PowerPoint Presentation

KARSKonsep dan Prinsip Pelayanan Berfokus pada Pasien Dalam Standar Akreditasi Versi 2012 (Patient Center Care)1Curiculum vitae: DR.Dr.Sutoto.,M.KesJABATAN SEKARANG: Ketua KARS (Komisi Akreditasi Rumah Sakit ) Th 2014-2018Ketua umum PERSI (Perhimpunan Rumah Sakit Seluruh Indonesia) Th 2009-2012/ 2012-2015Dewan Pembina MKEK (Majelis Kehormatan Etika Kedokteran) IDI Pusat 2009-2012/2012-2015Dewan Pembina AIPNI (Asosiasi Institusi Pendidikan Ners Indonesia)Anggota Komite Keselamatan Pasien Rumah Sakit Kementerian Kesehatan R.IDewan Pengawas RS Mata Cicendo,Pusat Mata NasionalPENDIDIKAN: SI Fakultas Kedokteran Univ Diponegoro SII Magister Manajemen RS Univ. Gajahmada S III Manajemen Pendidikan Universitas Negeri Jakarta (Cumlaude)PENGALAMAN KERJADirektur Utama RSUP Fatmawati Jakarta 2001 - 2005 Direktur Utama RS Kanker Dharmais Jakarta 2005-2010 Sesditjen/Plt Dirjen Bina Pelayanan Medis KEMENKES R.I( Feb-Juli 2010) Direktur RSUD Banyumas Jawa Tengah 1992-2001

Sutoto.KARS2KARSPOKOK BAHASANPENDAHULUANDEFINISI PATIENT CENTERED CARESEJARAH PATIENT CENTERED CAREKONSEP DAN PRINSIP PATIENT CENTERED CAREMANFAAT PATIENT CENTERED CARE ?KENDALA DALAM IMPLEMENTASI PATIENT CENTERED CARE

KARSPENDAHULUANKARSManaging a Hospital is much more difficult than Managing a Hotel or Other Service Company13600 diagnoses6000 procedures4000 surgeries100,000 drugs1.5 million medical devicesKARS

KARS

KARS

KARS

SIAPA YANG MENJADI PUSAT PELAYANAN DI RUMAH SAKIT ??????KARS2. DEFINISI PATIENT CENTERED CARE Definisi Patient Centered Care(Institute of Medicine) Pelayanan Kesehatan yang menetapkan kemitraan antara praktisi, pasien, dan keluarga mereka (jika sesuai) untuk memastikan bahwa pembuatan keputusan pelayanan kesehatan, menghormati keinginan, kebutuhan dan preferensi pasien. Serta pasien memiliki pendidikan dan dukungan yang mereka butuhkan untuk membuat keputusan dan berpartisipasi dalam pelayanan mereka sendiri. "

Institute of Medicine, Crossing the Quality Chasm (2001)Patient Centered Care care that is respectful of and responsive to individual patient preferences, needs and values, ensuring that patient values guide all clinical decisions

IOM. (2001). Crossing the Quality Chasm: A new health system for the 21s century. Washington, DC: National Academy Press.

PELAYANAN YANG MENGHORMATI DAN RESPONSIF TERHADAP PREFERENSI INDIVIDU PASIEN, KEBUTUHAN DAN NILAI-NILAI, UNTUK MEMASTIKAN BAHWA NILAI-NILAI PASIEN MEMANDU SEMUA KEPUTUSAN KLINIS "

12Patient- and Family-Centered Care:Why Is It Needed?

Pelayanan harus diberikan oleh sistem yang secara hati-hati dan sadar dirancang untuk memberikan Asuhan pasien yang aman, efektif, berpusat pada pasien, tepat waktu, efisien, dan adil.

Sistem tersebut harus dirancang untuk melayani kebutuhan pasien, dan untuk memastikan bahwa mereka diberi informasi secara lengkap mempertahankan kontrol dan berpartisipasi dalam pemberian pelayanan bila memungkinkan, dan menerima pelayanan yang menghormati nilai-nilai dan preferensi mereka. "KARS Institute of Medicine, Crossing the Quality Chasm (2001)3.SEJARAH PATIENT CENTERED CARE

KARSKARS Dr.Nico Lumenta

(McAdam, S : Transitioning to PCC to Improve Quality, HMA 2013, Bangkok)1988:The term patient-centered care was coined by Harvey Picker15PATIENT CENTEREDNESSEnid Balint seorang psikoanalis dari Inggris menciptakan istilah patient centeredness pada tahun 1969. Dia menggambarkan bentuk mini psiko terapi bagi dokter umum untuk menghadapi pasien psikosomatik partial dan general.Konsep ini sangat berlawanan dengan illness-oriented care.- Balint E. The possibilities of patient-centered medicine. J R Coll Gen Pract 1969;17:269-276- Bardes CL N Engl J Med 2012; 366:782-783 March 1, 2012

Enid Balint than 1969 yang pertama menciptakan istilah patient centerdness.Dia menggambarkan bentuk mini psiko terapi bagi dr umum untuk menghadapi pasien psikosomatik partial dan 16Tahun 1988, The Picker/Commonwealth Program For Patient-centered Care (The Picker Institute), menciptakan Istilah Patient Centered Care Untuk Menarik Perhatian Dokter, Staf, Dan Sistem Pelayanan Kesehatan Agar Mengalihkan Fokus Dari Penyakit Kepada Ke Pasien Dan Keluarga.

- Gerteis M, Edgman-Levitan S, Daley J, Delbanco T. Through the patient's eyes. San Francisco: Jossey-Bass, 1993.Patient Centered Care1988

PATIENT CENTERED CARE ISTILAH INI DICIPTAKAN UNTUK MENARIK perhatian dokter, staf, dan sistem peLAYANAN KESEHATAN untuk mengalihkan fokus dari penyakit dan kembali ke pasien dan keluarga.17Harvey Picker( 1915 2008)He was the founder of the Boston-based Picker Institute, whose goal is to promote patient-centered healthcare.The term patient-centered care was coined by Harvey Picker, 1988He believed that the American health care system was technologically and scientifically outstanding, but overall was not sensitive to patients' concerns and their comfortIn The Year 1986, they founded the Picker Institute, dedicated to developing a patient-centered approach to healthcare18

Standar AkreditasibaruFokus PasienPatient Centered Care1988Kapan PCC berkembang ? th 2000 Patient Safety 18Elements of Patient Centered Care Enhanced clinician/patient communication Health literacyClinician directed patient educationShared decision makingCollaborative care planningCollaborative goal settingPatient empowerment and self management

Why Patient-Centered Care?PCC has been shown to:Improve disease-related outcomes and quality of life Increase patient adherence to medications and improve chronic disease control Address racial, ethnic, and socioeconomic disparities in care and outcomesReduce overuse of diagnostic testing and some procedures- Epstein RM, et al. Why the Nation Needs a Policy Push on Patient-Centered Health Care, Health Affairs 2010;8:1489.Nothing about me without me. - Valerie Billingham, Through the Patient's Eyes, Salzburg Seminar Session 356, 1998 Salzburg Global Seminar1998 KARS

NO DECISION ABOUT ME WITHOUT MEI. Patient involvement: Shared decision-making: involving the patient and their carers in decisions about their care and treatment. Self-care: the patient being supported in taking more responsibility for the things that they can do to maintain and improve their health. Care planning: the patient jointly agreeing with the clinician a plan for their care, including as appropriate advanced planning for terminal care. II. Patient Choice: the ability for patients to choose the provider of their care, when and where it takes place, and who provides it.KARSLiberating the NHS. No Decision abut me without me. Government response. Dept of Health 24MODELS OF TREATMENT DECISION-MAKINGPaternalistic model Information transfer: One-way (doctor to patient) transfer of minimum medical information necessary for informed consentDeliberation: Doctor alone, or with other doctors Decision about implementing treatment: Doctor

Shared decision-making model Information transfer: Two way: doctor provides all medical information needed for decision- making. Patient provides information about preferencesDeliberation: Doctor and patient (possibly with others)Decision about implementing treatment: Doctor and patient

Informed (patient) modelInformation transfer: One way (doctor to patient) transfer of all medical information needed for decision makingDeliberation: Patient (possibly with others)Decision about implementing treatment: Patient

08/04/1024KARS

KARSBoth doctor and patient are involved in the decision-making processBoth parties share informationBoth parties take steps to build a consensus about the preferred treatmentAn agreement (consensus) is reached on the treatment to implement

Charles C, Whelan T, Gafni A 1999 What do we mean by partnership in making decisions about treatment? British Medical Journal 319:780782Four Requirements for Shared Decision making

Six aims for improvement health care systemInstitute of Medicine : Crossing the Quality Chasm: A New Health System for the 21st Century, 2001Safe. Effective. Patient-centered. Timely. Efficient.Equitable.Enam elemen ini dilahirkan oleh IHI Institute for Helathcare ImprovementPublikasi pertama PCC oleh IOMWHO menjadikan 6 elemen ini sbg definisi mutu pelayanan kesehatanD I G N I T Y A N D R E S P E C TI N F O R M AT I O N S H A R I N GPA R T I C I PAT I O NCO L L A B O R AT I O N27Six Dimension of QualityW.H.OEffective. Efficient AccessiblePatient-centered. Equitable.Safe. D I G N I T Y A N D R E S P E C TI N F O R M AT I O N S H A R I N GPA R T I C I PAT I O NCO L L A B O R AT I O N28Four Core Concepts of Patients Centered CareD I G N I T Y A N D R E S P E C THealth care practitioners listen to and honor patient and family perspectivesand choices. Patient and family knowledge, values, beliefs and culturalbackgrounds are incorporated into the planning and delivery of care.I N F O R M AT I O N S H A R I N GHealth care practitioners communicate and share complete and unbiasedinformation with patients and families in ways that are affirming and useful.Patients and families receive timely, complete and accurate information inorder to effectively participate in care and decision-making.PA R T I C I PAT I O NPatients and families are encouraged and supported in participating in careand decision-making at the level they choose.CO L L A B O R AT I O NPatients, families, health care practitioners, and hospital leaders collaboratein policy and program development, implementation and evaluation; inhealth care facility design; and in professional education, as well as in thedelivery of care.30Martabat dan Respek. Pemberi pelayanan kesehatan mendengarkan, menghormati & menghargai pandangan serta pilihan pasien & keluarga. Pengetahuan, nilai-nilai, kepercayaan, latar belakang kultural pasien & keluarga dimasukkan dlm perencanaan pelayanan dan pemberian pelayanan kesehatanBerbagi informasi. Pemberi pelayanan kesehatan mengkomunikasikan dan berbagi informasi secara lengkap pasien & keluarga. Pasien & keluarga menerima informasi tepat waktu, lengkap, dan akuratAsesmen : metode, substansi / kebutuhan edukasi, konfirmasi Partisipasi. Pasien & keluarga didorong dan didukung utk berpartisipasi dlm asuhan dan pengambilan keputusan / pilihan merekaKolaborasi / kerjasama. Pimpinan pelayanan kesehatan bekerjasama dgn pasien & keluarga dalam pengembangan, implementasi dan evaluasi kebijakan dan program; Partnering with Patients and Families to Design a Patient and Family-Centered Health Care System.Johnson, B et al. Institute for Family-Centered Care 2008KONSEP INTI PATIENT CENTERED CARE4. MANFAAT PATIENT CENTERED CARE

KARS

32KARS

SEKIAN TERIMA KASIH

Email : sutotocokro@gmail.com

SMS : 081381134839

www.kars.or.idSutoto. KARS 34