Professional Documents
Culture Documents
Dr. Nico-PatCenterCare-01-2012 (Compatibility Mode)
Dr. Nico-PatCenterCare-01-2012 (Compatibility Mode)
1915-2008
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• Patient centredness is becoming a widely used, but poorly
understood, concept in medical practice. It may be most commonly
understood for what it is not—technology centred, doctor centred,
hospital centred, disease centred.
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• For well over a decade, there has been growing recognition of the enormous
benefits patient- and family-centered care offers to health care providers,
patients, and families in all areas of health care.
• As hospitals, ........ struggle with issues related to quality, safety, HIPAA
compliance, workforce capacity, the use of technology, the need to renovate or
build new facilities, and cost control, .......
• they are recognizing that patient- and family-centered approaches and the
perspectives of patients and families are essential to their efforts.
• Selama lebih dari satu dekade, terjadi pertumbuhan atas pengakuan thd
begitu besarnya manfaat asuhan ‘patient- and-family-centered care’ yg
ditawarkan kepada para PPK, pasien, dan keluarga dalam semua sarana
pelayanan kesehatan
• Saat RS, .... berjuang dengan isu2 yang berhubungan dengan mutu,
safety /keselamatan, memenuhi persyaratan HIPAA, kapasitas tenaga
kerja, penggunaan teknologi, kebutuhan untuk merenovasi atau
membangun fasilitas baru, dan kendali biaya, ...
• mereka mengakui bahwa pendekatan ‘patient- and family-centered’ dan
perspektif ttg pasien & keluarga adalah penting dlm upaya mereka
Advancing the Practice of Patient-and Family- Centered Care, 6
Institute for Family-Centered Care, 2008
• Bringing the perspectives of patients and families directly into the planning,
delivery, and evaluation of health care, and thereby improving its quality and
safety is what patient- and family-centered care is all about.
• Studies increasingly show that when health care administrators / providers, and
patients & families work in partnership, the quality and safety of health care rise,
costs decrease, and provider and patient satisfaction increase.
(Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building
a safer health system. Washington, D.C.: National Academy Press, 2000.)
D A L A M 1 TAHUN
SETIAP HARI
1 PESAWAT JUMBO JET
BERPENUMPANG 268 ORANG
J A T U H !!!
Pasien & keluarga mengatur asuhan kes mereka bermitra dgn suatu tim yan
kes yg diakui, yg menghormati dan bertindak utk tujuan, kebutuhan, nilai2,
pilihan serta harapan budaya mereka, dan/atau faktor-faktor lain yg
diidentifikasi oleh pasien & keluarga.
Pasien & keluarga menerima asuhan berbasis-bukti dan dgn mutu yg efektif-
biaya yg memaksimalkan kesehatan, menurunkan rasa tidak nyaman dan
aman serta bebas dari error yg bisa dicegah
Pasien & keluarga mempunyai kemampuan utk memperoleh dan memahami
informasi maupun yan kes, dan mbuat kebutusan kesehatan yg tepat (NHC,
2004) 11
Australian Commission on Safety and Quality in Health Care
(ACSQHC) :
Patient-centred care is: ‘is an innovative approach to the
planning, delivery, and evaluation of health care that is grounded
in mutually beneficial partnerships among health care providers,
patients, and families. Patient- and family-centered care applies
to patients of all ages, and it may be practiced in any health care
setting.
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IAPO – International Alliance of Patients’ Organizations :
1. A collaborative effort consisting of patients, patients' families, friends, the
doctors and other health professionals...achieved through a
comprehensive system of patient education where patients and the health
care professionals collaborate as a team, share knowledge and work
toward the common goals of optimum healing and recovery.(Grin, 1994)
2. A construct that advocates simplifying the care at the bedside in the acute
care setting by focusing on the expected outcomes for the patient rather
than the multiplicity of tasks of each department. (Johnston & Cooper,
1997).
3. Health care that is closely congruent with and responsive to patients'
wants, needs, and preferences. (Laine & Davidoff, 1996).
4. Placing patients at the center of the system af care and developing good
services that revolve around them (Mallett, 1996).
1. Suatu upaya kolaboratif yg terdiri dari pasien, keluarga, teman2,
para dokter dan profesional kesehatan lain .............
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1. Suatu upaya kolaboratif yg terdiri dari pasien, keluarga, teman2,
para dokter dan profesional kesehatan lain ... tercapai melalui
suatu sistem edukasi pasien yg komprehensif dimana para pasien
dan profesional yan kes yg bekerjasama sbg suatu tim, saling
berbagi pengetahuan dan pekerjaan kearah tujuan yg sama yaitu
penyembuhan dan pemulihan yg optimum (Grin, 1994)
2. Suatu bentuk yg menyokong penyederhanaan yan ‘bedside’ pada
saat yan akut dgn cara memusatkan thd hasil yg diharapkan bagi
pasien daripada thd kemajemukan tugas dari setiap bagian
(Johnston & Cooper, 1997)
3. Yan kes yg sangat erat dan responsif thd keinginan, kebutuhan
dan pilihan pasien (Laine & Davidoff, 1996)
4. Menempatkan pasien pada pusat dari sistem asuhan dan
mengembangkan yan yg baik disekitar pasien (Mallett, 1996)
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What is “Patient-Centered Care”?
the essential theme is the importance of delivering healthcare in a
manner that works best for patients.
providers partner with patients and their family members to
identify and satisfy the full range of patient needs and preferences.
Hospital recognize that :
A patient is an individual to be cared for,
not a medical condition to be treated.
“Personalization of Care”
Partnering with Patients and Families to Design a Patient and Family-Centered Health Care
System. Johnson, B et al. Institute for Family-Centered Care 2008
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"Medical Excellence Model" / “ Model keunggulan medis”
Merupakan pengembangan dari model tim interdisiplin
Tim klinis dari para dokter dan perawat ahli yg bekerja bersama dgn
cara yg terintegrasi, memeriksa kebutuhan pasien, memerintahkan
pemeriksaan, merencanakan pengobatan, menjadwalkan operasi /
pembedahan, memonitor kemajuan dan merencanakan pasien pulang
cepat ke rumah
Pilar dari model ini termask
Clinical governance / Tata kelola klinis
Kredensialing dan pemberikan kewenangan klinis kpd para dokter
dan perawat
Penggunaan protokol yg terstandar dan berbasis bukti
Keselamatan Pasien dan Staf
Pengendalian infeksi
Suatu budaya yg dewasa dan pengembangan profesional secara
berkesinambungan
Partnering with Patients and Families to Design a Patient and Family-Centered Health Care
System. Johnson, B et al. Institute for Family-Centered Care 2008
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The MCG Health System in Augusta, Georgia.
Member University HealthSystem Consortium
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Declaration on Patient-Centred Healthcare
Patient-centred healthcare is the way to a fair and cost-
effective healthcare system
IAPO, International Alliance of Patients’ Organizations, 2006
1. Sistem kes di semua bagian dunia ada dibawah tekanan dan tdk dpt
mengatasinya bila mereka terus memusatkan perhatian pd penyakit dan
bukannya kepada pasien;
2. Mereka membutuhkan keterlibatan dari pasien secara individual yg
melekat thd pengobatan mereka, membuat perubahan perilaku dan kelola-
diri
3. Yan kes yg patient-centered bisa jadi merupakan cara yg paling efektif-
biaya utk meningkatkan hasil kes bagi pasien
4. Prioritas Pasien, keluarga dan PPK berbeda dlm setiap negara dan dalam
setiap area penyakit, tetapi dari keberagaman ini kita mempunyai
kesamaan prioritas. Untuk mencapai yan kes yg patient centered, kita
harus mendasarkan pada Lima Prinsip berikut ini :
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a) Hormat.
• Menghormati kebutuhan, pilihan dan nilai-nilai mereka yg unik,
• Juga otonomi dan kebebasan mereka
b) Pilihan dan pemberdayaan.
• Pasien mempunyai hak & tangg jwb utk berpartisipasi, sbg mitra,
dlm membuat keputusan yan kes yg mempengaruhi hidup mereka
c) Keterlibatan pasien dalam kebijakan kesehatan.
• Pasien dan organisasi pasien layak utk mengambil tangg- jwb
pembuatan-kebijakan yan kes
d) Akses dan dukungan.
• Pasien harus mempunyai akses ke yan kes dgn jaminan kondisi
mereka.
• Ini termasuk akses ke yan, pengobatan, yan pencegahan dan
kegiatan promosi kes yg aman, bermutu serta tepat
e) Informasi.
• Informasi yg akurat, relevan & komprehensif adalah penting utk
memampukan pasien dan PPK utk membuat keputusan yg
diberitahukan ttg pengobatan yan RS dan hidup dgn kondisi mereka
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Patient & Family Centerd Care in Patient Safety
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Beberapa Publikasi – Artikel ttg PFCC :
PARTNERING WITH PATIENTS AND FAMILIES TO DESIGN A
PATIENT- AND FAMILY-CENTERED HEALTH CARE DELIVERY
SYSTEM: A ROADMAP FOR THE FUTURE
PATIENT-CENTRED CARE: IMPROVING QUALITY AND SAFETY
BY FOCUSING CARE ON PATIENTS AND CONSUMERS
PATIENTS AND FAMILIES AS ADVISORS IN ENHANCING SAFETY
AND QUALITY : BROADENING OUR VISION
ENGAGING PATIENTS & FAMILIES: A HIGH LEVERAGE TOOL
FOR HEALTH CARE LEADERS
PATIENTS AND FAMILIES : POWERFUL NEW PARTNERS FOR
HEALTHCARE AND FOR CAREGIVERS.
Moving Forward with Patient-and Family- Centered Care:
One Step at a Time
The following steps can help set a hospital or health system on its
journey toward patient and family-centered care.
1. Implement a process for all senior leaders to learn about patient-
and family-centered care. Include patients, families, and staff from all
disciplines in this process.
2. Appoint a patient- and family-centered steering committee
comprised of patients and families and formal and informal leaders of
the organization.
3. Assess the extent to which the concepts and principles of patient-
and family-centered care are currently implemented within your
hospital or health system.
4. On the basis of the assessment, set priorities and develop an
action plan for establishing patient- and family-centered care at your
institution. ......
5. Using the action plan as a guide, begin to incorporate patient- and
family-centered concepts and strategies into the hospital’s strategic
priorities. Make sure that these concepts are integrated into your
organization’s mission, philosophy of care, and definition of quality.
6. Invite patients and families to serve as advisors in a variety of
ways. Appoint some of these individuals to key committees and task
forces.
7. Provide education and support to patients, families, and staff on
patient- and family centered care and on how to collaborate
effectively in quality improvement and health care redesign. For
example, provide opportunities for administrators and clinical staff to
hear patients and family members share stories of their health care
experiences during orientation and continuing education programs.
8. Monitor changes made, evaluate processes, measure the impact,
continue to advance practice, and celebrate and recognize success.
Advancing the Practice of Patient-and Family- Centered Care,
Institute for Family-Centered Care, 2008
Moving Forward with Patient-and Family- Centered Care:
One Step at a Time
Berikut ini adalah langkah-langkah yg dapat membantu RS / sistem
kes dalam perjalanannya menuju ‘Patient-and Family- Centered Care’
(PFCC)
1. Terapkan suatu proses bagi seluruh pimpinan senior utk
mempelajari ttg PFCC. Termasuk pasien, keluarga, dan staf dari
semua disiplin dalam proses ini
2. Angkat suatu Panitia Pengarah PFCC, terdiri dari pasien & keluarga
serta pimpinan formal maupun informal RS
3. Buat penilaian ttg sampai berapa jauh konsep & prinsip PFCC saat
ini diterapkan di RS
4. Berdasarkan asesmen, tetapkan prioritas dan kembangkan suatu
rencana aksi utk membentuk PFCC di RS anda
5. Gunakan rencana aksi sbg panduan, masukkan konsep & strategi
PFCC ke dalam prioritas strategi RS. Pastikan bhw konsep2 ini
terintegrasi ke dlm misi organisasi, falsafah yan, dan definisi mutu
Moving Forward with Patient-and Family- Centered Care:
One Step at a Time .....(2)
Jakarta Declaration