EVALUASI ETIKA BISNIS DALAM PENERAPAN ENHANCED RECOVERY AFTER SURGERY PADA SECTIO CAESAREA (ERAC)

KAMILANI BANIWATI, DR dr Andreasta Meliala, DPH., M.Kes, MAS;

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Masa pandemik Covid-19, mendorong kebutuhan pasien atas jenis perawatan dan pelayanan kesehatan yang cepat, aman serta nyaman saat di rumah sakit. Dengan semakin pendeknya masa rawat inap akan mengurangi resiko pasien dan keluarganya terpapar berbagai virus di rumah sakit. Salah satu jenis upaya yang dipilih adalah Enhanced Recovery After Surgery pada Sectio Caesarea (ERAC) yang merupakan percepatan perawatan pasca operasi yang dikenal dengan ERAS pada protokol bedah umum. Dengan protokol ini memungkinkan lama perawatan pasien tidak lebih dari 1x24 jam, dikarenakan mampu mempersingkat masa persalinan lebih cepat, nyaman, aman, tidak mengalami trauma pasca operasi karena minim nyeri, minimalisasi waktu perawatan, dan mobilisasi dini. Untuk menunjang protokol ERAC diperlukan kawalan etika bisnis sebagai alat pencegahan kerugian dan meminimalisasi munculnya faktor resiko dari tuntutan hukum masyarakat sehingga dapat menyelaraskan kepentingan strategis terhadap tuntunan moralitas. Tujuan: Mengidentifikasi peran etika bisnis dalam penerapan protokol ERAC sebagai salah satu solusi peningkatan mutu pelayanan kesehatan. Metode: Kualitatif deskriptif (naratif), studi kasus dengan sumber data primer dan sekunder; analisis data dengan pengumpulan (data collection), pereduksian (data reduction), penyajian (data display), penarikan/pemverifikasian dan kesimpulan (conclusion drawing/verification); uji keabsahan data dengan Trustworthiness (triangulasi sumber data dan member checking) Hasil dan Pembahasan: Menggunakan prinsip etika bisnis (kejujuran, integritas moral, kesetiaan, otonomi, keadilan), etika kedokteran (beneficence, non-maleficence, autonomy, justice) dan menguji keabsahan data dengan Trustworthiness (triangulasi sumber data dan member checking) sehingga menghasilkan data yang jelas dan akurat; ditemukan adanya peran etika bisnis saat penerapan protokol ERAC, yang menjadi acuan dalam menjaga komitmen dan menjaga hak pasien; ERAC pilihan tepat pasien Obgyn sebagai upaya percepatan lama perawatan pasien sehingga meningkatkan kepuasan dan kenyaman pasien Obgyn, diukur dari sisi klinis, biaya dan etik Kesimpulan: Pelayanan kesehatan yang baik dan bisnis yang bermutu wajib memiliki etika bisnis yang mematuhi peraturan hukum dengan dilandasi etika, moral, kejujuran dan profesionalisme, sehingga dapat mewujudkan citra yang baik; Berdasarkan data penelitian, etika bisnis sudah diterapkan dalam protokol ERAC sehingga dapat dipergunakan sebagai alat informasi, pertimbangan pencegahan kerugian ataupun munculnya resiko dari tuntutan hukum masyarakat, tidak terjadi supply induced demand, tidak ada kasus adverse event selama masa Pandemik Covid-19 ini, sehingga kepuasan dan kenyamanan pasien terhadap perawatan dan pelayanan kesehatan meningkat.

Background: The Covid-19 pandemic period has pushed patients' needs for fast, safe and comfortable types of health care and services while in hospital. With the shorter hospitalization period, the risk of patients and their families being exposed to various viruses in the hospital will be reduced. One of the selected efforts is Enhanced Recovery After Surgery in Sectio Caesarea (ERAC), which is an acceleration of postoperative care known as ERAS in general surgical protocols. With this protocol, it is possible for the patient to be treated for no more than 1x24 hours, because it is able to shorten the delivery period, which is faster, more comfortable, safer, does not experience postoperative trauma due to minimal pain, minimizes treatment time, and early mobilization. To support the ERAC protocol, it is necessary to control business ethics as a means of preventing losses and minimizing the emergence of risk factors from public lawsuits so that they can align strategic interests with moral guidance. Objective: To identify the role of business ethics in the application of the ERAC protocol as a solution to improve the quality of health services Method: Qualitative descriptive (narrative), case studies with primary and secondary data sources; data analysis by collecting (data collection), reduction (data reduction), presentation (data display), withdrawal/verification and conclusion (conclusion drawing/verification); test the validity of the data with Trustworthiness (triangulation of data sources and member checking) Result and Discussion: Using the principles of business ethics (honesty, moral integrity, loyalty, autonomy, fairness), medical ethics (beneficence, non-maleficence, autonomy, justice) and the validity of data test with Trustworthiness (triangulation of data sources and member checking) so as to produce clear and accurate data; it was found that there was a role for business ethics when implementing the ERAC protocol, which became a reference in maintaining commitment and protecting patient rights; ERAC is the right choice for Obgyn patients as an effort to accelerate the length of patient care, to increase the satisfaction and comfort of Obgyn patients, measured from the clinical, cost and ethical point of view. Conclusions: Good health services and quality businesses must have business ethics that comply with legal regulations based on ethics, morals, honesty and professionalism, so as to create a good image; Based on research data, business ethics has been applied in the ERAC protocol; it can be used as an information tool, consideration of preventing losses or the emergence of risks from public lawsuits, no supply induced demand, no adverse event cases during the Covid-19 pandemic; satisfaction and increased patient comfort in health care and services

Kata Kunci : Etika bisnis, Etika kedokteran, Enhanced Recovery After Surgery pada sectio caesarea (ERAC), Uji keabsahan data dengan teknik Trustworthiness, metode penelitian kualitatif deskriptif (naratif), Business Ethics, Medical Ethics, Enhanced Recovery After Surg