Overview:Rencana Penanggulangan Bencana di

Rumah Sakit.

Hendro WartatmoTim PMPK – FK UGM

Bencana di Rumah Sakit:• Situasi di RS dalam keadaan bencana:

– Kemampuan terlampaui ---- chaos ---- pelayanan sub standard• Rencana Penanggulangan Bencana di Rumah Sakit:

– Hospital Disaster Plan• Mengatur penanganan pasien yang jumlahnya banyak, saat

bencana:– Organization of Mass-Admission of Patients in the Hospital ( OMP )

• Tujuan / target:– Keadaan chaos sesingkat mungkin– Mortalitas dan morbiditas serendah mungkin– Distribusi pasien ke RS-RS merata– Tidak meninggalkan pelayanan individu

Pelaksanaan:

• Bekerja semaksimal mungkin dengan meningkatkan daya kemampuan

• Tidak meninggalkan prinsip penanganan individual

• Melanjutkan penanganan pasien yg sudah ada di RS sebelemnya

• Mengatasi problem non medis akibat bencana• Mendukung pelayanan di area bencana.

Prinsip RPB-RS

• Bukan sekedar eskalasi / peringatan dini• Based on existing organizational structures

( supaya pelayanan rutin tdk terganggu )• As simple as possible, as comprehensive as

necessary• OMP fro preparedness, Check-list during

emergency

Prinsip organisasi

• Bukan sekedar eskalasi / peringatan dini• Ramping• Pelimpahan wewenang yang cepat• Markas yg sudah disiapkan berserta

pendukungnya• Siapkan fasilitas – protap – personil sesuai

rencana• Collapsable Concept

Organisasi PB-RS:Coordination Team

Medical Coordinator

Senior Manager

SeniorNurse

SeniorEmergencyPhysician

Ketua TimMedis

Seksi Administrasi

Operator

telpon

Pekarya

Seksi Keperawatan

Ranap UGD

Seksi Medis

Dokter Gadar /

SpesialisLaboratorium

Organisasi PB RS Tipe D / Puskesmas Ranap

Senior Manager

Operation ManagementSuport

Facilities

Senior Porter

Senior TransportManger

Senior Enquiries

Officer

Senior SecurityManager

Senior Admissions

Officer

VolunteerCoordinator

ReligiousOfficer

Senior SocialWorker

SeniorTelephonist

Press Officer

LinenService

Manager

SeniorSuppliesManager

CSSUManager

TSSUManager

SeniorCateringManager

SeniorEngineer

MedicalPhotographer

CrecheManager

The Management Hierarchy

MedicalCoordinator

Medical SupportServices

ConsultanHaemato-

logist

ConsultanBiochemist

SeniorMLSO

ConsultanPathologist

ConsultantPsychiatrist

ConsultanRadiologist

HouseOfficers

Sub-SpcialityConsultants

SpRs

SeniorSurgeon

SeniorPhysician

SeniorEmergency Physician

SeniorPhamacist

SeniorIntensivist

SeniorPaediatrician

SurgicalArea

SeniorAnaesthetis

SeniorSurgeonTheatres

Trans-fer

Teams

OperatingTeams

SpecialistOperating

Teams

SeniorSurgeonPost-Op

SeniorSurgeonPre-Op

P3P1 & P2

PhysicianMinors

TreatmentTeams

SurgeonMinors

TreatmentTeams

PaediatricAssessment

Teams

SeniorRadiographer

RadiologistOn-call

DutyRadiographer

MLSOTransfusion

MLSOHaematology

MLSOBiochemistry

The Clinical Hierarchy

Senior Nurse

Senior NurseED

Senior NurseDischarge Area

Senior NurseITU

Senior NurseTheatres

Senior NurseWards

TriageNurse

SeniorNurse

P1 Resus

SeniorNurse

P2

SeniorNurse

P3

TeamCoordinator

TreatmentTeam

NursesP1

TreatmentTeam

NursesP2

TreatmentTeam

NursesP3

ITUNurses

Senior ODP/Anaesthetic

Nurse

TheatreNurse

AnaestheticNurses/ODPs

SeniorNurse

AdmissionsWards

SeniorNurse

Paediatrics

SeniorNursePre-Op

SeniorNurse

Post-Op

The Nursing Hierarchy

Harus ada Pengembangan1

Pengembangan 2

Organisasi PB-RS

Ketua Tim

MenejemenRS

KoordinatorParamedis

KoordinatorMedis

LaiasonOfficer

DIREKTURRS

Pelaksana / eksekutorBertanggung jawab ke Direktur

Profesional / mandiri / self generatingBertanggung jawab ke ketua tim

Organisasi PB-RSKa UGD

( Dokter Jaga Bedah

KaBid Pelayanan( Case Manager )

Logistik

Tehnik

KaBid Perawatan( KaRu UGD )

Perawat ICU

Perawat OK

KaBid YanMed( Dokter Jaga UGD )

BedahAnestesib

Organisasi PB-RS

Ka UGD( Dokter Jaga Bedah

KaBid Pelayanan

( Case Manager )

Logistik

Tehnik

Relawan

Komunikasi

KaBid Perawatan

( KaRu UGD )

Perawat ICU

Perawat OK

KaBid YanMed

( Dr Jaga UGD )

Bedah

OK

UGD

Anestesi

Tim Lapangan

PenunjangMedis

Lab. Radiologi

Prosedur tetap

Koordinator

BidangMenejemen

BidangKeperawatan

BidangMedis

Rekruitmen timPersiapan OKPersiapan Triase

Rapid Health AssessementPeringatan diniAktivasiPelaporanStandar SDMHazard mapingNetworkingKoordinasi relawan

Pengaturan MediaMenejemen relawanLogistik medisKomunikasiCadangan listrikLogistik teamTransportasi

Rekruitmen timTriaseArea cadanganRujukan

Standar Pelatihan

Koordinator

BidangMenejemen

BidangKeperawatan

BidangMedis

PPGDPerawat ICUPerawat OKKomunikasi medikEkstrikasi

Disaster Management Incident CommanderHOPE

HOPEKomunikasi medikMenejemen logistikStruktur gedung

ATLSACLCFirst reponder

The Ten Commandments

1. Scope and Run

2. Patient flooding

3. Write plant

4. Surge capacity

5. Triage at Hospital

6. Care Priorities

7. Mental Health

8. Family care

9. Decontamination

10. Drill

Conclussion

• HDP for every Hospital• Response is Function of Preparedness• Networking