Dody Firmanda 2012 - Materi Kuliah Clinical Governance KARS 9
Dody Firmanda 1997 - Evolusi Mutu di bidang Kesehatan
-
Upload
indonesian-centre-for-medical-management-and-leadership-icmml -
Category
Documents
-
view
655 -
download
2
description
Transcript of Dody Firmanda 1997 - Evolusi Mutu di bidang Kesehatan
PERKEMBANGAN (EVOLUSI)MUTU
DI BIDANG KESEHATAN
Dr. Dody Firmanda,Sp.A, MA.
Dody Firmanda
Definisi Mutu (Quality)
Evolusi Mutu
Perspektif
QA
TotalQuality
Assignment
Modul 3:Perkembangan (evolusi) mutu di bidang kesehatan
1. DEFINISI MUTU (QUALITY)
dodyfirmanda1997
Definisi• Zerodefect
• Fitnessfor purposes• Conformto standard
dll
Definisi
• Banyak definisitergantung sudutpandang, antara lain:
1. Sesuai standar(conform to standard)– banyak dianut untukjasa pelayanan
2. Zero defect (dianutoleh industri)
3. dll
• Pada saat ini bergeserke arah yang terdiridari 4 aspek:
1. Effectiveness2. Safety3. Timeliness4. Patient centeredness
• Dengan kombinasiDonabedian:
1. Struktur2. Proses3. Outcome/Output
Ruang Lingkup
SMF
Instalasi
Profesi lain Pasien
Rumah Sakit
Komponen:
SembuhMeninggalKomplikasiKomplain
ImplementasiAlur penerimaan pasiendi Rawat Jalan, KamarOperasi dan Rawat Inap
Patientcentredness
Ketepatan waktuImplementasiJadwal PoliJadwal Jaga KonsulenJadwal RuanganJadwal Pendidikan
Timeliness
SembuhMeninggalKomplikasi
ImplementasiSPM, Clinical PathwaysSafety
SembuhMeninggalKomplikasi
ImplementasiSPM, Clinical PathwaysEffectiveness
Outcome/OutputProsesStruktur
InspectionInspection QualityControl
QualityControl
QualityAssurance
QualityAssurance
TotalQuality
TotalQuality
a. Setting Standardsb. Conform with standards
(Audit/Akreditasi)c Maintained & Improve
a. Setting Standardsb. Conform with standards
(Audit/Akreditasi)c Maintained & Improve
ClinicalGovernance
ClinicalGovernance
NICE
CHImp
Understandingthe customers
Understandingthe customers CQ
I
CQI
QualitySystem
QualitySystem Quality
Tools
QualityToolsUnderstanding
the business
Understandingthe business
Readers’Guides toMedical
Literatures
Users’ Guidesto MedicalLiteratures
Evidence-based
Medicine(EBM)
Evidence-basedClinical
Specialities
Evidence-basedHealth Care
(EBHC):Policy• Health
TechnologyAssessment
Others80an 90an
InformationMastery
Abad 21
ClinicalEpidemiology
BSI 5751EN/ISO 9000MBNQAEQABenchmarking AwardDeming Prize AwardSQL
HealthNeeds
Assessment
BalancedScorecard
(SFO)
dodyfirmanda1997
2. EVOLUSIMUTU
(QUALITY):dari
Inspeksisampai Total
Quality
1
2
3 4
5
6
DemingDianggap sebagai ‘bapak’ revolusi mutu dalam
rekonstruksi Jepang pasca PD II
Mengubah paradigma/model tradisional‘inspeksi’ menjadi fokus kepada mutu (‘qualitycentred’)
Dengan mutu = Biaya ↓, produktifitas ↑, profit ↑& lapangan kerja ↑
Juran
Rekan kerja Deming pada tahun 1940an1950an: ≥85% kegagalan organisasi
karena sistem yang tidak benar, hanya15% dikarenakan faktor manusiaMelibatkan seluruh staf yang kreatif
TQM
CrosbyFivepr inciples:1. Conformanceto standards2.No qualityproblems3.No economicsquality4. Performancemeasure : Costof quality5. Performancestandard: Zerodefect
Donabedian
Structure
Process
Outcome
Goals
Objectives
Wants
Demands
Needs Input Process Ouput Outcome
Aims
Value/Benefit
Targets
RelevanceAdequacy
Accessability
Impact
Effectiveness
Efficiency Efficacy
Input Process Outcome
Maxwell
Donabedian
Impact = Relevance + EffectivenessAccessibility = Relevance + Adequacy
dodyfirmanda1997
3. PRINSIP PRINSIP PENDEKATAN MUTU (QUALITY)
1. Vision : futuristic mind-setting of the organisation
2. Missions: ways of the organisation towards the vision
3. Goals : are broad statements. There is generally one goal for aservice/task.
6. Targets/Minimal Thresholds : For each objective, there may bevarious points on the way to the attainment of the objective.They are defined in relation to a point in a time.
5. Objectives : For each programme aim, there may be a number ofobjectives which are specified in measurable terms.
4. Aims : There are a number of aims relating to the goal. They arespecific to particular problems.
IndicatorsCriteria
Systems/Standards
dodyfirmanda1997
4. QUALITY ASSURANCE
dodyfirmanda1997
TotalQuality
Understanding thebusiness
Understanding thecustomers
QualitySystem
CQI
Quality Tools
Benchmarking
Need Assessment
PIP (Investors in People)
P
DS/C
A
Statistical Process Control
QA Model:ISO 9000
TQM Model:MBNQAEQAEFQM
Setting standard
QA
dodyfirmanda1997
5. TOTAL QUALITY MANAGEMENT/SERVICES
Sangat dipengaruhi oleh sifatorganisasi institusi:
1. ‘Split’2. ‘Bonded’
Berkembang sebagaitehnik RCA dalamPatient Safety Risk
Assessment
Digunakan dalam rangkaCQI untuk meningkatkanstandar
Digunakan utk membuat• Sistem• Alur (Process of Care,
Clinical Pathways, SOP)
X1
X2
Masalah di:1. X12. X2
1
2
3
dodyfirmanda1997