Analysis Of The Role Of Management In The Implementation Of CP DBD In Inpatient Children At Hospital X
DOI:
https://doi.org/10.59188/eduvest.v4i8.1635Keywords:
Clinical Pathways, Pediatric DHF, Hospital ManagementAbstract
This study investigates the implementation of clinical pathways (CPs) for pediatric Dengue Hemorrhagic Fever (DHF) inpatients at Hospital X, a Type C hospital in Indonesia, focusing on the role of management in CP development and compliance. Clinical pathways aim to enhance hospital efficiency, quality of care, and patient satisfaction. However, the study identified several issues in CP implementation, including incomplete documentation, lack of socialization and training among staff, and inadequate managerial involvement in CP development and oversight. Data were collected through in-depth interviews with attending physicians, nurses, pharmacy staff, and medical management, along with analysis of 53 pediatric DHF CPs. Results showed that CP compliance rates were below 80%, and the hospital's organizational role in CP development, as assessed by the ICPAT dimension 6 instrument, was insufficient. Key areas of non-compliance included lack of evidence of clinical governance, integration with other hospital initiatives, and adequate support for CP documentation and variation reporting. Recommendations include increasing management involvement, providing comprehensive training for staff, and implementing regular CP evaluations. The findings highlight the need for stronger multidisciplinary collaboration and hospital management support to optimize CPs, ensure compliance, and improve service quality.
References
Aspland E, Gartner D, Harper P. Clinical pathway modelling: a literature review. Health Systems. 2021;10(1):1–23.
Mammen C, Matsell DG, Lemley K V. The importance of clinical pathways and protocols in pediatric nephrology. Pediatric Nephrology. 2014;29(10):1903–14.
Nurliawati. Analisis Pelaksanaan Clinical Pathway di Rumah Sakit Umum dr. Fauziah Bireuen Tahun 2018. Proceeding of International Conference on Postgraduate Research (ICPR 2014). 2018;
Thomas R, Kinsman, EL J. Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. Int J Evid Based Healthc. 2011;9(2):191–2.
Haninditya B, Andayani TM, Yasin NM, Ilmu M, Universitas F, Mada G, et al. Analisis Kepatuhan Pelaksanaan Clinical Pathway Sesarea di Sebuah Rumah Sakit Swasta di Yogyakarta Seksio. JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice). 2019;9(1):38–45.
Fitria A, Armani AS, Rochmah TN, Purwaka BT, Pudjirahardjo WJ. Penerapan Clinical Pathways sebagai Instrumen Pengendalian Biaya Pelayanan : Studi Penelitian Tindakan Penderita BPJS yang Menjalani Operasi Caesar dengan Sistem Pembayaran INA-CBG. Jurnal Keperawatan Silampari. 2021;4(2):593–9.
Pahriyani A, Andayani TM, Dewa I, Pramantara P. Pengaruh Implementasi Clinical Pathway Terhadap Luaran Klinik Dan Ekonomik Pasien Acute Coronary Syndrome the Clinical Pathways Implementation on Clinical and Economic Outcomes Acute Coronary Syndromes. 2014;4(3):146–50.
Aljunid syed mohamed. Clinical Pathways : Development and Implementation at a Tertiary Hospital in Malaysia. Int J Public Health Res. 2012;2(2):153–60.
Milroy S, Wong J, Eberg M, Ieraci L, Forster K, Holloway CMB, et al. Associations between clinical pathway concordance, cost, and survival outcomes for stage II colon cancer: a population-based study. Int J Qual Health Care. 2023;35(2):1–8.
Widjaja L, Wijayanti CD, Tjitra E. Pengaruh Clinical Pathway Terhadap Mutu Pelayanan Keperawatan dan Kepuasan Pasien. Jurnal Ilmiah Ilmu Keperawatan Indonesia. 2019;9(03):616–22.
Kim TK, Chang MJ, Kim SJ, Song YD, Kim SK. Continuous improvements of a clinical pathway increased its feasibility and improved care providers’ perception in tka. Knee Surg Relat Res. 2014;26(4):199–206.
Kementerian Kesehatan Republik Indonesia. Standar Akreditasi Rumah Sakit Berdasarkan KMK 1128. Keputusan Menteri Kesehatan. 2022;1–342.
Rozany F, Yuliansyah N, J Susilo S. Panduan Praktek Klinis dan Clinical Pathway Sebagai Solusi Efisiensi Pembiayaan Diagnosa Hernia Inguinalis, Appendisitis, dan Sectio Caesarea di RSI Gondanglegi. Jurnal Medicoeticolegal dan Manajemen Rumah Sakit. 2017;6(2):122–8.
Fushen F, Tj HW, Lie S. Challenges in the Implementation of Clinical Pathway: a Qualitative Study At Private Hospital in Jakarta. JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit). 2022;11(1):LAYOUTING.
Kementerian Kesehatan Republik Indonesia. Indikator Nasional Mutu Pelayanan Kesehatan Tempat Praktik Mandiri Dokter dan Dokter Gigi, Klinik, Pusat Kesehatan Masyarakat, Rumah Sakit, Laboratorium Kesehatan, dan Unit Transfusi Darah. Keputusan Menteri Kesehatan. 2022;89–91.
Anggara C, Arini M, Jennie IM, Administrasi M, Sakit R, Yogyakarta UM, et al. Evaluasi Implementasi Clinical Pathway DHF Anak Pada RS Tipe D Di Yogyakarta. Jambura Journal of Health Sciences and Research. 2021;3(2):226–40.
Vanhaecht K, De Witte K, Depreitere R, Sermeus W. Clinical pathway audit tools: A systematic review. J Nurs Manag. 2006;14(7):529–37.
Whittle CL, Mcdonald PS, Dunn L, de Luc K. Developing the integrated care pathway appraisal tool (ICPAT): A pilot study. Int J Care Pathw. 2004;8(2):77–81.
Whittle C. ICPAT: Integrated care pathways appraisal tool. Int J Care Pathw. 2009;13(2):75–7.
Menteri Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Infeksi Dengue Anak dan Remaja. Pedoman nasional pelayanan kedokteran. 2021;67(MENTERI KESEHATAN):1–67.
Kementerian Kesehatan RI. Pedoman Pencegahan Dan Pengendalian Demam Berdarah Dengue Di Indonesia. Pedoman pencegahan dan pengendalian demam berdarah di indonesia. 2017;5:1–128.
Peraturan Menteri Kesehatan Republik Indonesia Nomor 1501/Menkes/Per/X/2010. 2011;2008:1–30.
Kementerian Kesehatan RI. Profil Kesehatan Indonesia 2021. Pusdatin.Kemenkes.Go.Id. 2022. Kementrian Kesehatan Republik Indonesia.
Helzainka AA. Challenges in the Implementation of Clinical Pathway in Indonesia: A Systematic Review. Cermin Dunia Kedokteran. 2021;48(7):430–4.
Mater W, Aldwairi M, Ibrahim R. Enhanced Teamwork Communication Model for Electronic Clinical Pathways in Healthcare. Open Bioinforma J. 2018;11(1):140–63.
Romeyke T, Stummer H. Clinical pathways as instruments for risk and cost management in hospitals - a discussion paper. Glob J Health Sci. 2012;4(2):50–9.
Kementerian Kesehatan RI. PMK NO. 1438/MENKES/PER/IX/2010. 2010;132(464):140–5.
Buchert AR. Clinical Pathways, Driving High-Reliability and High-Value Care. Pediatric Clinics of NA. 2016;63(2):317–28.
Firmanda D. Clinical Pathways Kesehatan Anak. Sari Pediatri. 2016;8(3):195.
Dharmanegara IBA. Pengembangan Kompetensi Sumber Daya Manusia Pada Universitas Warmadewa Dalam Rangka Penguatan Daya Saing Perguruan Tinggi di Masa Depan. WICAKSANA: Jurnal Lingkungan dan Pembangunan. 2019;3(2):61–70.
Firmansyah A, Mahardhika BW. Pengantar Manajemen. Yogyakarta: Deepublish; 2018.
Kementrian Kesehatan RI. UU no. 44 Tahun 2009 Tentang RS. Undang-Undang Republik Indonesia. 2009;1:41.
World Health Organization. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. WHO. WHO; 2011.
Paat C, Kristanto E, Kalalo FP. Analisis Pelaksanaan Clinical Pathway di RSUP Prof. Dr. RD Kandou Manado. Jurnal Biomedik: JBM. 2017;9(1).
Wardhana A, Rahayu S, Triguno A. Implementasi Clinical Pathway Tahun 2018 dalam Upaya Meningkatkan Mutu Pelayanan di Rumah Sakit Umum Daerah Koja. Majalah Sainstekes. 2019 Jun 30;6(1).
Astuti YD, Dewi A, Arini M. Evaluasi implementasi clinical pathway sectio caesarea di RSUD Panembahan Senopati Bantul. JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit). 2017;6(2):95-106.
Septiani AC, Arini M, Dewi A. Evaluasi Implementasi Clinical Pathway Pneumonia di Ruang Bangsal Anak RSUD Panembahan Senopati Bantul. InProsiding Interdisciplinary Postgraduate Student Conference 3rd Program Pascasarjana Universitas Muhammadiyah Yogyakarta (PPs UMY) 2016 (Vol. 10).
Puspita W, Taslim Pinzon R, Djasri H. EVALUASI PELAKSANAAN CLINICAL PATHWAY KASUS DIABETES MELLITUS DI RUMAH SAKIT UMUM DAERAH Dr. SOETOMO SURABAYA [Internet]. Available from: http://etd.repository.ugm.ac.id/
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