QUALITY ASSURANCE DAN PERFORMANCE IMPROVEMENT (2 SKS ) : Topik 4 : Peningkatan praktik klinik dan analisis akar masalah TUJUAN INSTRUKSIONAL MATERI PERKULIAHAN

TUJUAN INSTRUKSIONAL UMUM Setelah selesai mengikuti perkuliahan ini diharapkan mahasiswa dapat mengetahui ruang lingkup dan tujuan mata ajar Peningkatan praktik klinik dan analisis akar masalah Klik di sini untuk melanjutkan

TUJUAN INSTRUKSIONAL KHUSUS Mahasiswa dapat menyebutkan Peningkatan praktik klinik dan analisis akar masalah Mahasiswa dapat menguraikan Peningkatan praktik klinik dan analisis akar masalah Mahasiswa dapat menggambarkan Peningkatan praktik klinik dan analisis akar masalah Klik di sini untuk melanjutkan

Ny. Rokiah Kusumapradja Peningkatan praktik klinik dan analisis akar masalah (CLINICAL PRACTICE IMPROVEMENT AND ROOT CAUSE ANALYSIS ) Ny. Rokiah Kusumapradja

KUALITAS DALAM PELAYANAN KESEHATAN DEFINISI : “DOING THE RIGHT THING, THE FIRST TIME, IN THE RIGHT WAY, AT THE RIGHT TIME” PELAYANAN KESEHATAN DAN KLINISI BERKEWAJIBAN MEMBERIKAN KUALITAS PEL. SECARA EFEKTIF DAN MENJAMIN BAHWA PELAYANAN YANG DIBERIKAN : AMAN, EFEKTIF, MEMADAI, FOCUS PD PASIEN, MUDAH DIJANGKAU, DAN EFISIEN.

STRATEGI PENCAPAIAN PELAYANAN BERKUALITAS : MEMFASILITASI MONITORING INSIDEN MONITORING SENTINEL EVENT MENGGUNAKAN INDIKATOR KLINIK SECARA EFEKTIF PEER REVIEW MEETING MORBIDITY AND MORTALITY MEETING AD HOC AUDITS RETROSPECTIVE CHART REVIEW

2 PENDEKATAN : CLINICAL PRACTICE IMPROVEMENT (CPI) CLINICAL PRACTICE IMPROVEMENT (CPI) MENJELASKAN MODEL YANG DIGUNAKAN UNTUK MENINGKATKAN PROSES ASUHAN DAN PEMBERIAN PELAYANAN QUALITY IMPROMENT TOOLS AND TECHNIQUES  SUATU PETUNJUK DALAM MEMILIH DAN MENGGUNAKAN ALAT DAN TEHNIK YANG TEPAT UNTUK BERBAGAI TAHAPAN PROSES PENINGKATAN 2. ROOT CAUSE ANALYSIS ( RCA)

CLINICAL PRACTICE IMPROVEMENT AND ROOT CAUSE ANALYSIS (JCAHO,2003) Single incident, sentinel event or near miss identified If SAC = 1 -Do RCA A team is assessbled RCA undertaken Determine sequence of events Identify causal factors, Select root causes Action and recommendations Made to management Implementation / Change occur Lessons learnt System issue Assesment against the Safety assesst code(SAC) If a criminal or Intentionally unsafe Act, substance related Or abuse = performance review Determine the Significance Of the event Collect The facts Bring together The people who have the knowledge Understand The event To ensure Investi gation accuracy Identify the Factors that Contributed To the event Ensure Recommended Action address To causes Ensure corrective Action plan is implemented Evaluate Effectiveness Of actions Aggregate, complex or Validation data obtained from incidents, indicators, Peer review and complaints Form Guidance team Form project team Develop Aims statement Evidence needed to Diagnose problem Organize and prioritise information Decide on intervention Small test PDSA cycles Sustain the gains And evaluation Ensure action achieve the desired result Process flow chart  Customer focus groups Brainstorming /tally chart cause & effect diagram  Afinity diagram Pareto diagram,Graphs  Run chart or SPC chart Measure impact Implement the changes Annotated run chart SPC Chart  Other graphs  Standardisation  Documentation  Measurement  training 1. The project 2. Diagnostic phase 3. Inter vention 4. Im pact 5. Sustai ning improv Select Appropriate 1. The plan 2. do 3. study 4. act

Assesment against the Safety Single incident, sentinel event or near miss identified If a criminal or Intentionally unsafe Act, substance related Or abuse = performance review System issue Assesment against the Safety assesst code(SAC) Determine the Significance Of the event 1. The plan If SAC = 1 -Do RCA Collect The facts Bring together The people who have the knowledge A team is assessbled Select Appropriateteam RCA undertaken Determine sequence of events Understand The event To ensure Investi gation accuracy 2. do Identify causal factors, Select root causes Identify the Factors that Contributed To the event Action and recommendations Made to management 3. study Ensure action achieve the desired result Ensure Recommended Action address To causes Implementation / Change occur Ensure corrective Action plan is implemented 4. act Lessons learnt Evaluate Effectiveness Of actions

Customer focus groups Brainstorming /tally chart Aggregate, complex or Validation data obtained from incidents, indicators, Peer review and complaints 1. The project Form project team Form Guidance team Develop Aims statement Process flow chart  Customer focus groups Brainstorming /tally chart Collect Evidence needed to Diagnose problem 2. Diagnostic phase Organize and prioritise information cause & effect diagram  Afinity diagram Pareto diagram,Graphs  Run chart or SPC chart Decide on intervention 3. Inter vention Small test PDSA cycles Annotated run chart SPC Chart  Other graphs  5. Sustai improv ning Measure impact Implement the changes 4. Im pact Standardisation  Documentation  Measurement  training Sustain the gains And evaluation

Clinical practice improvement model What are we trying to accomplish ? How will we know that a change is an improvement ? What changes can we make that will result in an improvement ? PLAN Plan The Change That to be trialed ACT Implement the Change that have Been proven to Be effective STUDY Evaluate the Impact of the trial DO Conduct a trial Of the proposed change

5 TAHAP PROSES PENINGKATAN ( THE IMPROVEMENT PROCESS ) 1. PROJECT PHASE 5. SUSTAINING IMPROVEMENT PHASE 2. DIAGNOSTIC PHASE 3. IMPACT PHASE p S D A 3. INTERVENTION PHASE p S D A p S D A p S D A p S D A

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