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

HEALTH chiefs have unveiled plans to improve access to health and social care services closer to home as part of efforts to reduce demand on hospitals.

Officials from the GP-led NHS Scarborough and Ryedale Clinical Commissioning Group (CCG), working with North Yorkshire County Council and other NHS organisations, say the programme involves a series of projects to improve access to care in the community.

Its focus will be on elderly patients and those with long-term conditions including respiratory disease, diabetes and heart problems.

Patients with a high risk of being admitted to hospital will be given packages of care to prevent their condition deteriorating, allowing them to stay at home.

Teams of health and social care staff will work together to devise the plans, while evening services until 10pm for people with urgent care needs will be stepped up to also prevent hospital admissions.

Individual support will be offered to people leaving hospital to help them settle back to life at home.

Patients with the respiratory condition chronic obstructive pulmonary disease, asthma and heart failure will be helped to better use their medicines and health trainers will give people with long-term conditions one-to-one support.

Better links with care homes will also be created through the appointment of dedicated nurses to support patients.

GP Phil Garnett, chairman of the CCG, said: “This programme of work is a really positive step forward for patient care in the area.

“It’s important, now more than ever, that we look at how we can better support patients in the community and avoid the risk of them needing hospital treatment – particularly as the number of elderly people living in the area is on the rise and in light of the pressures on our A&E departments.

“Our ageing population, which will see the number of over 65s increase by 30 per cent by 2021, will bring real challenges for NHS and social care organisations as demand for services increases.”

Coun Clare Wood, executive member for health and adult services at North Yorkshire County Council, said: “It is the goal of both organisations to improve how care is delivered to people through better integration of health and social care services.

“These programmes aim to reduce duplication and provide more streamlined and co-ordinated health and social care which
is designed around people’s needs.”

Source: yorkshirepost.co.uk

Chase Farm Hospital has opened an urgent care centre to treat people with non life threatening injuries.

Urgent care centres now open at the Enfield hospital and at Barnet Hospital will help to take pressure off accident and emergency units.

Staffed by doctors, they will treat broken bones, minor head injuries, bad sprains or strains and eye injuries.

The Enfield centre will run alongside the existing A&E at Chase Farm in The Ridgeway, which is due to close next month following a decision by the Clinical Commissioning Group.

Cathy Geddes, director of clinical strategy at Barnet and Chase Farm Hospitals NHS Trust, said: “The opening of these centres shows there is a determination to provide the very best services possible for everyone living in the area. There is no need to book an appointment, people can simply turn up and will be seen by either a doctor or nurse.

“However, they are for patients with urgent care needs. Those who attend A&E or the new urgent care centres with minor illnesses or injuries will be sent back to their GPs or an appointment made for them. The centres are part of a raft of changes aimed at ensuring people in the area receive the right treatment at the right place and the right time.”

It was revealed that more than 40 per cent of patients who go to either hospital’s A&E departments do not need emergency care, but can be treated in an urgent care centre.

An assessment will be carried out and patients can be transferred to a local A&E department if necessary.

There will be a GP out-of-hours service available when the urgent care centres are closed, which can be contacted by calling 111.

Enfield Borough Council has since opted to take legal action against the proposed closure of Chase Farm A&E.

Source: enfieldindependent.co.uk

Upaya itu dilakukan untuk mendukung target RSUD dr Murjani Sampit mengejar akreditasi versi 2012 pada 2014 nanti

SAMPIT, Jaringnews.com – Rumah Sakit dr Murjani Sampit, Kabupaten Kotawaringin Timur (Kotim) Kalimantan Tengah mengancam akan memotong insentif pegawai rumah sakit setempat jika tidak menjalankan prosedur pelayanan, salah satunya adalah mencuci tangan. Juga termasuk untuk insentif para dokter yang bertugas di rumah sakit itu.

“Tim TKPRS (tim keselamatan pasien rumah sakit) akan melakukan pembinaan. Kami juga sedang membuat sistem renumenerasi, apabila tidak dilakukan maka akan dipotong jasa pelayanan sebagai penilaiannya,” kata Direktur RSUD dr Murjani Sampit, dr Yuendri Irawanto di Sampit, Senin (21/10).

Kewajiban cuci tangan sebelum dan sesudah memberikan pelayanan kepada pasien, hanyalah sebagian kecil prosedur tetap yang kini harus benar-benar dijalankan oleh seluruh pegawai di rumah sakit itu. Langkah itu merupakan bagian upaya untuk meningkatkan pelayanan dan menjamin keselamatan pasien.

Dituturkan Yuendri, semua upaya itu dilakukan untuk mendukung target rumah sakit ini mengejar akreditasi versi 2012 pada 2014 nanti. Pihak rumah sakit menargetkan bisa meraih akreditasi Utama, atau paling tidak bisa mendapatkan akreditasi Madya.

Ada 15 buku terkait prosedur tetap yang dibuat pihak rumah sakit dan harus dijalankan dengan disiplin oleh seluruh pegawai. Mengingat, penilaian akreditasi dilakukan secara menyeluruh dan tim penilai akan langsung mengevaluasi di lapangan, termasuk mengonfirmasi kepada pasien apakah benar mendapatkan pelayanan maksimal yang dijanjikan.

“Ini upaya untuk meningkatkan pelayanan kepada pasien. Dengan pasien selamat, kualitas pelayanan kita jadi tinggi. Selain itu rumah sakit bisa menciptakan hal ini agar tidak ada “bonus” penyakit dari rumah sakit. Ini sederhana tapi penting sekali, termasuk dalam hal cuci tangan, jangan sampai terjadi penularan dari tangan petugas kita,” terangnya.

Sumber: jaringnews.com

PAMEKASAN, KOMPAS.com – Kecewa terhadap pelayanan Rumah Sakit dr.Slamet Martodirdjo, Pamekasan, Jawa Timur, puluhan warga yang mengatasnamakan Aliansi Masyarakat Peduli Pamekasan Sehat (Ampas), mendatangi Kantor DPRD Pamekasan, Senin (21/10/2013).

Mereka ingin mengadukan kekecewaannya kepada anggota dewan menyusul tak membaiknya pelayanan di rumah sakit milik Pemkab Pamekasan itu. Bahkan, tidak sesuai dengan undang-undang dan norma di suku Madura.

Wahyu Garuda, koordinator aksi dalam orasinya menyampaikan, pelayanan rumah sakit plat merah itu tidak memperhatikan nilai-nilai kemanusiaan dan norma orang Madura. Itu terbukti ketika ada pasien yang sakit tidak boleh ditunggui oleh anggota keluarganya.

Bahkan pasien yang sudah kritis menjelang kematiannya, juga tidak diperbolehkan untuk ditunggui. “Pelayanan macam apa yang diinginkan rumah sakit Pamekasan ini? Kalau pasien miskin rumitnya minta ampun untuk dijenguk anggota keluarganya,” ungkap Wahyu.

Lebih lanjut Wahyu megatakan, penerapan aturan baru di rumah sakit itu bertentangan dengan Undang-undang Nomor 44 Tahun 2009 tentang Rumah Sakit. Dalam undang-undang itu dijelaskan dalam Pasal 32 poin C dijelaskan, setiap pasien memperoleh layanan yang manusiawi, adil, jujur dan tanpa diskriminasi.

Di dalam poin L dijelaskan pula, setiap pasien didampingi keluarganya dalam keadaan kritis. “Di Rumah Sakit Pamekasan, pasien yang sudah kritis justru ditinggalkan sendirian dan tidak boleh didampingi keluarganya. Ini sudah tindakan melawan hukum,” imbuh Wahyu.

Menanggapi hal itu, Wakil Ketua DPRD Pamekasan Khairul Kalam mengaku, demi peningkatan pelayanan rumah sakit, pihak dewan mengaku rajin melakukan inspeksi mendadak.

Diakuinya, selama ini memang rumah sakit belum memberikan pelayanan sesuai dengan harapan masyarakat. Namun, dia berharap perlahan pelayanan di rumah sakit segera membaik.

Sementara itu, Pelaksana Tugas Direktur Rumah Sakit Saleh Lalhadi mengaku pelayanan di rumah sakit sudah sesuai prosedur. Sedangkan, pengunjung yang datang ke rumah sakit, memang diberi waktu dan diatur untuk kebutuhan pasien sendiri. Sebab, jika tidak diatur maka pasien akan terganggu.

“Tidak ada upaya mempersulit pelayanan di rumah sakit. Yang kami lakukan semata-mata untuk kebaikan pasien,” ungkap Saleh.

Penjelasan dewan dan pihak rumah sakit itu dinilai tidak memuaskan massa. Massa menuntut agar DPRD Pamekasan mebentuk tim khusus penanganan pelayanan rumah sakit. Sebab selama ini, pelayanan rumah sakit dan PDAM Pamekasan disebut paling banyak dikeluhkan warga.

Sumber: kompas.com

(dailyRx News) It’s not uncommon for hospitalized patients to have weakened immune systems that aren’t able to fight off infections. And that can make a hospital stay a risk to sick people.

Helping to stop the spread of infectious illness in healthcare facilities is the reason behind International Infection Prevention Week — which runs October 20 through 26.

“Cleanliness protects against hospital infections.”

Laura Buford, RN, BSN, CIC, told dailyRX News that just about everyone who comes in contact with a hospitalized patient can play a role in protecting that ailing person from avoidable diseases spread by human contact.

“Healthcare personnel, patients and even families,” said Buford, listing those key players in infection prevention.

“Each year, nearly 100,000 lives are lost due to preventable healthcare-associated infections. This is a tragedy. [We] want to raise awareness of the issue and empower everyone on how they can help to reduce this number.”

Reducing the tally of infectious illnesses isn’t that hard, added Buford, who works in infection prevention at St. David’s South Austin Medical Center in Austin, Texas.

“So often, people forget about the basics. They forget about washing their hands. They forget about covering their cough,” said Buford, also a member of the Association of Professionals in Infection Control and Epidemiology (APIC). “They forget about simple cleaning. Infection prevention doesn’t have to be complicated. It truly is about doing easy things, and the results of those save lives.”

Beyond this specially designated awareness week, there are ongoing efforts to curb hospital-borne infections. APIC’s “Infection Prevention and You” campaign, in part, encourages patients themselves to champion their own safety against hospital infections. They include:

Asking whether to bathe with germ-killing soap prior to surgery

Taking all medications as directed

Ensuring that needled syringes are sterile, only used once and then properly disposed of

Requesting that an untidy room be cleaned

Asking daily whether it’s time for removal of a catheter, which can result in urinary tract infections

Also, according to APIC, patients and others should sneeze into their elbows instead of their hands, which touch other people and objects.

Those at highest risk for becoming infected or having the hardest time bouncing back from infectious disease include the very young, very old, and individuals whose immune systems are consistently weak, Buford said.

With flu season looming — and avoidance of the flu on many people’s minds — those groups that are especially at risk deserve added attention and protection, Buford said. Those three at-risk groups should have limited contact with carriers of the flu or, for that matter, all other infections.

Special care should be given to the cleanliness and safety of their food. Everyone who comes into contact with those vulnerable populations should wash their hands. And, Buford added, “Don’t visit if you are sick.”

People who have been sick should also be mindful that they can be “…re-infected,” Buford said, “or, at least prolong your illness, if you don’t wash your hands [regularly].”

Source: dailyrx.com