Implementationof ClinicalPathways

Dr. Dody Firmanda, Sp.A, MA Head of Medical Committee Fatmawati Hospital, Jakarta
Presented in 1st Indonesian-Malaysian Casemix Conference, Batam 19-21 Oktober 2006

CLINICAL GOVERNANCE, MEDICAL STAFF BYLAWS, CLINICAL PATHWAYS AND CASEMIX SYSTEM

http://www.yanmedik-depkes.net/dokumen_casemix.htm Roles of Medical Committee: from enforcing medical ethics and quality to implementation of casemix System

Paper: Preparation of Fatmawati Hospital in the implementation of Casemix System

Clinical Risks Management and Patient Safety High Impact Interventions Medical Audits

ClinicalPathways

First Edition of Fatmawati Hospital’s Clinical Pathways

Contents of Fatmawati Hospital’s Clinical Pathways

General Format and explanation of

Clinical Pathways

ROLE OF MEDICAL AUDIT AND PSBH IN PATIENT SAFETY

MEDICAL AUDIT & PSBH

TIME TABLE:

ImplementationDesign:
• Introductions and Aims: • Methods:
– Retrospective : January – September 2006 – Prospective (Cross Sectional) : October 2006

• Results:
– Forms and Tables

• Analysis:
– Descriptive – Statistical Analytic (if applicable)

• Discussions: • Conclusions:

MONITORING FORM :

ClinicalPathways: Orthopaedics
1. Closed-type Fractureof Tibia 2. Closed-type Fractureof Tibia with Impending CompartmentSyndrome 3. Thoracal Spondylitis TBC 4. Thoraco-vertebralFracture with neurologicaldeficits less than 8 hours 5. Thoraco-vertebralFracture with neurologicaldeficits more than 8 hours

Clinical Pathways: Closed-type Fracture of Tibia

Closed-type Fracture of Tibia with Impending Compartment Syndrome

Thoracal Spondylitis TBC

Thoraco-vertebralFracture withn eurological deficits less than8 hours

Thoraco-vertebral Fracture with neurological deficits more than 8 hours

IMPLEMENTATION OF ORTHOPAEDICS CLINICAL PATHWAYS 1. Closed-type Fracture of Tibia 2. Thoracal Spondylitis TBC 3. Closed –type Fracture of Tibia with Impending Compartment Syndome

1

2

Audit Medis

MILIK KOMITE MEDIK RSUP FATMAWATI
df-2006

1

2

MILIK KOMITE MEDIK RSUP FATMAWATI
df-2006

1

2

MILIK KOMITE MEDIK RSUP FATMAWATI
df-2006

3

4

Audit Medis

MILIK KOMITE MEDIK RSUP FATMAWATI
df-2006

Audit Medis

MILIK KOMITE MEDIK RSUP FATMAWATI
df-2006

Laporan tentang Kodefikasi dalam Clinical Pathways

Solusi: Pelatihan petugas input koding di ruangan In-house Training of ICD 10 and ICD 9 CM

ClinicalPathways: Paediatrics

ClinicalPathways: Paediatrics

Paediatrics Clinical Pathways: Pneumonia

n=16

n=18

n=28 n=35

Hasil sementara CP Kes Anak: Pneumonia (N=97)

Analyses:
1. LOS: a. Planned : 5 days b. Reality: 4 days c. Finance : 3 days Notes: Recommendation : Formula (Date of Discharge – Date of hospitalised) +1 2. Antibiotics: a. Standard: Gram (+) and Gram (-) b. Reality: Gram (+) Notes: • Surveilance and HII (for Patient Safety) • Revision of Practice Guidelines

Clinical Pathways & Patient Safety

IMPLEMENTATION OF PAEDIATRICS CLINICAL PATHWAYS ACUTE DIARHEA ROLES OF: PSBH, PATIENT SAFETY AND HIGH IMPACT INTERVENTIONS (HII)

PSBH

Clinical Pathways: Pulmonology

ClinicalPathways: Pulmonology
1. Pulmonary TBC 2. TBC Pleural Effusion 3. Avian Pneumonia 4. COPD-Acute Exacerbation 5. Acute Bronchitis 6. Pneumothorax 7. Bronchial Asthma 8. Pulmonary malignancy 9. Bronchiecstasis 10. Pneumonia

Clinical Pathways Of Pulmonary TBC

Clinical Pathways of TBC Pleural Efusion

Clinical Pathways of Avian Pneumonia

COPD Acute Exacerbation

Acute Bronchitis

Pneumothorax

Clinical Pathways: Dermatology

Clinical Pathways: Dermatology Eritroderma Psoariatika

Herpes Zoster with Nervous System Involvement

Clinical Pathways: Dermatology

Clinical Pathways: Dermatology Opthalmics Herpes Zoster

Clinical Pathways: Dermatology Leprosy with reaction

Clinical Pathways: Dermatology Pemphigoid Bulosae

TERIMAKASIH

Sign up to vote on this title
UsefulNot useful