OPTIMALISASI FUNGSI CASE MANAGER DALAM PATIENT CENTERED CARE PADA PASIEN STROKE DI RSUD CILACAP

FITRI ARDININGSIH, Khudazi Aulawi,SKp.,M.Kes.,MNSc.,PhD; Prof.dr.Adi Utarini MPH.MSc.,PhD

2019 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Case management system diterapkan untuk memperbaiki koordinasi asuhan pada pasien kronis dan pasien dengan permasalahan yang kompleks. RSUD Cilacap telah menerapkan hal tersebut tetapi implementasinya belum optimal. Optimalisasi perlu dilakukan pada sistem tersebut. Salah satu cara dengan mengoptimalkan fungsi case manager. Tujuan: Mengoptimalkan fungsi case manager dalam patient centered care pada pasien stroke di RSUD Cilacap. Metode: Jenis penelitian yang digunakan adalah action research. Pengambilan data dengan wawancara mendalam terhadap case manager, diskusi kelompok terarah dengan profesional pemberi asuhan, studi dokumen kelengkapan formulir fungsi case manager dan kuesioner untuk pasien stroke iskemik. Evaluasi luaran dibatasi pada kesiapan pasien menghadapi kepulangan. Hasil : Pada tahap diagnosing action, penerapan fungsi case manager di RSUD Cilacap belum optimal karena belum ada pendokumentasian formulir fungsi case manager, case manager belum mendapat pelatihan case management system, patient centered care dan discharge planning. Pada tahap planning action direncanakan untuk pelatihan kepada case manager dan kepala ruang tentang case management system, patient centered care, discharge planning dan penyusunan formulir fungsi case manager. Pada tahap taking action dikirimkan 2 orang case manager untuk mengikuti pelatihan case management system, patient centered care, discharge planning dan mensosialisasikan kepada case manager dan kepala ruang, penyusunan formulir fungsi case manager. Tahap evaluasi kepada pasien stroke iskemik dan hasilnya menunjukkan bahwa kesiapan pasien menghadapi kepulangan meningkat, studi dokumen kelengkapan formulir fungsi case manager terisi lengkap oleh case manager, dan diskusi untuk mengetahui faktor pendukung dan faktor penghambat implementasi optimalisasi fungsi case manager. Kesimpulan : Setelah pelatihan case management system, patient centered care , discharge planning dan penerapan formulir fumgsi case manager, fungsi case manager menjadi lebih mudah dan terstruktur. Kesiapan pasien menghadapi kepulangan pada pasien stroke iskemik meningkat setelah optimalisasi fungsi case manager.

Background: Case management systems are applied to improve coordination of care for chronic patients and patients with complex problems. Cilacap Hospital has implemented this but the implementation needs to be optimized. One way to optimize the case manager function. Objective: To optimize the case manager function in patient centered care in stroke patients in Cilacap Hospital. Method: The type of research used was action research. Retrieval of data by in-depth interviews with case managers, focus group discussions with professional caregivers, study of complete document case manager function forms and questionnaires for ischemic stroke patients. Output evaluation is limited to the readiness of patients to face return Results : At the diagnosing action stage, the implementation of the case manager function in Cilacap Hospital was not optimal because there was no documentation of the case manager function form, the case manager had not received case management system training, patient centered care and discharge planning. In the planning action phase, it is planned to train the case manager and the head of the room about the case management system, patient centered care, discharge planning and preparation of the case manager function form. At the taking action stage, 2 case managers were sent to take part in the case management system, patient centered care, discharge planning training and socialize to the case manager and head of the room, compiling the case manager function form. The evaluation phase for ischemic stroke patients and the results show the readiness of patients to face increased return, the study document completeness of the case manager function form is completely filled by the case manager, and discussion to find out the supporting factors and inhibiting factors for the implementation of optimization of the case manager function Conclusions : After training on case management systems, patient centered care (PCC), discharge planning and implementing a case manager function form, the case manager function becomes easier and structured. Readiness of patients facing return in ischemic stroke patients increases after optimizing the case manager function.

Kata Kunci : optimalisasi, fungsi case manager, stroke; optimization, patient centered care, stroke