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Untuk mengevaluasi terhadap penerapan clinical pathway bagi pasien skizofrenia di Rumah Sakit Jiwa dr. Radjiman Wediodiningrat Lawang, dilakukan penelitian menggunakan desain cross-sectional retrospektif dengan pengambilan sampel berdasarkan proporsi kejadian variabel yang diukur. Hasil yang diperoleh adalah indikator kejadian percobaan bunuh diri menurun dari 6% menjadi 2% (p= 0,097). Indikator kejadian pasien lari 6% vs 5% (p = 0,756). Kejadian pasien jatuh menurun dari 2% menjadi nol (p= 0,155). Indikator kejadian pasien yang difiksasi satu kali menurun dari 26% menjadi 12%, sedangkan pasien yang difiksasi lebih dari satu kali menurun dari 12% menjadi 10% (p = 0,028). Indikator kejadian infeksi nosokomial akibat scabies terdapat peningkatan bermakna dari tidak ada kasus menjadi 19% (p = 0,001). Tidak ada kejadian infeksi nosokomial akibat luka fiksasi. Kejadian re-hospitalisasi sebanyak satu kali mengalami penurunan sesudah penerapan clinical pathway sebanyak 7% (26% menjadi 19%). Kejadian re-hospitalisasi lebih dari satu kali meningkat sebesar 42% (10% menjadi 52%). Interval re-hospitalisasi kurang dari satu bulan menurun dari 2% menjadi 1%. Rata-rata lama rawat menurun dari 80,8 menjadi 59,16 (p = 0,04). Sedangkan indikator kepuasan pelanggan terdapat kecenderungan terjadi peningkatan setelah penerapan clinical pathway, namun pada tahun 2011 terdapat tren yang menurun. Saran: perlu dilakukan penelitian lebih lanjut tentang adanya faktor-faktor selain clinical pathway, yang berpengaruh terhadap perubahan tingkat keselamatan pasien, re-hospitalisasi, efektivitas pelayanan, serta perlunya revisi formulir clinical pathway.
This study was conducted to evaluate the implementation of clinical pathway for patients with schizophrenia in the Dr. Radjiman Wediodiningrat Mental Hospital. This research used cross-sectional design with retrospective sampling events based on the proportion of measured variables. We found that the incidence of suicide attempts decreased from 6% to 2% (p = 0.097). There was no different of run away event ( 6% vs 5%; p = 0.756). The incidence of patient fell decreased from 2% into zero (p = 0.155). The events of one-time fixation decreased from 26% to 12%, while patients who got more than once fixation declined from 12% to 10% (p = 0.028). The incidence of nosocomial infection scabies increased to 19% (p = 0.001). There was no wound infections from fixation events. The incidence of re-hospitalization, one-time decreased after the implementation of clinical pathways as much as 7% (26% to 19%). But the incidence of rehospitalization for more than one time increased by 42% (10% to 52%). The average length of stay decreased from 80.8 to 59.16 (p = 0,04). In term of customer satisfaction, there was a tendency an increase after the implementation of clinical pathways, but in 2011 there was a downward trend. The study suggest to asses factor beside clinical pathways that influence patient safety, rehospitalized, care of effectivenes and review the clinical pathway form.
Stroke is the leading cause of death and illness in Indonesia, according to Riskesdas data the prevalence continues to increase by 10.9 per mile in 2018. Non-hemorrhagic strokes are the most frequent inpatients cases at dr.Chasbullah Abdulmadjid Hospital. The hospital has made the clinical pathway, but no updates have been made after more than 3 years. This study aims to get an overview of the inputs, processes, outputs, and outcomes and challenges faced when implementing clinical pathways. This is retrospective research, uses quantitative and qualitative approaches in a system evaluation framework. The results showed that the input variables in terms of HR, funds, policies, infrastructure, drugs and medical equipment are available and ready to apply CP, the challenge is lies in the team coordination. Process variables are already running with challenges in team identification, team leader election and the CP socialization still not optimal. Output variables obtained an average LHR in accordance with CP, variants were obtained on the visit, supporting examinations, nursing services, drug consultations and medical devices. The outcome variable, there is a price difference between real and appropriate CP of Rp. 224,103 (5%), Positive difference in physiotherapy services Rp. 178,470 (143%), Visite Rp. 88,215 (26%), Nutrition Rp. 78,014 (18%), Accommodation Rp. 53,625 (10%), nursing services Rp. 45,805 (7%) and Consultation Rp. 6,750 (6%). A negative difference occurs in the drug service Rp. 123,911 (25%), Laboratory Rp. 92,465 (21%), Radiology Rp. 8,238 (1%) and Medical Devices Rp. 2,162 (1%).
This thesis discusses about the evaluation of the suitability of the clinical pathway application of clinical pathway diarrhea in infants, with the aim of obtaining the results of an evaluation of the implementation of Clinical Pathway diarrhea in infants and the calculation of unit cost in cases of diarrhea in infants in Bhakti Rahayu General Hospital Denpasar. The research design used is the mix method, namely quantitative and qualitative research designs. The study was conducted in May 2019 to June 2020. The results obtained are still getting some variations in the services provided to patients so that the total cost of action in accordance with clinical pathway is Rp. 675,281, - with the real cost of services provided at Rp. 1,045,212 , - which means there is still a difference of Rp. 369,931, -.
Diarrhea is a disease that is often found and causes 4% of all deaths in the world. Cases of acute diarrhea in children is a disease that includes high risk, high volume, and high cost. According to 2018 data, there were 938 cases of acute diarrhea and were in first place in the top 10 causes of hospitalization at Bhakti Yudha General Hospital. The implementation of clinical pathways is closely related to efforts to control the quality and cost of affordable and predictable health services. Cost control can be realized if the process of overall health services can be planned and standardized from the start. Clinical pathways if done properly and correctly can reduce the cost of health services, reduce the length of stay, and improve patient clinical outcomes. The existence of a mismatch in the application of clinical pathways can affect the number of billing patients. This study aims to determine the appropriateness of the application of clinical pathways of mild acute diarrhea - moderate inpatient children in Bhakti Yudha General Hospital. The mixed-method research design is quantitative descriptive and qualitative case studies. The results showed that doctor compliance was still lacking in the provision of medical management. There are still discrepancies between clinical pathways and services provided. These discrepancies include variations in drug therapy, supporting examinations, and nursing actions. This variation was made because the patient's condition needed different treatments. The biggest gap in the use of drugs is 145% wherein real billing is greater than the bill according to the clinical pathway due to the use of drugs that are not following the clinical pathway. The number of variants that do not fit the clinical pathway will affect the amount of the hospital bill.
Clinical Pathway in the hospital is a guideline which includes all activities fromadmission until hospital discharge. This thesis discusses the effect of clinicalpathways towards length of stay and cost of prescription patient in IMC hospital.This study is a qualitative and quantitative, analysis of a descriptive case studydesign. Results of the study illustrate the stages of the process of implementingclinical pathways in IMC Hospital that begins with planning, team building, clinicalpathways form drafting, dissemination, trial and implementation; as well as adecline in length of stay and cost of prescription inguinal hernia patients due to theeffect of the implementation of clinical pathways in IMC Hospital.Keyword:Clinical pathway, length of stay, prescription cost, inguinal hernia.
Tesis ini membahas hubungan antara kepuasan pasien terhadap mutu layanan kesehatan dengan minat berkunjung kembali di unit rawat inap RSIA Selaras Cikupa tahun 2009, setelah diadakan penelitian yang dilakukan dari bulan Januari - Juni 2009. Penelitian ini dilakukan karena peneliti melihat adanya penurunan jurnlah pasien rawat inap di RSIA Selaras pada tahun 2008. Penelitian ini adalah penelitian kuantitatif yang bersifat analitik untuk melihat apakah ada hubungan antara tingkat kepuasan pelanggan terhadap mutu pelayanan kesehatan dengan minat berkunjung kembali. Metode yang digunakan untuk mengukur kepuasan pasien yaitu metode Servqual (Service Quality) yang terdiri dari 5 dimensi yaitu TangibIes,ReaIibiIity,Responsiveness,Assurance dan Emphaty. Hasil penelitian menyarankan dimensi mutu Tangibles harus diperhatikan karena merupakan indikator yang paling berpengaruh terhadap kepuasan dan minat berkunjung kembali. Dan pihak RSIA secara berkala memberikan kuesioner mengenai kepuasan pasien terhadap layanan kesehatan sebagai masukan dari pasien sehingga bisa menjadi koreksi bagi RSIA Selaras untuk meningkatkan mutu pelayanan kesehatan.
This thesis studies the relation between patient satisfaction of the healthy Quality service to visiting interest in RSIA Selaras Cikupa,year 2009.This study was held to kind out if there is relation between patient satisfaction of the health quality service to visiting interest.This study is quantitative study and uses service quality method. Which is content of five dimention Tangible, Reliability, Responsiveness, Assurance and Emphaty. The result of study ,suggest that the dimention of Tangible quality must be concerned, because this indicator is the most effected to the patient satisfaction and revisiting interest RSIA Selaras is also suggested to publish the patient satisfaction of the health service quality questioner periodically to the patient,to know their pation satisfaction and RSIA Selaras can increase the quality of the health service.
