EVALUATING THE IMPLEMENTATION OF PEDIATRIC DHF CLINICAL PATHWAY IN TYPE D HOSPITAL IN YOGYAKARTA
Abstract
Abstract
Background: Dengue haemorrhagic fever (DHF) is an endemic disease that has a high incidence and mortality rate in Indonesia. Implementating clinical pathways (CP) in hospitals can be used as the basis for treating patients with DHF so as to improve service quality and minimize complications. Objective: This study aims to evaluate the implementation of CP DHF in the pediatric unit at Type D Private Hospital in Yogyakarta. Methods: This is a mix method research with case study design. Qualitative data was collected through in-depth interviews and observations of pediatricians n=2), nurses (n=3), directors of medical services (n=1) and medical committees (n=1). Quantitative data was collected through document review and interviews with the Integrated Clinical Pathway Appraisal Tools (ICPAT). Results: Documents is true a CP. The role of the organization has been running well. The process of documenting, developing and implementing CP DHF is not optimal. The maintenance process is bad. Compliance completes of CP DHF is 9%. The majority of lenght of stay are above 3.86 days with treatment costs above the BPJS package. The incidence of complications is low. The obstacles found during the implementation of CP DHF were that the patient did not have access to CP, low adherence to CP and human resource management factors. Conclusion: The development and implementation of CP DHF needs to be improved both in terms of content and quality. Strong policies are needed, good organizational support and the active role of clinicians are the keys to the successful implementation of CP.
Keywords: Clinical Pathway, Dengue Haemorragic Fever, Integrated ServicesFull Text:
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Kementerian Kesehatan RI. Data Kasus Terbaru DBD di Indonesia [Internet]. 2020 [cited 2021 May 18]. Available from: https://sehatnegeriku.kemkes.go.id/baca/umum/20201203/2335899/data-kasus-terbaru-dbd-indonesia/
Kemenkes RI. Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional (JKN) dalam Sistem Jaminan Sosial Nasional. Jakarta; 2014.
Riza RC, Nurwahyuni A, Faculty of Public Health, University of Indonesia. The Implementation and Outcome of Clinical Pathway: A Systematic Review. In: Promoting Population Mental Health and Well-Being [Internet]. Masters Program in Public Health, Universitas Sebelas Maret; 2019 [cited 2021 May 5]. p. 677–86. Available from: http://theicph.com/id_ID/2019/07/06/sleep-quality-of-inpatients-at-pasar-rebo-hospital-jakarta/33-rizka-chairani-riza/
Sastroasmoro S, Budiwaluyo W, Mha D, Sulistyo HR, Darmadjaja D, Lalopua E, et al. Pedoman Penyusunan Panduan Praktik Klinis Dan Clinical Pathway Dalam Asuhan Terintegrasi Sesuai Standar Akreditasi Rumah Sakit 2012. 2015;234.
Joint Commission International. JCI Accreditation Standards for Hospitals 5th Edition. 2013.
Komite Akreditasi Rumah Sakit. STANDAR NASIONAL AKREDITASI RUMAH SAKIT Edisi 1. 2017.
Widyanita A, Arini M, Dewi A. EVALUASI IMPLEMENTASI CLINICAL PATHWAY APPENDICITIS AKUT PADA UNIT RAWAT INAP BAGIAN BEDAH DI RSUD PANEMBAHAN SENOPATI BANTUL. 2017;7.
Fitri DA, Sundari S. EVALUASI IMPLEMENTASI CLINICAL PATHWAY INFARK CEREBRI PADA UNIT RAWAT INAP RUMAH SAKIT X BANTUL. 2018;8.
Dwi Astuti Y, Dewi A, Arini M. Evaluasi Implementasi Clinical Pathway Sectio Caesarea di RSUD Panembahan Senopati Bantul. JMMR [Internet]. 2017 [cited 2021 May 7];6(2). Available from: http://journal.umy.ac.id/index.php/mrs/article/view/2430/pdf_37
Septiani AC, Arini M, Dewi A. EVALUASI IMPLEMENTASI CLINICAL PATHWAY PNEUMONIA DI RUANG BANGSAL ANAK RSUD PANEMBAHAN SENOPATI BANTUL. Prosiding Interdisciplinary Postgraduate Student Conference 3rd Program Pascasarjana Universitas Muhammadiyah Yogyakarta (PPs UMY). 2016;10.
Whittle C. ICPAT: Integrated Care Pathways Appraisal Tool. International Journal of Care Pathways. 2009 Nov;13(2):75–7.
De Bleser L, Depreitere R, Waele KD, Vanhaecht K, Vlayen J, Sermeus W. Defining pathways. J Nurs Manag. 2006 Oct;14(7):553–63.
Neame MT, Chacko J, Surace AE, Sinha IP, Hawcutt DB. A systematic review of the effects of implementing clinical pathways supported by health information technologies. Journal of the American Medical Informatics Association. 2019 Apr 1;26(4):356–63.
Paat C, Kristanto E, Kalalo FP. Analisis pelaksanaan clinical pathway di RSUP Prof. Dr. R. D. Kandou Manado. JBM [Internet]. 2017 Mar 23 [cited 2021 May 7];9(1). Available from: https://ejournal.unsrat.ac.id/index.php/biomedik/article/view/15322
Aspland E, Gartner D, Harper P. Clinical pathway modelling: a literature review. Health Systems. 2021 Jan 2;10(1):1–23.
Jayanti LD, Hariyati RrTS. Pengembangan Sistem Informasi Manajemen Dengan Integrated Clinical Pathway Terhadap Mutu Pelayanan Keperawatan. 2020;
Rotter T, de Jong RB, Lacko SE, Ronellenfitsch U, Kinsman L. Clinical pathways as a quality strategy [Internet]. OECD; 2019 [cited 2021 May 7]. Available from: https://www.oecd-ilibrary.org/social-issues-migration-health/improving-healthcare-quality-in-europe_b11a6e8f-en
Abrahams E, Balch A, Goldsmith P, Kean M, Miller AM, Omenn G, et al. Clinical Pathways: Recommendations for Putting Patients at the Center of Value-Based Care. Clin Cancer Res. 2017 Aug 15;23(16):4545–9.
Evans-Lacko S, Jarrett M, McCrone P, Thornicroft G. Facilitators and barriers to implementing clinicalcare pathways. 2010;6.
Mutiarasari D, Pinzon RT, Gunadi G. EVALUASI PROSES PENGEMBANGAN DAN PENERAPAN CLINICAL PATHWAY KASUS STROKE ISKEMIK AKUT DI RUMAH SAKIT ANUTAPURA KOTA PALU. berk.ilm.kedokt.duta.wacana. 2017 May 3;2(2):335.
Asmirajanti M, Hamid AYS, Hariyati RrTS. Supporting factors of the implementation of clinical pathway approach in nursing care. Enfermería Clínica. 2019 Sep;29:455–8.
Bryan MA, Desai AD, Wilson L, Wright DR, Mangione-Smith R. Association of Bronchiolitis Clinical Pathway Adherence With Length of Stay and Costs. Pediatrics. 2017 Mar;139(3):e20163432.
Haninditya B, Andayani TM, Yasin NM. Analysis of Cesarean Section Clinical Pathway Compliance at a Private Hospital in Yogyakarta. J Manaj dan Pelayanan Farm. 2019 Mar 29;9(1):38.
Siswanto M, Chalidyanto D. IMPACT OF CLINICAL PATHWAYS COMPLIANCE FOR REDUCING LENGTH OF STAY. JAKI. 2020 May 18;8(1):79.
Rohman H, Susilowati E. Analisis Perbedaan Biaya Pasien Demam Berdarah Dengue Dengan Dan Tanpa Clinical Pathway Di Rumah Sakit Condong Catur. 2020;7.
Iroth JS, Ahmad RA, Pinzon R. DAMPAK PENERAPAN CLINICAL PATHWAY TERHADAP BIAYA PERAWATAN PASIEN STROKE ISKEMIK AKUT DI RS BETHESDA YOGYAKARTA. berk.ilm.kedokt.duta.wacana. 2017 Jan 7;2(1):267.
Tanjung HP, Nurwahyuni A. The Impact of Clinical Pathway Implementation on Length of Stay and Hospital Cost: A Systematic Review. In: Strengthening Hospital Competitiveness to Improve Patient Satisfaction and Better Health Outcomes [Internet]. Masters Program in Public Health, Graduate School, Universitas Sebelas Maret; 2019 [cited 2021 May 7]. p. 388–96. Available from: http://theicph.com/id_ID/2020/01/20/the-impact-of-clinical-pathway-implementation-on-length-of-stay-and-hospital-cost-a-systematic-review-2/22-herlin-putri-tanjung/
Asmirajanti M, Syuhaimie Hamid AY, Hariyati TS. Clinical care pathway strenghens interprofessional collaboration and quality of health service: a literature review. Enfermería Clínica. 2018 Feb;28:240–4.
Budiarto A, Kusumo MP, Nugroho WS. DOCTOR BEHAVIOR IN FILLING THE MEDICAL RESUME SHEET IN BAGAS WARAS HOSPITAL, KLATEN. 2017;8.
Oktoriani EN, Sutrisno J, Mayasari E, Sodik MA. Analysis of Medical Record Complete Flexibility to Complete Claims of Health BPJS RS Baptis Kota Batu. 2018;3(1):8.
Pratama TWY, Tamtomo D, Sulaeman ES. Factors Associated with the Completeness of Inpatient Medical Record Filling in Dr. R Sosodoro Djatikoesoemo, Bojonegoro, East Java. J HEALTH POLICY MANAGE. 2018;3(1):1–10.
Yim H-Y, Seo H-J, Cho Y, Kim J. Mediating Role of Psychological Capital in Relationship between Occupational Stress and Turnover Intention among Nurses at Veterans Administration Hospitals in Korea. Asian Nursing Research. 2017 Mar;11(1):6–12.
Wan Q, Li Z, Zhou W, Shang S. Effects of work environment and job characteristics on the turnover intention of experienced nurses: The mediating role of work engagement. J Adv Nurs. 2018 Jun;74(6):1332–41.
DOI: https://doi.org/10.35971/jjhsr.v3i2.10673
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