EVALUASI PELAKSANAAN CLINICAL PATHWAY KASUS DIABETES MELLITUS DI RUMAH SAKIT UMUM DAERAH Dr. SOETOMO SURABAYA

WINDA PUSPITA, Dr. dr. Rizaldy Taslim Pinzon, M.Kes, Sp.S ; dr. Hanevi Djasri, MARS

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang Clinical pathway mampu menurunkan komplikasi penyakit di rumah sakit, serta memperbaiki dokumentasi. Rumah Sakit Umum Daerah Dr. Soetomo Surabaya telah menggunakan clinical pathway Diabetes Mellitus dalam proses pengobatan, namun belum pernah dievaluasi sehingga perlu dilakukan evaluasi. Evaluasi dilakukan terhadap dokumen clinical pathway Diabetes Mellitus yang terdapat di RSUD Dr. Soetomo Surabaya dengan menggunakan Integrated Care Pathway Appraisal Tools (ICPAT). Tujuan Penelitian ini bertujuan untuk mengevaluasi pelaksanaan clinical pathway kasus Diabetes Mellitus di RSUD Dr. Soetomo Surabaya. Metode Penelitian ini menggunakan pendekatan mixed method dengan desain explanatory sequential mixed methods. Jumlah clinical pathway yang dievaluasi menggunakan ICPAT sebanyak 1 formulir yaitu penyakit Diabetes Mellitus. Clinical pathway yang diteliti sebanyak 368 clinical patwhay. Penelitian tahap pertama yaitu penelitian kuantitatif dan tahap kedua penelitian kualitatif. Hasil Kelengkapan pengisian clinical pathway rata-rata tahun 2013-2015 adalah sebesar 56%. Dimensi ICPAT yang sesuai 100% adalah dimensi 1. Kendala pelaksanaan clincial pathway diantaranya kepatuhan staf terkait dalam pengisian clinical pathway masih rendah, kurangnya edukasi tentang clinical pathway kepada staf, terlalu banyak dokumen yang harus diisi oleh dokter maupun perawat sehingga mengakibatkan banyaknya clinical pathway tidak terisi, belum terintegrasinya clinical pathway dengan rekam medis, serta belum sesuainya clinical pathway dengan kondisi pasien yang mayoritas multiple disease. Kesimpulan Rata-rata kelengkapan pengisian clinical pathway dari tahun 2013 – 2015 adalah sebesar 56% clinical pathway yang terisi lengkap. Tingkat kesesuaian setiap dimensi ICPAT adalah : dimensi 1 untuk konten 100%, mutu 100%; dimensi 2 untuk konten 26%, mutu 25%; dimensi 3 untuk konten 92%, mutu 88%; dimensi 4 untuk konten 60%, mutu 100%; dimensi 5 untuk konten 25%, mutu 15%; dan dimensi 6 untuk konten 67%, mutu 67%.

Background Clinical pathway can reduce disease complications in the hospital and improve the documentation. Dr. Soetomo Hospital used Diabetes Mellitus clinical pathway in the treatment process, but has not been evaluated, so it should be evaluated. Evaluation of Diabetes Mellitus clinical pathway documents in Dr. Soetomo Hospiral used Integrated Care Pathway Appraisal Tools (ICPAT). Objective This study aims to evaluate the implementation of clinical pathway of Diabetes Mellitus case in Dr. Soetomo Hospital. Method This research used a mixed method approach with explanatory sequential mixed methods design. The clinical pathway that were evaluated by ICPAT was 1 form that was Diabetes Mellitus. Clinical pathway studied as many as 368 clinical pathway documents. The first phase of the study was quantitative research and the second was qualitative research. Results The average completeness of clinical pathways from the year 2013 - 2015 were 56%. The score of ICPAT that 100% only 1st Dimension. Implementation constraints of clincial pathway were obedience of relevant staff in filling clinical pathway still low, the lack of education about clinical pathway to the staff, too many documents to be filled by doctors and nurses resulting in the number of clinical pathway is not filled, clinical pathway and medical record were not yet integrated and clinical pathway was not suitable with patients condition that the majority of multiple disease. Conclusion The average completeness of DM clinical pathway from the year 2013 - 2015 were 56% of the completed clinical pathway. Suitability rate of ICPAT dimension were : the 1st dimension for content was 100%, for quality was 100%; the 2nd dimension for content was 26%, for quality was 25%; the 3rd dimension for content was 92%, for quality was 88%; the 4th dimension for content was 60%, for quality was 100%; the 5th dimension for content was 25%, for quality was 15%; and the 6th dimension for content was 67%, for quality was 67%.

Kata Kunci : evaluasi, clinical pathway, ICPAT, Diabetes Mellitus