobatan mereka, membuat perubahan perilaku dan kelola-diri

3. Yan kes yg patient-centered bisa jadi merupakan cara yg paling efektif-biaya utk meningkatkan hasil kes bagi pasien

4. Prioritas Pasien, keluarga dan PPK berbeda dlm setiap negara dan dalamsetiap area penyakit, tetapi dari keberagaman ini k ita mempunyaikesamaan prior itas. Untuk mencapai yan kes yg patient centered, kitaharus mendasarkan pada Lima Prinsip berikut ini :


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a) Hormat.• Menghormati kebutuhan, pilihan dan nilai-nilai mereka yg unik,• Juga otonomi dan kebebasan mereka

b) Pilihan dan pemberdayaan.• Pasien mempunyai hak & tangg jwb utk berpartisipasi, sbg mitra,

dlm membuat keputusan yan kes yg mempengaruhi hidup merekac) Keterlibatan pasien dalam kebijakan kesehatan.

• Pasien dan organisasi pasien layak utk mengambil tangg- jwb

pembuatan-kebijakan yan kes

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ses an u ungan.• Pasien harus mempunyai akses ke yan kes dgn jaminan kondisi

mereka.• Ini termasuk akses ke yan, pengobatan, yan pencegahan dan

kegiatan promosi kes yg aman, bermutu serta tepate) Informasi.

• Informasi yg akurat, relevan & komprehensif adalah penting utkmemampukan pasien dan PPK utk membuat keputusan ygdiberitahukan ttg pengobatan yan RS dan hidup dgn kondisi mereka


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Patient & Family Centerd Care in Patient Safety

• PFCC “dipopulerkan” oleh gerakan Patient Safety (PS)

• Induk PS adalah Hospital Risk Management. Melalui proses manajemen risiko perlu

diterapkan :

• Patient Centeredness

• Patient Safety

• Salah satu hasil analisis penting, sewaktu pasien dirawat maka terjadi “Isolasi Sosial”,

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suatu kondisi sosiopatologis PFC

• Pada PS konsep2 PFCC dijalankan pada :

• Tujuh Langkah menuju Keselamatan Pasien

• Tujuh Standar Keselamatan Pasien

• Sasaran Keselamatan Pasien

• Program WHO Patient Safety : Patients for Patient Safety

• Standar Akreditasi Baru Rumah Sakit : Pelayanan berfokus pd Pasien


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Beberapa Publikasi – Artikel ttg PFCC :

PARTNERING WITH PATIENTS AND FAMILIES TO DESIGN APATIENT- AND FAMILY-CENTERED HEALTH CARE DELIVERYSYSTEM: A ROADMAP FOR THE FUTURE

PATIENT-CENTRED CARE: IMPROVING QUALITY AND SAFETYBY FOCUSING CARE ON PATIENTS AND CONSUMERS

AND QUALITY : BROADENING OUR VISION

ENGAGING PATIENTS & FAMILIES: A HIGH LEVERAGE TOOLFOR HEALTH CARE LEADERS

PATIENTS AND FAMILIES : POWERFUL NEW PARTNERS FORHEALTHCARE AND FOR CAREGIVERS.


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Moving Forward with Patient-and Family- Centered Care:

One Step at a Time

The following steps can help set a hospital or health system on i ts journey toward patient and family-centered care.

1. Implement a process for all senior leaders to learn about patient-and family-centered care. Include patients, families, and staff from alldisciplines in this process.

2. Appoint a patient- and family-centered steering commit teecomprised of patients and families and formal and informal leaders ofthe organization.

3. Assess the extent to which the concepts and principles of patient-

and family-centered care are currently implemented within yourhospital or health system.

4. On the basis of the assessment, set priorities and develop anaction plan for establishing patient- and family-centered care at yourinstitution. ......


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5. Using the action plan as a guide, begin to incorporate patient- andfamily-centered concepts and strategies into the hospi tal’s strategicpriorities. Make sure that these concepts are integrated into yourorganization’s mission, philosophy of care, and definit ion of quality.

6. Invite patients and families to serve as advisors in a variety ofways. Appoint some of these individuals to key committees and taskforces.

7. Provide education and support to patients, families, and staff onpa en - an am y cen ere care an on ow o co a ora eeffectively in quality improvement and health care redesign. Forexample, provide opportunities for administrators and clinical staff tohear patients and family members share stories of their health care

experiences during orientation and continuing education programs.8. Monitor changes made, evaluate processes, measure the impact,cont inue to advance practice, and celebrate and recognize success.




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One Step at a Time

Berikut ini adalah langkah-langkah yg dapat membantu RS / sistemkes dalam perjalanannya menuju ‘Patient-and Family- Centered Care’(PFCC)1. Terapkan suatu proses bagi seluruh pimpinan senior utk

mempelajari ttg PFCC. Termasuk pasien, keluarga, dan staf dari

semua disiplin dalam proses ini . ,serta pimpinan formal maupun informal RS

3. Buat penilaian ttg sampai berapa jauh konsep & prinsip PFCC saatini d iterapkan di RS

4. Berdasarkan asesmen, tetapkan prioritas dan kembangkan suaturencana aksi utk membentuk PFCC di RS anda

5. Gunakan rencana aksi sbg panduan, masukkan konsep & strategiPFCC ke dalam prior itas strategi RS. Pastikan bhw konsep2 initerintegrasi ke dlm misi organisasi, falsafah yan, dan definis i mutu


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6. Undang pasien dan keluarga utk berperan sbg panasehat dlmberbagai cara. Tetapkan bbrp dari inividu ini masuk ke dlm panitiakunci dan pokja.

7. Berikan edukasi dan dukungan kpd pasien, keluarga, dan stafmengenai PFCC dan ttg bagaimana berkolaborasi secara efektif


One Step at a Time .....(2)

. ,berikan kesempatan bagi para administrator dan staf klinis utkmendengarkan pasien & keluarga membagikan cerita ttgpengalaman yan kes mereka selama orientasi maupun program

pendidikan berkelanjutan8. Monitor perubahan yg terjadi, evaluasi proses, ukur dampak,teruskan utk praktek lanjutan, dan rayakan serta buat pengakuanatas keberhasilan.




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WHO SEAR Patient Safety Workshop on

“ Patients for Patient Safety”

Jakarta, Hotel Four Seasons, 19 July 2007Jakarta, Hotel Four Seasons, 19 July 2007


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1. Tdk boleh ada pasien yg menderita cedera yg dpt dicegah;2. Pasien adalah pusat dari semua upaya KP (Keselamatan Pasien);3. Menyatakan bhw rasa takut disalahkan & hukuman seharusnya tdk

menghalangi komunikasi terbuka dan jujur antara pasien & PPK;4. Mengakui bhw kami harus bekerja dlm pola kemitraan utk mencapai

perubahan perilaku utama & sistem yg dibutuhkan utk penerapan KP

di regional kami;

Patient For PS : Jakarta Declaration 27 July 2007

.• transparansi, tangg-jwb & pendekatan manusiawi adalah yg utama

pd suatu sistem yan kes yg aman;• dasar hub adalah saling percaya & saling menghormati antara para

profesional kesehatan & pasien;• pasien & pendampingnya perlu mengetahui mengapa st pengobatan

diberikan & diberitahu semua risiko, kecil / besar, shg mereka dptmengambil bgn dlm keputusan terkait dgn asuhan kpd mereka;

• pasien perlu mempunyai akses kpd rekam medisnya;


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6. Mengakui bhw ketika cedera terjadi :• hrs ada suatu sistem dimana kejadian itu dpt dilaporkan & disel idiki

secara rahasia;• pasien & keluarganya harus memperoleh informasi dan dukungan;• PPK yg terlibat pd cedera yg tak disengaja juga menerima dukungan;• t indakan korektif harus diambil utk mencegah cedera di masa depan &

pelajaran yg didapat perlu disebarkan secara luas;

• harus ada mekanisme kompensasi yg wajar atas kerugian pasien dan

7. Komit terhadap:• pemberdayaan konsumen melalui pendidikan yg jujur & tulus;• bekerjasama dgn media utk mendorong pelaporan yg bertangg-jwb &

utk berkesempatan mendidik masyarakat;• partisipasi aktif konsumen di dalam pelaporan KTD;• komunikasi 2 arah antar pasien & pemberi yan kes utk mendorong

adanya tanya jawab;• wakil pasien di komite keselamatan pasien dan forum-forum;


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8. Berikrar melalui upaya yg berkesinambungan untuk mencapaisasaran sbb:• berfungsinya sistem mutu & KP pd setiap sarana yan kes, baikpubl ik & swasta, mulai dgn pembentukan suatu komite KP & dalamsuatu s istem pelaporan KTD serta sistem tanggapannya;• taat pd pedoman berbasis bukti & etik, dan hindari pengobatan yg

irrasional spt pemberian obat , pemeriksaan & operasi yg tidak perlu;

• konsep KP yg terintegrasi ke dlm pelatihan professional kes;• indikasi yg rasional utk admisi pasien pd setiap sarana yan kes;• sumber daya yg adekuat utk KP;

• professional kesehatan yg termotivasi & kompeten;• pasien & PPK yg puas.

WHO, South-East Asia Regional Office 2007


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Integrasi Patient Centred Care di Rumah Sakit

Organisasi : Visi, Misi , Nilai

Manajemen :• Rencana Strategis, RKA Tahunan

• Tingkatkan cakupan Komite/Tim KPRS Komite PCC (kaji kemungkinan adaanggota dari pasien)

• Asesmen Budaya, Sosial isasi , Monev penerapan

• Kredensial, Pelatihan•

Pelayanan & Asuhan Pasien : Personalization of care

• Kemitraan

• Hak pasien & keluarga : martabat, hormat, pilihan, informasi, partisipasi

• Edukasi Pasien

• Atasi hambatan / kendala : bahasa, budaya, pasien cacad

• Kebutuhan klin is pasien : mulai dari admisi, asuhan se-hari2, kondis i khusus: manajemen nyeri, pelayanan akhir kehidupan.

• Kontinuitas pelayanan, Asesmen terintegrasi / Integrated note

• Semua staf terlibat : “ dari pintu gerbang di tempat tidur pulang”


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Kesimpulan1. Pada model asuhan pasien yang tradisional, Dokter merupakan

pusat dari asuhan pasien, patient safety belum terjamin.2. Pada model Patient Centered Care (PCC), pasien adalah pusat,

para pemberi pelayanan kesehatan mengelil ingi / melayani pasien,dan PPK tsb dalam fungsi yg setara dan berkolaborasi, sehinggadisebut “ interdisciplinary team model”

3. PCC merupakan “ mainstream model” dalam pelaksanaan asuhan

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pasien, namun masih belum dipahami sepenuhnya, belumsepenuhnya dihargai

4. PCC di Indonesia “ dipopularkan” melalui Keselamatan PasienRumah Sakit

5. PCC dilaksanakan dalam KPRS pada 7 Langkah, 7 Standar, 6Sasaran Keselamatan Pasien, Program WHO P4PS, Standar Akreditasi Baru Rumah Sakit

6. Terapkan PCC “ one step at a t ime”


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LET THE ‘MIRACLE’ BEGIN

Robert Shaw, creator of the 200-voice Atlanta Symphony

Orchestra Chorus, is internationally known for his ability to

blend hundreds of voices into unforgettable music.

Once Shaw was asked how he was able to do this, often with

very short rehearsal times. His answer says a lot about what ittakes to bring about winning combinations of people and

organizations. “Once we find each other,” he said simply, “the

miracle begins.”

The same is true of patients and families and health care

providers. Once we find each other, the miracle begins.

It is time to get started !!

Sodomka, P : Engaging Patients & Fam:

A High Leverage Tool for Healthcare Leaders,



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LET THE ‘MIRACLE’ BEGIN

Robert Shaw, pencipta dari 200-voice Atlanta Symphony

Orchestra Chorus, terkenal secara internasional krn

kemampuannya utk memadukan ratusan suara ke dlm musik

yg tak terlupakan.

Suatu saat Shaw ditanya bagaimana dia bisa melakukan semua

ini, bahkan seringkali dengan waktu latihan yg sangat singkat.

orang dan organisasi. “Begitu kita bertemu satu sama lain”

katanya dengan sederhana, “mujizat itu mulai terjadi”.

Begitu pula halnya dengan pasien & keluarga serta pemberi

pelayanan kesehatan. Begitu kita bertemu satu sama lain, makamujizat itu mulai terjadi.

Saatnya kita memulai !! - It is time to get started !!

Sodomka, P : Engaging Patients & Fam:

A High Leverage Tool for Healthcare Leaders,



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TerimakasihTerimakasih Atas perhatiannya Atas perhatiannya

Dr. Nico A. Lumenta, K.Nefro, MM

02. dr. nico patcentercare

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