Kettering Hospital says it is working to eliminate risks highlighted in a report by a national watchdog.

The Care Quality Commission (CQC) regulator has claimed the trust is one of 20 hospitals in the second of six bands ranked by the risk caused to patients.

Band one includes those hospitals deemed by the CQC to be the highest risk and which it says do not offer safe and good-quality care to patients. Northampton General Hospital is one of 24 trusts in that band.

Among the risks identified at Kettering Hospital were cancelled operations, aftercare of hip fracture patients and the hospital’s governance.

The hospital was also marked down after a “never event”, a serious procedural incident, took place this year.

Kettering Hospital’s chief operating officer, Sue Watkinson, said the hospital had already addressed many of the risks highlighted by the CQC.

She added: “We welcome this new initiative to provide a comprehensive and up-to-date system that monitors the many different activities, and potential risks, that modern hospitals have to manage.

“Overall the CQC found no evidence of risk at KGH for 150 indicators covering a very wide range of hospital activity including compassionate care, mortality, infections, discharge, overall experience and waiting times.

“Maintaining high standards of care and clinical safety are our top priority and, in addition to these external checks, we have a very robust internal safety and quality system.

“Our internal system recently attracted national attention for the way we monitor a wide range of patient experience and safety indicators using modern technology so that we are alerted to any concerns and can act on them immediately.

“The new CQC system has highlighted some risks for us to tackle – most of which we were already working on, and some of which are looking in to.”

She also said two of the risks highlighted by the CQC regarding stroke care no longer applied to Kettering because services had been transferred to the county’s acute stroke centre at Northampton General Hospital.

Source: northantstelegraph.co.uk

A quarter of hospital trusts in England are at raised risk of providing poor care, a review by the regulator shows.

The findings are based on monitoring by the Care Quality Commission (CQC) of a host of data, including death rates, serious errors and patient surveys.

It found 44 out of 161 trusts fell into the two highest risk categories.

The exercise has been carried out as part of the regulator’s new hospital inspection regime, which will see inspectors go into every trust by 2015.

The first inspections got under way in September and by Christmas the first 18 will have been completed.

It will result in every trust being given a rating of either ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’ as part of a shake-up in the system ordered after the Stafford Hospital scandal.

How the highest risk trusts compare

Health Foundation chief executive Dr Jennifer Dixon, who is also a CQC board member, said: “It makes sense to use the wealth of routinely available data in the NHS to try to spot patterns which might identify or predict poor quality care for patients.

“The intelligent monitoring tool can never by itself be a crystal ball, but it is a great start and will surely develop over time.”

Dr Mark Porter, head of the British Medical Association, said publishing the data was an “important step” towards improving transparency across the NHS, informing and empowering patients and identifying under-performing hospitals.

But he added: “Hospitals are large, complex organisations so we need to avoid oversimplifying or reducing vast amounts of data to a simple band or rating.”

Labour Shadow Health Minister Jamie Reed said: “David Cameron should be ashamed that he’s put so many of England’s hospitals in this position.

“He siphoned £3bn out of the NHS front-line to blow on a back-office re-organisation nobody voted for. Hospitals were left on a financial knife-edge and they are clearly struggling to maintain standards of patient care after more than three years of chaos.”

But Health Secretary Jeremy Hunt said: “Sadly, under the last government, a lack of transparency about poor care meant problems went unchecked for too long, some times with tragic consequences for patients.

“This government is being honest with the public about the quality of care at their local hospitals, and taking tough action where standards aren’t up to scratch. Patients and staff deserve nothing less.”

Source: bbc.co.uk

JAKARTA – Mayapada Group melalui Mayapada Healthcare Group meresmikan Mayapada Hospital Jakarta Selatan rumah sakit modern bertaraf internasional yang terletak di Jalan Lebak Bulus Cilandak, Jakarta Selatan.

Dalam peresmian tersebut, tampak hadir beberapa menteri kabinet bersatu jilid II, salah satunya Menteri Badan Usaha Milik Negara (BUMN) Dahlan Iskan.

Namun dalam kehadiran kali ini, Dahlan tidak seperti biasa menggunakan pakaian khas dengan kemeja putih serta sepatu kets berwarna putih Demi Indonesia (DI). Kali ini mantan Direktur Utama PLN ini memakai jas hitam dengan kemeja putih serta sepatu pantovel dan kaus kaki putih.

Namun dibalik gaya flamboyannya, apa tanggapan Dahlan atas peluncuran rumah sakit ini?

“Hebat, bagus yah, saya kan orang Surabaya, jadi saya kenal lama dengan beliau karena sama-sama orang Surabaya,” ungkap Dahlan kepada Okezone saat ditemui di Mayapada Hospital, Jakarta, Kamis (24/10/2013).

Menurut Dahlan, sosok Chairman Mayapada Group, Tahir merupakan orang yang sangat bekerja keras, gigih.

“Makanya sekarang beliau menjadi konglomerat,” ucapnya.

Rumah sakit ini berdiri diatas tanah seluas 3,8 hektar dengan gedung setinggi 10 lantai dengan menghabiskan dana investasi sebesar Rp1,5 triliun.

Chairman Mayapada Group, Tahir mengatakan, membangun rumah sakit ini sebagai bentuk dedikasi tinggi Mayapada Healthcare Group kepada bangsa Indonesia dalam memberikan layanan kesehatan yang lebih baik.

“Hidup secara sehat adalah landasan utama selama di dunia, untuk itu kami ingin memberikan karya terbaik bagi bangsa ini melalui kesehatan,” ungkap Tahir. (kie) (wdi)

Sumber: okezone.com

Jakarta, Seruu.com – Anggota Komisi IX DPR RI, Rieke Diah Pitaloka geram dengan masih adanya komersialisasi dan perlakuan diskriminatif terhadap pasien yang dilakukan oleh Rumah Sakit milik pemerintah.

Hal tersebut terjadi saat istri dari Uchok Sky Khadafi, Direktur Forum Indonesia untuk Transparansi Anggaran (FITRA) yang menderita kanker payudara, stadium 4 dan membutuhkan pelayanan Kemotherapi di RS Dharmais.

Istri Uchok adalah pemegang kartu Jamkesmas dan sudah melakukan pendaftaran dari tanggal 17 Oktober lalu dan harus dikemoterapi tanggal 21 Oktober, tapi pihak RS Dharmais mengatakan tidak ada kamar hingga hari ini, Kamis (24/10/2013).

Ketika Rieke menyampaikan permasalahan tersebut kepada Dirjen BUK Kemenkes, pihak yang bersangkutan memberikan jawaban via SMS:

“Ya Bu, saat ini waiting list untuk khemo di RS DHARMAIS ada 103 orang. Dirut sedang membuka ruangan baru agar bisa mengatasi problem antrian. Semoga cepat bisa diatasi. Salam”

Tentu, lanjut politisi PDI Perjuangan ini, jawaban tersebut bukan sebuah solusi. Pasalnya, berdasarkan informasi dari sang suami pasien, Uchok ada pasien yang daftar tanggal 22 Oktober dan tanggal 23 Oktober langsung bisa mendapatkan pelayanan kemoterapi.

“Biaya kemoterapi bisa puluhan juta,” kata Rieke saat ditemui Seruu.com di Gedung DPR RI, Jakarta (24/10/2013).

Rieke melihat, ada indikasi “permainan menyogok bagian pendaftaran jika ingin cepat “dilayani”. Karenanya, Rieke mendesak agar pihak RS Dharmais sebagai rumah sakit negara di bawah Kemenkes yang didanai APBN, agar memberikan pelayanan pada para pasien.

“Jangan mendiskriminasi pasien,” tegasnya.

Selain itu, Rieke juga mendesak agar Dirut RS Dharmais mengevaluasi karyawan yang berindikasi “memeras pasien”. Apabila Dirut tidak mampu menyelesaikan persoalan-persoalan seperti ini, dirinya akan mendesak agar Kemenkes mencopot Dirut RS Dharmais

“Demikian pernyataan ini saya buat, untuk menghentikan komersialisasi kesehatan yang mengorbankan nyawa rakyat,” tandasnya. [Cesare]

Sumber: seruu.com

Patients newly colonized with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of clinical MRSA infection. At present, there are limited data on the duration or magnitude of this risk in a hospital population with a known time of MRSA acquisition.

Balm, et al. (2013) reported on a retrospective cohort study of 909 adult patients known to have newly identified MRSA colonization during admission to National University Hospital, Singapore that was undertaken between July 1, 2007 and June 30, 2011. Patients were excluded if they had history of previous MRSA colonization or infection, or if they had been a hospital inpatient in the preceding 12 months. Data were collected on the development of MRSA infection requiring hospitalization up to June 30, 2012.

Of 840 patients newly colonized with MRSA as identified on active surveillance and not clinical specimens, 546 were men (65.0 percent) and the median age was 65 years (range 18-103 years). Median follow up was 24 months (range 0-64 months, 85.1 percent followed >6 months). Clinical infection occurred in 121 patients (14.4 percent) with median time to infection of 22 days (95 percent CI 14-31). Overall 71.9 percent (87/121) of infected patients developed infection within 60 days of the date MRSA colonization was detected. However, 17/121 patients (14.0 percent) developed clinical infection more than six months after documented MRSA acquisition. The most common sites of clinical infection were skin and soft tissue (49/121, 40.5 percent, 95 percent CI 31.7-49.8), respiratory tract (37/121, 30.6 percent, 95 percent CI 22.5-39.6) and bone and joint infections (14/121, 11.6 percent, 95 percent CI 6.5-18.7). Thirteen patients (13/121, 10.7 percent, 95 percent CI 5.8-17.7) had bacteremias, of which six (5.0 percent 95 percent CI 1.8-10.5) were primary and seven (5.7 percent, 95 percent CI 2.3-11.6) were secondary to infection at other sites. Crude mortality at 30 days and six months was higher in patients with MRSA infection than colonization alone (aOR 5.49, 95 percent CI 2.75-10.95, p<0.001 and aOR 2.94, 95 percent CI 1.78-4.85, p<0.001 respectively).

The researchers concluded that risk of clinical infection is highest soon after MRSA acquisition and say that prevention of MRSA acquisition in the hospital will have significant impact on morbidity and mortality for patients. Their research was published in BMC Infectious Diseases.

Reference: Balm MND, Lover AA, Salmon S, Tambyah PA and Fisher DA. Progression from new methicillin-resistant Staphylococcus aureus colonization to infection: an observational study in a hospital cohort. BMC Infectious Diseases 2013, 13:491 doi:10.1186/1471-2334-13-491

Source: infectioncontroltoday.com

Meski pelayanan di Rumah Sakit Umum Daerah (RSUD) Tarakan, Jakarta Pusat, telah mengalami peningkatan. Namun, ada saja masyarakat yang kurang puas dengan pelayanan yang diberikan. Termasuk adanya keluhan terkait pembatasan obat yang disampaikan langsung masyarakat kepada Gubernur DKI Jakarta, Joko Widodo, saat ia berkunjung ke rumah sakit tersebut.

Kepada pasien, Jokowi mengatakan, sebenarnya tidak ada pembatasan-pembatasan seperti itu. Meski begitu, pasien memang tidak bisa memilih obat untuk pengobatannya.

“Tidak ada seperti itu (pembatasan), tapi memang tidak boleh memilih obatnya, harus sesuai dengan formularium (daftar obat). Karena sudah ada standarnya, kita punya aturannya,” kata Jokowi kepada seorang ibu, di RSUD Tarakan, Rabu (23/10).

Dikatakan Jokowi, untuk pemberian obat kepada pasien adalah kewenangan dokter yang menanganinya. Namun, tetap sesuai dengan penyakit yang diderita oleh pasien. “Tergantung dokter kasih apa, kalau butuhnya berapa tapi dikasihnya berapa nanti tidak sembuh-sembuh dong,” tegasnya.

Kendati mendapat keluhan dari pasien, Jokowi tetap menilai pelayanan kesehatan di RSUD Tarakan sudah meningkat dibandingkan dengan sebelumnya. Terlebih jumlah pasein sudah menurun dibandingkan dengan awal penerapan program Kartu Jakarta Sehat (KJS). “Tadi itu kita cuma cek saja pelayanannya seperti apa, ternyata sekarang sudah mulai menurun (antrean pasien),” kata Jokowi.

Diakui Jokowi program KJS menimbulkan euforia pada bulan pertama hingga bulan keenam pada awal peluncurannya, sehingga pasien membludak di setiap RSUD. Tapi saat ini kondisinya sudah mulai normal. “Kalau pertama-pertama itu kan karena bertahun-tahun bertumpuk-tumpuk semua ke rumah sakit. Kita mau menunjukkan bahwa yang penting adalah sistem dan kebijakan itu bisa diakses dengan mudah di masyarakat,” tandasnya.

Sumber: beritajakarta.com

Jakarta, InfoPublik – Ketetapan berlakunya jaminan kesehatan oleh Badan Pengelola Jaminan Sosial (BPJS) Kesehatan mulai 2014 terhadap seluruh rakyat Indonesia, hendaknya diikuti kesiapan puskesmas dan rumah sakit.

“Kalau tidak disertai dukungan sarana, prasarana maupun tenaga medisnya tentu akan menimbulkan masalah baru, karena puskesmas dan rumah sakit belum siap, sehingga memungkinkan adanya penumpukan warga yang berobat lantaran tenaga medis masih terbatas,” kata anggota Komisi IX DPR Zuber Safawi di Jakarta, Selasa (22/10).

Zuber menilai, dukungan anggaran perlu ditingkatkan agar sarana dan prasarana puskesmas dan rumah sakit dapat meningkat. Saat ini baru sekitar 1,9 hingga 2 persen dari APBN. “Semestinya anggaran yang ideal untuk kesehatan adalah 5 persen dari APBN.”

Keberadaan BPJS kesehatan menurutnya sangat dibutuhkan oleh masyarakat, sehingga kalau sakit mereka tidak bingung lagi mau berobat kemana.

Program BPJS Kesehatan harus lebih menjangkau seluruh masyarakat Indonesia, sehingga kerjasamanya pun perlu lebih luas, yakni rumah sakit daerah milik pemerintah maupun swasta.

Kepesertaan BPJS Kesehatan harus lebih dipahami oleh masyarakat. Kalau seseorang sudah menjadi peserta Askes berarti cukup mendatangi kantor Askes dengan mendaftar kembali menjagi anggota BPJS Kesehatan. Sementara bagi swasta didaftarkan oleh kantornya dan iuran dibayar oleh perusahan.

Adapun masyarakat yang tidak bekerja dan keluarga miskin dapat mendaftar langsung dan iuranya dibayarkan oleh negara, tapi bagi yang mampu iuran dibayar sendiri setiap bulannya.

Sumber: kominfo.go.id

YOGYAKARTA – Hasil audit investigasi Badan Pengawas Keuangan dan Pembangunan (BPKP) Perwakilan DIY dalam kasus dugaan korupsi pengadaan alat kesehatan (alkes) Rumah Sakit Jogja belum juga keluar.

Padahal, hasil audit itu sangat dibutuhkan Kejaksaan Tinggi (Kejati) DIY untuk menyelesaikan proses penyidikan. Penyidik Kejati meminta bantuan BPKP untuk mengaudit proyek pengadaan alkes RS Jogja pada 2012 lalu. Proyek yang memakai dana APBN Rp4,5 miliar ini, Kejati DIY menduga ada penyimpangan hingga keuangan negara merugi.

“Hasil audit belum keluar, kami masih menunggu hasil audit dan bisa diketahui berapa jumlah pasti kerugian negaranya,” ucap Asisten Bidang Tindak Pidana Khusus Kejati DIY Pindo Kartikani kepada wartawan, kemarin. Pengajuan bantuan audit sudah diajukan Kejati ke BPKP sejak beberapa bulan lalu. Tim penyidik berharap hasil audit segera rampung. “Semoga cepat rampung.”

Dalam kasus ini, Kejati DIY menetapkan dua orang yang diduga kuat bertanggung jawab dalam dugaan penyimpangan pengadaan alkes. Yakni, Pejabat Pembuat Komitmen (PPK) Bambang Suparyono dan pihak rekanan CV Jogja Mitra Solusindo Johan Hendarman. Sejauh ini, tim penyidik telah memeriksa puluhan saksi baik itu dari rumah sakit yang dulu bernama RSUD Wirosaban, pihak rekanan, Pemkot Yogyakarta, dan beberapa saksi ahli.

Bahkan, dua tersangka juga telah dimintai keterangannya. Terpisah, Jogja Corruption Watch (JCW) mendesak BPKP segera menuntaskan audit agar penanganan kasus bisa tuntas. “Jangan berlama-lama lagi, memang audit harus dilakukan secara teliti dan cermat. Tetapi jangan berlama-lama, agar kasus ini segera rampung,” kata Divisi Pengaduan Masyarakat JCW Baharudin Kamba.

Selain itu, JCW juga mendesak Kejati DIY segera menahan kedua tersangka. Karena hasil penyidikan selama ini telah menemukan bukti-bukti adanya dugaan penyimpangan dalam proses pengadaan alkes Rumah Sakit Jogja. ● ristu hanafi

Sumber: koran-sindo.com

The use of telemonitoring to remotely support patients with managing COPD did not reduce their risk of being admitted to hospital with an acute exacerbation, according to the authors of a one-year randomised study.

Patients receiving the telemonitoring intervention were just as likely to end up in hospital as a result of an exacerbation as those who were not remotely monitored, despite having many more telephone consultations and home visits and the approach is unlikely to be cost-effective, the researchers found.

The findings come as GPs face concerns over the cost of setting up the government’s new DES for remote telemonitoring and add further doubts over the benefits of the approach for people with long-term conditions such as COPD, after the government-backed Whole Systems Demonstrator (WSD) trial found telemonitoring was not cost-effective.

Moreover, the authors said their findings suggest the benefits of telemonitoring seen in WSD – in which the remote monitoring did cut admissions and mortality in people with long-term conditions – are likely down to ‘enhancement of the underpinning clinical service’ rather than telemonitoring itself.

They concluded telemonitoring ‘is unlikely to reduce admissions unless it is a means of enhancing clinical services’.

The study, published in the BMJ, included 256 patients registered with practices in Lothian, all of whom had a recent history of being admitted to hospital for an acute exacerbation of COPD.

All participants received the usual clinical care provided in their region, including self-management advice, but the half assigned to telemonitoring also submitted daily recordings of their symptoms, treatment and oxygen saturation levels for remote monitoring by the supporting clinical team.

The median time from the beginning of the study until the first hospital admission with an exacerbation did differ between patient groups, at 362 days in those using the telemonitoring and 361 days in the control group.

The mean number of admissions was also similar, with 1.2 admissions per person in the telemonitoring arm and 1.1 in the control arm, as was the mean length of stay in hospital.

Telemonitoring failed to improve patients’ health-related quality of life, with similar changes recorded on the St George’s respiratory questionnaire in each group, and was associated with a slight, albeit non-significant, increase in self-reported exacerbations, in which patients needed to take antibiotics or steroids.

The telemonitoring group also needed significantly more home visits, including 113 as a result of telemonitoring alerts – working out at around 25 contacts per patient over the year, or one contact every two weeks – as well as another five telephone and eight home contacts per patient, compared with four telephone and seven home contacts over the year in the control group.

The authors concluded: ‘Integration of telemonitoring into existing clinical services – such that both intervention and control groups had access to the same clinical care – had no effect on delaying time to a hospital admission, and had a substantial impact on workload.

‘The positive effect of telemonitoring seen in previous trials could thus be due to enhancement of the underpinning clinical service rather than the telemonitoring communication. Specific developments that could improve the performace of telemonitoring in COPD in the future include the validation of measures and algorithms that can predict potentially serious exacerbations more reliably, and an understanding of clinical contexts in which telemonitoring is most effective.

‘In the meantime, long-term telemonitoring of people with COPD is unlikely to reduce admissions unless it is a means of enhancing clinical services.’

Source: pulsetoday.co.uk

The mortality figures as they are currently calculated for Dutch hospitals are not a good measure for the quality of the health care they provide.

The picture of hospitals with the lowest intramural mortality figures can look less favourable when the number of patients who die shortly after having been discharged from the hospital is taken into consideration as well. This was shown in a study conducted by University Medical Center Utrecht and Erasmus Medical Center in the Netherlands, which was published today in the leading medical publication the British Medical Journal. The researchers recommended that post-discharge mortality figures should be incorporated into official mortality figures.

The study showed that hospitals with low intramural mortality have relatively high mortality levels after discharge and vice versa. This is why, based on the 30-day mortality (deaths that occur within the first 30 days after hospital admission, irrespective of the place of death), many hospitals have a different so-called ‘Hospital Standardized Mortality Ratio’ (HSMR) than that based on hospital mortality (deaths that occur during the hospital stay). The absolute differences in the HSMR between hospitals are also smaller when the new calculation method is used.

“A lower HSMR, which is currently being interpreted as a rough indication for a good quality of care, may partially be the result of a shorter hospital stay and a relatively higher mortality rate after discharge. A hospital’s responsibility doesn’t stop after the patient has been discharged. This is why it is important that mortality shortly after the discharge is incorporated when calculating the HSMR”, says Prof. Cor Kalkman, Professor of Anaesthesiology at UMC Utrecht and co-author of the BMJ publication.

A measure of the quality of care

The HSMR is a standard used to express mortality in hospitals. The HSMR is published annually and is presented as an important measure for the quality of care. Currently, only patients that die while in hospital are included in the calculation of the HSMR. For example: a patient undergoing a hip operation is discharged from hospital A after three days. That same patient might be discharged from hospital B after five days. If this patient would die on day four, the death would not be counted in hospital A but it would be included in hospital B. This difference between the method of recording data results is an unfair comparison between the quality of care in the hospitals in question.

Deaths within 30 days after discharge should be included

The study used the Municipal Personal Records Database to be able to continue monitoring patients even after their discharge from the hospital. This has made it possible to include all deaths within 30 days after admission in the calculation of the HSMR, irrespective of the place of death.

According to the researchers, the HSMR has other limitations as a measure for the quality of care as well. For example, the adjustment made for the patient’s health status at the time of their hospital admission is limited. Furthermore, a single number as a measure of quality for an entire hospital is difficult to interpret: patients don’t know how the hospital performs with respect to their specific condition.

The study was subsidised by a grant from the Ministry of Health, Welfare and Sport. The study data was collected by the Dutch Hospital Data Foundation (on behalf of the Dutch Association of Hospitals and the Dutch Federation of University Medical Centres) and Statistics Netherlands.

Source: european-hospital.com