Standar Fasilitas RS.

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CURRICULUM VITAEDATA PRIBADI

Nama : dr.ADIB ABDULLAH YAHYA,MARS

Pangkat : Brigjen TNI (Purn)

Tempat/tanggal lahir : Magelang,16 Februari 1949

Jabatan : DIREKTUR UTAMA RUMAH SAKIT MMC

Agama : Islam

ALAMAT : Jl. Punai H‐24,Kel.Tengah,Jakarta Timur – 13540

Telp : (021)8404580

Fax : (021) 8408047

HP : 08161803497

E‐MAIL : [email protected]

PENDIDIKAN UMUM

SMA Negeri Magelang 1966

S1 : Fakultas Kedokteran Universitas Gajah Mada (UGM),

Yogyakarta, 1973

S2 : Fakultas Kesehatan Masyarakat, Universitas Indonesia (UI), Jakarta,

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Program Kajian Administrasi Rumah Sakit ( KARS )

PENDIDIKAN MILITER

Sekolah Staf dan Komando TNI Angkatan Darat (SESKOAD), 1987/1988

PELATIHAN

Combined Humanitarian Assistance Response Training, oleh Singapore Armed Forces (SAF), Singapura, 2000

Health as a Bridge for Peace Workshop, olehWorld Health Organization (WHO), Yogyakarta, 2000

PENGALAMAN JABATAN

Komandan Detasemen Kesehatan Pasukan Pengamanan Presiden (DanDenkes Paspampres), 1987‐1991

Kepala Rumah Sakit “Muhammad Ridwan Meuraksa”, Jakarta, 1992

Kepala Kesehatan Daerah Militer (Kakesdam) Jaya, Jakarta, 1993

Komandan Pusat Pendidikan Kesehatan TNI –AD,1995 – 1999

Wakil Kepala Pusat Kesehatan TNI, 1999 – 2000

Kepala RSPAD Gatot Soebroto, 2000 – 2002

Dekan Fakultas Kedokteran UPN, Jakarta, 2000 – 2002

Wakil Ketua Tim Dokter Kepresidenan RI, 2000 – 2002

Direktur Kesehatan TNI Angkatan Darat (Dirkesad), 2002‐2004

Wakil Ketua Tim Pemeriksaan kesehatan untuk calon Presiden dan calon Wakil Presiden RI Th.2004

DOSEN Pasca Sarjana FKM UI, Kajian Administrasi Rumah Sakit (KARS)

DOSEN Pasca Sarjana URINDO

DIREKTUR UTAMA RUMAH SAKIT MMC

ORGANISASI

Ketua Ikatan Rumah Sakit Jakarta Metropolitan (IRSJAM), 2000‐2003

Ketua Umum Perhimpunan Rumah Sakit Seluruh Indonesia ( PERSI), 2003‐2009

Anggota Komnas FBPI.

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Ketua Komtap Bidang Kebijakan Kesehatan KADIN Indonesia

Angggota TNP2K.

Dewan Pakar Perhimpunan Rumah Sakit Seluruh Indonesia ( PERSI)

Dewan Pakar IDI

Anggota Majelis Kehormatan Etik Kedokteran (MKEK) IDI Pusat

Tim Konsultan Institut Manajemen Risiko Klinis ( IMRK )

Anggota KNKPRS

Koordinator Bidang 1 : KAJIAN KESELAMATAN PASIEN, IKPRS‐ PERSI

Instruktur HOPE ( Hospital Preparedness for Emergencies and Disasters}

PRESIDENT OF ASIAN HOSPITAL FEDERATION ( AHF ) 2009 – 2011

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STANDAR PRASARANA DAN

Prof. Dr. Budi Sampurna, SH, SpFDr. AdibA Yahya, MARS

STANDAR PRASARANA DAN SARANA RUMAH SAKIT

LOKASI BANGUNAN

Pasal 8 UU Rumah Sakit

(1) Persyaratan lokasi sebagaimana dimaksuddalam Pasal 7 ayat (1) harus memenuhiketentuan mengenai kesehatan, keselamatanlingkungan, dan tata ruang, serta sesuaidengan hasil kajian kebutuhan dan kelayakang j ypenyelenggaraan Rumah Sakit.

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Syarat administratif danteknisPasal 9 UU RS

Persyaratan bangunan sebagaimana dimaksuddalam Pasal 7 ayat (1) harus memenuhi :

a. persyaratan administratif dan persyaratan teknisbangunan gedung pada umumnya, sesuai denganketentuan peraturan perundang‐undangan; dan

b t t k i b R h S kit ib. persyaratan teknis bangunan Rumah Sakit, sesuaidengan fungsi, kenyamanan dan kemudahan dalampemberian pelayanan serta perlindungan dankeselamatan bagi semua orang termasukpenyandang cacat, anak‐anak, dan orang usia lanjut.

Sesuai kebutuhan

Pasal 10 UU RS

1) Bangunan Rumah Sakit sebagaimanadimaksud dalam Pasal 9 harus dapatdigunakan untuk memenuhi kebutuhanpelayanan kesehatan yang paripurna, pendidikan dan pelatihan, serta penelitianp p , pdan pengembangan ilmu pengetahuan danteknologi kesehatan.

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Meliputi: (1) Prasarana Rumah Sakit sebagaimana dimaksud dalam Pasal

7 ayat (1) dapat meliputi:a. instalasi air;b. instalasi mekanikal dan elektrikal;c. instalasi gas medik;d. instalasi uap;e. instalasi pengelolaan limbah;f. pencegahan dan penanggulangan kebakaran;g. petunjuk, standar dan sarana evakuasi saat terjadi keadaan darurat;h. instalasi tata udara;i sistem informasi dan komunikasi; dani. sistem informasi dan komunikasi; danj. ambulan.

Standar dan berfungsi

Pasal 11 UU RS) P b i di k d d t ( ) 2) Prasarana sebagaimana dimaksud pada ayat (1)

harus memenuhi standar pelayanan, keamanan, serta keselamatan dan kesehatan kerjapenyelenggaraan Rumah Sakit

3) Prasarana sebagaimana dimaksud pada ayat (1) harus dalam keadaan terpelihara dan berfungsidengan baik.

4) Pengoperasian dan pemeliharaan prasarana RumahSakit sebagaimana dimaksud pada ayat (1) harusdilakukan oleh petugas yang mempunyaikompetensi di bidangnya.

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Peraturan Menteri Kesehatan 340/2010

Peraturan Menteri Kesehatan 340/2010

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40/2010

Rumah Sakit Khusus Mata

ranMen

teriKeseh

atan

3Peratu

Lebih lanjut dapat dilihat di Pedoman

PedomanTeknis Bangunan RS kelas B

PedomanTeknis RuangOperasi

PedomanTeknis Ruang Perawatan Intensif

PedomanTeknis RuangGawat Darurat

PedomanTeknis Ruang Rawat Inap

PedomanTeknis Ruang Rehabilitasi Medis

PedomanTeknis Instalasi Elektrikal

PedomanTeknis Gas medik

PedomanTeknisTata Udara

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Standar di negara lain

Persyaratan terkaitPerizinan Install and operate medical equipment required for provision of the proposed hospital services in accordance with manufacturer specificationsaccordance with manufacturer specifications.

Maintain adequate lighting and utilities, including temperature controls, water taps, sinks and drains, electrical outlets and communications.

Keep floors, work surfaces, and other areas clean and neat.

Clearly display hospital signage and direction for y p y p g gdifferent services provided in the hospital at least in two languages (Indonesian and English).

Clearly displayed hazardous signs aimed to restrict access for the safety of patients, visitors and staff.

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Ketentuan Umum

Designate secured areas for the collection of medical waste general storage facilities for supplies and waste, general storage facilities for supplies and equipment and storing area for hazardous materials.

Provide a sufficient number of toilets for patients, their families, and staff.

Provide at least one toilet for disabled individuals in each floor.

Maintain hospital accessible for handicapped and disabled individuals.

The hospital safety plan, design and equipment shall comply with the fire safety requirements by the Dubai Civil Defense Department.

General Design

The hospital building shall be freestandingfacility; located on a main road, access to the premises must be easy and convenient both to people using both public transportation and vehicles.

Consideration must be given to the ganticipated disabled patients as determined by the functional program of the hospital.

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General design

Hospital design shall ensure appropriate l l f i i l d i llevels of patient acoustical and visual privacy and dignity throughout the care process.

In multiple‐bed rooms, visual privacy from casual observation by other patients and visitors shall be provided for each patientvisitors shall be provided for each patient

Color contrast between walls, floors and doors shall be considered as it may reduce falling risk of blurred vision patients

Zoning

Zoning: The different areas of a hospital shall be d di f llgrouped according to zones as follows:

Outer Zone – areas that are immediately accessible to the public: emergency service, outpatient service, and administrative service. They shall be located near the entrance of the hospital.

Second Zone – areas that receive workload from the outer zone: laboratory, pharmacy, and radiology. They shall be located near the outer zoneshall be located near the outer zone.

Inner Zone – areas that provide nursing care and management of patients nursing service. They shall be located in private areas but accessible to guests.

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Zoning

Deep Zone – areas that require asepsis to perform the ib d i i l i d li i prescribed services: surgical service, delivery service,

nursery, and intensive care. They shall be segregated from the public areas but accessible to the outer, second and inner zones.

Service Zone – areas that provide support to hospital activities: dietary service, housekeeping service, activities: dietary service, housekeeping service, maintenance and motorpool service, and mortuary. They shall be located in areas away from normal traffic.

Function

The emergency service shall be located in the ground floor to ensure The emergency service shall be located in the ground floor to ensure immediate access. A separate entrance to the emergency room shall be provided.

The administrative service, particularly admitting office and business office, shall be located near the main entrance of the hospital. Offices for hospital management can be located in private areas.

The surgical service shall be located and arranged to prevent non‐l d ffi Th i h ll b i bl related traffic. The operating room shall be as remote as practicable

from the entrance to provide asepsis. The dressing room shall be located to avoid exposure to dirty areas after changing to surgical garments. The nurse station shall be located to permit visual observation of patient movement.

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Function

The delivery service shall be located and arranged to prevent non‐related traffic. The delivery room shall be as remote as practicable from the entrance to provide asepsis. The dressing room shall be located to avoid exposure to dirty areas after changing to surgical garments The nurse station shall be located to permit visual changing to surgical garments. The nurse station shall be located to permit visual observation of patient movement. The nursery shall be separate but immediately accessible from the delivery room.

The nursing service shall be segregated from public areas. The nurse station shall be located to permit visual observation of patients. Nurse stations shall be provided in all inpatient units of the hospital with a ratio of at least one (1) nurse station for every thirty‐five (35) beds. Rooms and wards shall be of sufficient size to allow for work flow and patient movement. Toilets shall be immediately accessible from rooms and wards.

The dietary service shall be away from morgue with at least 25‐meter distance.

Operating Theatre There should be sufficient space to accommodate all

necessary equipment and personnel to allow for swift access to patients and all monitoring equipment.p g q p

The OT entrance door must be wide (about 2.13 meters width) preferably consisting of two parts, which can be opened in either sides or automatic one.

Independent dirty exit is recommended in OT The floors, ceilings, and walls must be created by a

continuous connection. Interior surfaces should be constructed of materials that

are monolithic and impervious to moisture. The floors and walls should be anti‐static, heat resistant,

anti‐bacterial, anti‐fungal and resistant to disinfectants.

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Operating theatreOperation room shall be equipped with the following:

Multi purpose operation table

Anesthesia machine with adequate vital sign monitors ( i i f b k h i hi )(minimum of one back up anesthesia machine).

Adequate medical gases supply

X‐Ray Viewer

Cautery equipment

ECG machine

Emergency/crash cart.

Suction machine Suction machine

Pulse oximeter

Appropriate size pediatric medical equipment must be available if services are provided to infants/children

Calling station

Operating Theatre Adequate ventilation and air exchange (with at least 25 air changes per

hour as per American Society of Heating, Refrigerating and Air‐Conditioning Engineers (ASHRAE) requirement) shall be maintained in the operation room which should be at positive pressure relative to th dj t ti the adjacent preparation areas.

Minimum of two air supply inlets with proper contamination control filters i.e. High Efficiency Particulate Air (HEPA) filters delivered at or near the ceiling, which should not be directed over the operation table, in addition to a minimum of two exhaust outlets located near floor level, bottom exhaust outlets should be at least 75mm above the floor. Differential pressure indicating device, humidity indicator, and thermometers should be installed and should be located for easy observation.

Operating room temperature shall be maintained between 18‐22 °C with room humidity between 35‐70% and the temperature and relative humidity set points should be adjustable.

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Ruang cuci dan ganti

The scrub facility shall be located adjacent to the The scrub facility shall be located adjacent to the operation room(s). Ceiling, surfaces or tiles at this area shall be smooth, washable and free of particular matter that can be contaminated.

Staff changing area shall be separate for males and females. It must contain special entrance for the staff and suitable place for changing of clothes with a minimum of p g gone toilet for the staff in this area. Toilets air pressure should be kept negative pressure with respect to any adjoining areas and should have minimum 10 air changes per hour.

Gas Medik

Sufficient supply of different medical gases Sufficient supply of different medical gases should be available and adequate for procedure(s) preformed (centralized medical gas system in accordance to HTM 2022 or its equivalent internationally accepted standard is preferable)is preferable).

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Critical Care

All general hospital shall provide Critical Care services this All general hospital shall provide Critical Care services; this may include Intensive Care Unit (ICU), Coronary Care Unit (CCU), Neonatal Intensive Care Unit (NICU) or Burns Unit.

Number of beds per critical care services shall be based on many factors such as: type of services provided in the hospital, bed occupancy rate, etc.

In general the hospital should provide one critical care bed for each operation theater, but it should not be less than one critical care bed for every 20 general beds.

Critical Care

The critical care unit has the following necessary equipment and supplies:

Ventilators (see appendix 1 regarding ventilator specifications)Ventilators (see appendix 1 regarding ventilator specifications)

Tracheotomy set

Emergency/crash cart with a plastic breakable seal that can be easily removed during emergency. It must be equipped with defibrillator, necessary drugs and other CPR equipment and test strips. A log book must be nearby to indicate the maintenance and regular check of the crash cart and its components.

Pulse Oximetry and vital signs monitor.y g

Transfusion pumps

Vital Signs Monitors.

Blood gas analyzer with capability for electrolytes measuring should be available in the hospital (preferably at ICU facility)

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Critical Care and Medical Gas

The critical care beds must be supplied with medical gases outlets (02, Air, Suction), enough numbers of electrical outlets, examination lights.

Supply of medical gases should be available and centralized medical gas system shall be according to HTM 2022 or its equivalent internationally accepted standard.

Environment of Critical Care

Adequate ventilation and air exchange, with at least 6 air changes per hour as per ASHRAE requirement shall be changes per hour as per ASHRAE requirement, shall be maintained in Intensive Care Unit area.

Intensive Care Unit should be kept at positive pressure relative to the adjacent areas. The area temperature should be maintained at 21 °C 24 °C and relative humidity 30 % to 60% and should be adjustable.

High efficiency filters should be installed in the air handling system, with adequate facilities provided for maintenance, without introducing contamination to the delivery system or the area served.

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Airborne Infection Isolation

The hospital should specify airborne infection isolation (AII) room(s) for treatment of infectious diseases based on the needs of specific community and patient populations served by the hospital.

At least one airborne infection isolation room in the critical care area shall be provided in all general hospitals.

Ruang IsolasiIsolation rooms design requirements shall include but not limited to the following:

Each patient room shall contain only one bed

The isolation room should be independent from other critical care area The isolation room should be independent from other critical care area.

A separate toilet with bathtub (or shower) shall be provided for each patient room.

A hand‐washing station shall also be provided for each patient room

Additional hand‐washing or hand rub station outside the room entrance maybe provided.

AII room perimeter walls, ceilings, and floors, including penetrations, shall be sealed tightly so that air does not infiltrate the environment from the outside or from other spaces

An area for gowning and storage of clean and soiled materials shall be located either directly outside or inside the entry door to the patient room.

There should be an oxygen source and first‐aid kit available inside the room

Isolation Room Instruments shall include: Intravenous solutions, needles of various gauges, lumbar puncture kit, liver biopsy kit, liver abscess aspiration kit and pleural fluid and asciticfluid aspiration kit

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Emergency

Emergency Entrance: A well‐marked, easily accessible entrance at ground level for both emergency vehicles and pedestrian g g y paccess.

Waiting Area: Patients and visitors waiting area(s) must be located in away that can be under direct observation of the reception staff, triage station, or control station, with access to a public phone.

Consultation room with space area not less than 12 square Consultation room with space area not less than 12 square meters. It must be fitted with a wash basin and the attached faucet can be sensor‐regulated or single‐lever elbow operated. Care shall be taken in location and arrangement of fittings to provide the clearance required for operation of blade‐type handles

Emergency

Consist of:

One Triage room One Triage room.

Observation bed area with suitable patient privacy

Minimum of two treatment rooms

Resuscitation Area: with adequate space area, appropriate equipment and emergency medication. Door shall be 2.0 meters width and consists of two parts opening on both sides.

P ti t t il t i i f l d th f Patient toilet: minimum one for male and another for female

At least one dedicated toilet for handicapped patients/visitors equipped with safety hand rails and suitable hand washing sink

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Ambulance

Ambulance vehicle: well‐equipped Ambulance vehicle: well‐equipped ambulance vehicle(s) should be ready with qualified medical staff for patient transportation if required, for more details see ambulance requirements in DHA website www dha gov aewww.dha.gov.ae

Oxygen

Source of Oxygen:

There should be in each location a reliable source of oxygen.

Oxygen piped from a central source is strongly recommendedstrongly recommended

There should be backup supply of oxygen equivalent to at least a full cylinder

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Delivery Suite

Th b i l i h ll b l d d The obstetrical unit shall be located and designed to prohibit nonrelated traffic through the unit LDR rooms may be located in a separate LDR suite, as part of the cesarean delivery suite, and in the postpartum unit

Wh d li l t d When cesarean delivery rooms are located within the obstetrical suite, access and service arrangements shall be such that neither staff nor patients must travel through the cesarean delivery area to access other services

N b i d ith d t i f t Newborn nursery equipped with adequate infant beds and incubators for the premature babies.

Adequate ventilation and air exchange, with at least 25 air changes per hour as per ASHRAE requirements, shall be maintained in Delivery requirements, shall be maintained in Delivery Suite area. Delivery Suite should be kept at positive pressure relative to the adjacent areas.

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Inpatient Service Area Single‐patient rooms should be at least 3.65 meters (12 feet)

wide by 3.96 meters (13 feet) deep (approximately 160 square feet or 14.86 square meters) exclusive toilet rooms, closets, lockers wardrobes alcoves or vestibules These spaces should lockers, wardrobes, alcoves, or vestibules. These spaces should accommodate comfortable furniture for one or two family members without blocking staff member access to patients.

In shared inpatient rooms, the enclosed area for each bed shall be provided with curtains to ensure patient privacy. Such area should be at least 7.5 square meters (80 square feet). The curtains must be washable/cleanable, fireproof and maintained , pclean at all times.

Patient room

A hand‐washing station for the exclusive use of h ff h ll b id d h i the staff shall be provided to serve each patient room and shall be placed outside the patient toilet room

Door opening to inpatient bedrooms shall be wide enough for easy movement of bed or stretcher a minimum clear width of 1 12 meters stretcher, a minimum clear width of 1.12 meters (3 feet 8 inches) with a frame that is 2.13 meters (7 feet) high is required

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Patient room

Suitable area for toileting, bathing, dressing and hand washing (minimum of one toilet for inpatient hand washing (minimum of one toilet for inpatient room with three beds and one toilet in private inpatient rooms).

Appropriate dedicated area for medical equipments, medications and supplies shall be provided near the inpatient area.p

Overnight accommodation for family members can be provided in private inpatient bedrooms.

Outpatient area

A reception/information counter or desk shall be located to provide visual control of the entrance to the outpatient unit and shall be immediately apparent from that entrance; the information counter should provide paccess to patient files and records.

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Clinical Laboratory

Clinical Laboratory facilities shall be provided for the Clinical Laboratory facilities shall be provided for the performance of tests. Each lab must be able to cover the following minimum specialties: hematology, clinical chemistry, Immunology and serology, microbiology, anatomic pathology, cytolopathology, and blood banking to meet the expected workload in the hospital functional program

A specimen collection facility may be located outside the clinical laboratory area.

The blood collection area shall have a work counter, space for patient seating, and hand‐washing stations

Radiology and Diagnostic Imaging

R di l d di i i i i Radiology and diagnostic imaging services performs examinations and produces images from non‐invasive or minimally invasive procedures performed on patients in specially equipped examination rooms.

H it l t id ti l di h Hospital must provide conventional radiography (general radiology), ultrasound services and CT within the premises of the hospital to meet the patient needs

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Pharmacy

The size and type of services to be provided in the pharmacy shall depend upon the type of drug distribution system used, number of patients to be served, and extent of shared or purchased servicesp

Nutrition Services

Strict hygienic conditions should be Strict hygienic conditions should be maintained in the hospital kitchen during preparing, storing and serving food. Such services may be provided on the hospital premises or by an external provider with written agreement However if such services written agreement. However, if such services are out‐sourced it should fulfill the DHA and DM hygiene requirements.

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Laundry Service

Hospital shall provide laundry services either on the hospital premises or by an external provider with hospital premises or by an external provider with written agreement. If the laundry is in‐house it shall be fully equipped with machines used for cleaning and washing clothes, sheets and covers.

Adequate ventilation and air exchange, with at least 10 air changes per hour as per ASHRAE g p prequirements, shall be maintained in Laundry Service area. Laundry Service area should be kept at negative pressure relative to the adjacent areas

Sanitary Service

Clean and hygienic water supply should be provided in the hospital. Water tanks should be maintained, clean and well closed.

Clean Bathrooms for outpatients should be provided (separate for men and women), every bathroom should have at least one washbasin and commode with soap and hand dryer. All the staff and patients’ toilets should be kept clean. Water drainage and sanitation should be hygienic.

Hand rubs must be available in the toilets and patient rooms.

All hospital drainage and sewage should be connected to general sewerage and be according to DM regulations.

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External Service

External services provider shall be managed effetely to provide safe, quality care and services. Many healthcare facilities use external contractor and / or services to provide specific services that are essential to the ongoing operation of the organization e.g. Radiology, laboratory, oncology, pathology, allied health, transport laundry food cleaning maintenance transport, laundry, food, cleaning, maintenance, security, and education.

Outsourcing While a contracted or services agreement is

important for both the healthcare facility and service provider to ensure good quality services, the fundamental responsibility for quality shall remain u da e ta espo s b ty o qua ty s a e awith the main healthcare facility. The health facility should outline in its services agreements / contracts exactly what services what level of services is expected and evidence with compliance with that service’s regulatory or industry standards e.g. compliance with DM standards for laundry or food servicesservices.

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Take Home Note

Standar Sarana dan Prasarana masih sangatlonggar aturannya, demikian pula pelaksanaannya

Kemenkes sedang menyusun peraturan Kemenkes sedang menyusun peraturantentang standar sarana dan prasarana rumahsakit

Standar Fasilitas RS.

Documents

Transcript of Standar Fasilitas RS.