HOW TO MANAGE HOSPITAL

ON PUBLIC HEALTH
EMERGENCIES

KOHAR HARI SANTOSO

DIRECTOR OF DR. SAIFUL ANWAR HOSPITAL
KHS - MMRS UB 19102020 1

MALANG – EAST JAVA

 CURICULUM
Nam e
VITAE
: Dr. dr. Kohar Hari Santoso, SpAn. KAP. KIC.
Telp : 08123216768
E-Mail : koharhs@yahoo.com
Job Experiences :
1. 1988 dokter UGD RSUD dr. Soebandi Jember Jawa Timur
2. 1989 Kepala Penyusunan Program & Laporan RSUD dr. Soebandi Jember
3. 1993 Dokter PPDS Anestesiologi & Reanimasi FK Unair
4. 1999 Ka SMF Anestesiologi RSUD Dok 2 Jayapura – Papua
5. 2000 Staf Medik Anestesiologi RSUD dr. Soetomo Surabaya.
6. 2008 Kepala Bidang Pelayanan Medik RSUD dr. Soetomo Surabaya.
7. 2011 Wakil Direktur Pelayanan Medik RSUD dr. Soetomo Surabaya
8. 2015 Direktur RSUD dr. Soedono Madiun Jawa Timur
9. 2016 Kepala Dinas Kesehatan Provinsi Jawa Timur
10.2020 Direktur RSUD. Dr. Saiful Anwar Malang Jawa Timur.

Educational Background :
1. 1987 Lulus Fakultas Kedokteran Universitas Airlangga
2. 1998 Lulus Program Pendidikan Dokter Spesialis Anestesiologi, FK Unair
3. 2008 Konsultan Pediatric Anestesia Kolegium Anestestesiologi
4. 19102020
KHS - MMRS UB 2011 Konsultan Intensive Care Perhimpunan Dokter Intensive Care 2

5. 2011 Lulus Doktor Pasca Sarjana Universitas Airlangga.

 HDI
(Human Development Index)

Health – Education - GDP

Hendrik L Blum
Public Health Indicator
MoH
Life

Environment (40 %)

Behaviour (35 %)

Genetic ( 5 % )
Dinkes Prov

Health Facility (25 %)

Expectancy
Dinkes Kab/Kota
Promotive
Preventive
Curative
Rehabilitativ PUSKESMAS
ACCESS
e Clinic
&
HOSPITAL
QUALITY 3
 COVID – 19 Strategy
House Home
Qualifies Isolation
Conductive
Environment
Clinically Unqualifies
healthy
Isolation
Unconductive Centre (Wisma
Health Atlit,
RSLapangan)
Condition
Mild
Hospital
Moderate
Clinically ill
Severe Refferal
Pneumonia Hospital
(ICU)
Testing & Tracing
 Public Health Response System
( LIFE SUPPORT CHAIN )

Community Public Refferal

Health
Hospital
(prae hospital) Hospital
Centre

The Role of Hospital

-Active Responder
-Active Responder & “Local” Coordinator
KHS - MMRS UB 19102020 5
 Preparing Hospital for Covid

COVID
HOSPITAL
REGULAR
HOSPITAL

COVID SERVICE REGULAR SERVICE

AREA AREA

KHS - MMRS UB 19102020 6

PUBLIC HOSPITAL
• The owner is Government
• Subject to the Government regulation
• Human Resources is determined by the goverment
• Budget must be approved by The Regional Parliament
• Not just looking for profit
• Should contribute to overcome public health emergencies
KHS - MMRS UB 19102020 7
PUBLIC HEALTH EMERGENCIES
• Natural disaster
Disaster • Man made disaster
• Compleks Disaster

• Increased  virulence
• Introduction into a novel setting
Epidemics • Changes in host susceptibility to
the infectious agent
• Outbreak
KHS - MMRS UB 19102020 8
 Disaster Epidemics
Cause Natural move unnatural Microorganism

Time event Relatively short Prolonged - persistence

Impact Visible Need monitoring

Area affected Localized Can be widely - Pandemi

Public Response Receive Various

Hospital Condition Can also damaged Should Prevent

Transmission
KHS - MMRS UB 19102020 9
OUTBREAK TYPES
• Common source outbreak
- point source outbreak.
- continuous outbreak
• Propagated outbreak
Affected individuals may become
independent reservoirs leading to further
exposures.

KHS - MMRS UB 19102020

• Mixed outbreak 10
 MODES OF TRANSMISSION

• Airborne transmission
• Waterborne transmission
• Bloodborne transmission
• Arthropod transmission.
• Biological transmission
• Contact transmission
KHS - MMRS UB 19102020 • Cyclopropagative transmission. 11
HOSPITAL DISASTER & EPIDEMIC PLAN

• Early warning & response system

• Command Organization
• Resetting Officer & Staff
• Identification, Recording & Reporting
• Expansion of Caring Space
• Prevention propagated outbreak
KHS - MMRS UB 19102020
• The addition of logistics & support 12

• Public information
EARLY WARNING & RESPONSE SYSTEM
cases

KHS - MMRS UB 19102020

Monitoring number of cases regularly 13
 14

27 April 2020
25 April 2020
JUMLAH KASUS CENDERUNG MENINGKAT

23 April 2020
21 April 2020
19 April 2020
17 April 2020
15 April 2020
13 April 2020
11 April 2020
09 April 2020
07 April 2020
05 April 2020
03 April 2020
01 April 2020
30 March 2020
28 March 2020
Kondisi tanggal 22 April 2019 (767 kasus confirm)

26 March 2020
24 March 2020
Kondisi akhir maret 2019 (152 kasus confirm)

22 March 2020
20 March 2020
18 March 2020
KURVA EPIDEMIOLOGI Jawa Timur,

16 March 2020
14 March 2020
12 March 2020
10 March 2020
08 March 2020
berdasar mulai sakit (confirm)

06 March 2020
04 March 2020
02 March 2020
29 February...
27 February...
25 February...
23 February...
21 February...
19 February...
17 February...
15 February...

KHS - MMRS UB 19102020

pertama 13 February...
Kasus 11 February...
09 February...
07 February...
40

35

30

25

20

15

10

0
 Hospital
Commander

COM Field

MAN Commander

D Chief of
Support
Chief of
Medical Team
ORG Management

ANIZ Logistic &

Operasional
Prae Hospital
Team
ATIO
N Facility
Support
Intra hospital
Team

KHS - MMRS UB 19102020 Supporting 15

Finance
Team
 RESETTING OFFICER & STAFF
Design before the incident

How to add officer & team

The role of officer & team

Relocation medical team

Management of assistance &
KHS - MMRS UB 19102020
volunteers 16
IDENTIFICATION, RECORDING & REPORTING

Give an Record the

Reports to
identity of
identity each patient
Record all the stakeholders
bracelet handling done and
clear correct
community
and complete

KHS - MMRS UB 19102020 17

 Number of
cases

Kinds of Risk of
Expansio transmisio
cases n
n of
Caring
Space

Cohort
grouping
Isolation
KHS - MMRS UB 19102020 18
PREVENTION PROPAGATED OUTBREAK

Staff,
Personal Special
Patient &
protective Procedure
Family
equipment of treatment
Education

KHS - MMRS UB 19102020 19

THE ADDITION OF LOGISTICS & SUPPORT
Drugs

Medical devices

Reagent

Water supply

Electricity
KHS - MMRS UB 19102020 20
 HOSPITAL SAFETY
Safety Safety Safety
Safety Safety

Environmet
Financial

Employer
Fascility

Patients
KHS - MMRS UB 19102020 21
REALOCATION & EFFICIENCY

• The addition of logistics & support

• Change in the number of services
• Impact on hospital revenue

KHS - MMRS UB 19102020 22

 HOSPITAL BUSINESS
Type Classificati Segment
Service on market
A&E
Cito
Out Patient Public
In Patient
Urgent
Diagnostic
Intervension Private
Elective
Forensik
KHS - MMRS UB 19102020 23
 Review Data
FIN
ANC
IAL Analysis Resource &
Market
SAF
ETY
Refocusing Bussiness
KHS - MMRS UB 19102020 24
 THANK U

KHS - MMRS UB 19102020 25