PEMBERLAKUAN CLINICAL PATHWAY DALAM PEMBERIAN LAYANAN KESEHATAN DAN AKIBAT HUKUMNYA
Keywords:
clinical pathway, health quality; effectiveness; efficiency; financing; medicolegal.
Abstract
In today's modern era, hospitals as part of health services require an internal regulation based on law, otherwise known as hospital by laws. One form of implementation of hospital by laws is the implementation of clinical pathways, which become a reference or standard for medical services from the time the patient arrives until the patient leaves the hospital. This research is descriptive-analytical-explorative research with a statutory approach. The data used in this study is secondary data, which consists of primary, secondary, and tertiary legal materials. The results of this study discuss a clinical pathway that describes a method or instrument used in providing care to patients by all health and medical personnel at the hospital. Clinical pathways have been shown to reduce unnecessary variation in patient care, reduce discharge delays through more efficient discharge planning, and increase the cost-effectiveness of clinical services. The approach and goals of the clinical pathway are consistent with total quality management and continuous quality improvement and are essentially the application of these principles at the patient's bedside. This article investigates the increasing use of clinical pathways, their benefits to healthcare organizations, their use as a tool for continuous quality improvement activities directly related to patient care, and the medico-legal implications involved.
References
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Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlus Open, 2, 8–14. https://doi.org/10.1016/j.npls.2016.01.001
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Cheah, T. S. (1998). Clinical pathways—The new paradigm in healthcare? The Medical journal of Malaysia, 53(1), 87–96.
Croucher, M. (2005). An Evaluation of the Quality of Integrated Care Pathway Development in the UK National Health Service. Journal of integrated Care Pathways, 9(1), 6–12. https://doi.org/10.1177/147322970500900102
Davis, N., Leadership, Wales. N., & for Healthcare, I. A. (2005). Integrated Care Pathways: A Guide to Good Practice. National Leadership and Innovation Agency for Healthcare.
De Allegri, M., Schwarzbach, M., Loerbroks, A., & Ronellenfitsch, U. (2011). Which factors are important for the successful development and implementation of clinical pathways? A qualitative study. BMJ quality & safety, 20(3), 203–208. https://doi.org/10.1136/bmjqs.2010.042465
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Grimshaw, J. M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., Grilli, R., Harvey, E., Oxman, A., & O’Brien, M. A. (2001). Changing provider behavior: An overview of systematic reviews of interventions. Medical care, 39(8 Suppl 2), II2-45.
Handayani, R. P., Perwitasari, D. A., Setiawan, D., & Suwantika, A. A. (2020). Cost-Effectiveness analisys on the implementation of clinical pathway of pediatric treatment for dengue hemorrhagic fever in PKU Muhammadiyah Hospital Yogyakarta. Pharmaciana, 10(1), 51. https://doi.org/10.12928/pharmaciana.v9i2.12332
Harvey, V. L. Currie, G. (2000). The use of care pathways as tools to support the implementation of evidence-based practice. Journal of Interprofessional Care, 14(4), 311–324. https://doi.org/10.1080/13561820020003874
Hotchkiss, R. (1997). Integrated care pathways. NT Research, 2(1), 30–36. https://doi.org/10.1177/136140969700200106
Johnson, K. B., Blaisdell, C. J., Walker, A., & Eggleston, P. (2000). Effectiveness of a clinical pathway for inpatient asthma management. Pediatrics, 106(5), 1006–1012.
Kampan, P. (2006). Effects of counseling and implementation of clinical pathway on diabetic patients hospitalized with hypoglycemia. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 89(5), 619–625.
Kemenkes RI. (2010). Peraturan Menteri Kesehatan Republik Indonesia Nomor 1438/MENKES/IX/2010 Tentang Standar Pelayanan Kedokteran. Peraturan Menteri Kesehatan, 132(464), 140–145.
Kemenkes RI. (2014). Undang-undang RI No. 38 Tentang Keperawatan (Nomor 10, hlm. 2–4).
Kim, M. H., Morady, F., Conlon, B., Kronick, S., Lowell, M., Bruckman, D., Armstrong, W. F., & Eagle, K. A. (2002). A prospective, randomized, controlled trial of an emergency department-based atrial fibrillation treatment strategy with low-molecular-weight heparin. Annals of emergency medicine, 40(2), 187–192. https://doi.org/10.1067/mem.2002.126169
Kinsman, L. (t.t.). Clinical pathway compliance and quality improvement. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 18(18), 33–35.
Kitchiner, D., Davidson, C., & Bundred, P. (1996). Integrated Care Pathways: Effective tools for continuous evaluation of clinical practice. Journal of Evaluation in Clinical Practice, 2(1), 65–69. https://doi.org/10.1111/j.1365-2753.1996.tb00028.x
Lehman, H. (1990). The system approach to education, spesial presentation conveyed in the international seminar on educational innovation and technology. Manila Innotech Publication, 20(5).
Midleton, & Robert. (2000). Integration clinical pathways: A practical approach to implementation. McGraw-Hill, 1(1).
Neubauer, S. (2020). Clinical pathways: Reducing costs and improving quality across a network. The American Journal of Managed Care, 26(Spec. No. 2), SP60–SP61. https://doi.org/10.37765/ajmc.2020.42550
Phillippi, J., & Lauderdale, J. (2018). A Guide to Field Notes for Qualitative Research: Context and Conversation. Qualitative Health Research, 28(3), 381–388. https://doi.org/10.1177/1049732317697102
Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). The Cochrane database of systematic reviews, 3, CD002213. https://doi.org/10.1002/14651858.CD002213.pub3
Roberts, R. R., Zalenski, R. J., Mensah, E. K., Rydman, R. J., Ciavarella, G., Gussow, L., Das, K., Kampe, L. M., Dickover, B., McDermott, M. F., Hart, A., Straus, H. E., Murphy, D. G., & Rao, R. (1997). Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: A randomized controlled trial. JAMA, 278(20), 1670–1676.
Roeder, N., Hensen, P., Hindle, D., Loskamp, N., & Lakomek, H.-J. (2003). Instrumente zur Behandlungsoptimierung. Der Chirurg, 74(12), 1149–1155. https://doi.org/10.1007/s00104-003-0754-z
Rotter, T., Kinsman, L., James, E., Machotta, A., Gothe, H., Willis, J., Snow, P., & Kugler, J. (2010). Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. The Cochrane database of systematic reviews, 3, CD006632. https://doi.org/10.1002/14651858.CD006632.pub2
Rotter, T., Kinsman, L., Machotta, A., Zhao, F. L., van der Weijden, T., Ronellenfitsch, U., & Scott, S. D. (2013). Clinical pathways for primary care: Effects on professional practice, patient outcomes, and costs. Cochrane Database of Systematic Reviews, 2013(8). https://doi.org/10.1002/14651858.CD010706
Schrijvers, G., van Hoorn, A., & Huiskes, N. (2012). The care pathway: Concepts and theories: An introduction. International journal of integrated care, 12(Spec Ed Integrated Care Pathways), e192. https://doi.org/10.5334/ijic.812
Tachdan. (2006). Implementasi kebijakan publik. AIPI Bandung-Puslit KP2W Lemlit UNPAD, 1(1).
Uchiyama, K., Takifuji, K., Tani, M., Onishi, H., & Yamaue, H. (2002). Effectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery. Surgical endoscopy, 16(11), 1594–1597. https://doi.org/10.1007/s00464-002-9018-0
VANHAECHT, K., WITTE, K. DE, DEPREITERE, R., & SERMEUS, W. (2006). Clinical pathway audit tools: A systematic review. Journal of Nursing Management, 14(7), 529–537. https://doi.org/10.1111/j.1365-2934.2006.00705.x
Wijono, D. (2000). Manajemen mutu pelayanan kesehatan teori, strategi dan aplikasi (1 ed.). Airlangga Unniversity Press.
Zhang, W., Wang, B.-Y., Du, X.-Y., Fang, W.-W., Wu, H., Wang, L., Zhuge, Y.-Z., & Zou, X.-P. (2019). Big-data analysis: A clinical pathway on endoscopic retrograde cholangiopancreatography for common bile duct stones. World journal of gastroenterology, 25(8), 1002–1011. https://doi.org/10.3748/wjg.v25.i8.1002
Bauer, M. S., McBride, L., Williford, W. O., Glick, H., Kinosian, B., Altshuler, L., Beresford, T., Kilbourne, A. M., Sajatovic, M., & Cooperative Studies Program 430 Study Team. (2006). Collaborative care for bipolar disorder: Part I. Intervention and implementation in a randomized effectiveness trial. Psychiatric services (Washington, D.C.), 57(7), 927–936. https://doi.org/10.1176/ps.2006.57.7.927
Bayliss, V., Cherry, M., Locke, R., & Salter, L. (2000). Pathways for continence care: Background and audit. British Journal of Nursing, 9(9), 590–596. https://doi.org/10.12968/bjon.2000.9.9.6295
Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlus Open, 2, 8–14. https://doi.org/10.1016/j.npls.2016.01.001
Buse, K., Mays, N., & Walt, G. (2005). The health policy framework: Context, process and actors. Making Health Policy, 2–206.
Campbell, H., Hotchkiss, R., Bradshaw, N., & Porteous, M. (1998a). Integrated care pathways. BMJ, 316(7125), 133–137. https://doi.org/10.1136/bmj.316.7125.133
Campbell, H., Hotchkiss, R., Bradshaw, N., & Porteous, M. (1998b). Integrated care pathways. BMJ, 316(7125), 133–137. https://doi.org/10.1136/bmj.316.7125.133
Cheah, J. (2000). Clinical pathways—An evaluation of its impact on the quality of care in an acute care general hospital in Singapore. Singapore medical journal, 41(7), 335–346.
Cheah, T. S. (1998). Clinical pathways—The new paradigm in healthcare? The Medical journal of Malaysia, 53(1), 87–96.
Croucher, M. (2005). An Evaluation of the Quality of Integrated Care Pathway Development in the UK National Health Service. Journal of integrated Care Pathways, 9(1), 6–12. https://doi.org/10.1177/147322970500900102
Davis, N., Leadership, Wales. N., & for Healthcare, I. A. (2005). Integrated Care Pathways: A Guide to Good Practice. National Leadership and Innovation Agency for Healthcare.
De Allegri, M., Schwarzbach, M., Loerbroks, A., & Ronellenfitsch, U. (2011). Which factors are important for the successful development and implementation of clinical pathways? A qualitative study. BMJ quality & safety, 20(3), 203–208. https://doi.org/10.1136/bmjqs.2010.042465
Depkes RI, 2004. (2004). UU No. 29 Tahun 2004 Tentang Praktik Kedokteran. Aturan praktik kedokteran, 157–180.
Evans-Lacko, S., Jarrett, M., McCrone, P., & Thornicroft, G. (2010). Facilitators and barriers to implementing clinical care pathways. BMC health services research, 10, 182. https://doi.org/10.1186/1472-6963-10-182
Falconer, J. A., Roth, E. J., Sutin, J. A., Strasser, D. C., & Chang, R. W. (1993). The Critical Path Method in Stroke Rehabilitation: Lessons from an Experiment in Cost Containment and Outcome Improvement. QRB - Quality Review Bulletin, 19(1), 8–16. https://doi.org/10.1016/S0097-5990(16)30582-6
Firmansyah, H. (2009). Clinical Pathway: Integrasi Pendokumentasian Berbagai Disiplin Ilmu Kesehatan di Rumah Sakit. Pelayanan Jantung Terpadu RSCM, Fakultas Ilmu Keperawatan Universitas Indonesia, 1(1), 10.
Grimshaw, J. M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., Grilli, R., Harvey, E., Oxman, A., & O’Brien, M. A. (2001). Changing provider behavior: An overview of systematic reviews of interventions. Medical care, 39(8 Suppl 2), II2-45.
Handayani, R. P., Perwitasari, D. A., Setiawan, D., & Suwantika, A. A. (2020). Cost-Effectiveness analisys on the implementation of clinical pathway of pediatric treatment for dengue hemorrhagic fever in PKU Muhammadiyah Hospital Yogyakarta. Pharmaciana, 10(1), 51. https://doi.org/10.12928/pharmaciana.v9i2.12332
Harvey, V. L. Currie, G. (2000). The use of care pathways as tools to support the implementation of evidence-based practice. Journal of Interprofessional Care, 14(4), 311–324. https://doi.org/10.1080/13561820020003874
Hotchkiss, R. (1997). Integrated care pathways. NT Research, 2(1), 30–36. https://doi.org/10.1177/136140969700200106
Johnson, K. B., Blaisdell, C. J., Walker, A., & Eggleston, P. (2000). Effectiveness of a clinical pathway for inpatient asthma management. Pediatrics, 106(5), 1006–1012.
Kampan, P. (2006). Effects of counseling and implementation of clinical pathway on diabetic patients hospitalized with hypoglycemia. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 89(5), 619–625.
Kemenkes RI. (2010). Peraturan Menteri Kesehatan Republik Indonesia Nomor 1438/MENKES/IX/2010 Tentang Standar Pelayanan Kedokteran. Peraturan Menteri Kesehatan, 132(464), 140–145.
Kemenkes RI. (2014). Undang-undang RI No. 38 Tentang Keperawatan (Nomor 10, hlm. 2–4).
Kim, M. H., Morady, F., Conlon, B., Kronick, S., Lowell, M., Bruckman, D., Armstrong, W. F., & Eagle, K. A. (2002). A prospective, randomized, controlled trial of an emergency department-based atrial fibrillation treatment strategy with low-molecular-weight heparin. Annals of emergency medicine, 40(2), 187–192. https://doi.org/10.1067/mem.2002.126169
Kinsman, L. (t.t.). Clinical pathway compliance and quality improvement. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 18(18), 33–35.
Kitchiner, D., Davidson, C., & Bundred, P. (1996). Integrated Care Pathways: Effective tools for continuous evaluation of clinical practice. Journal of Evaluation in Clinical Practice, 2(1), 65–69. https://doi.org/10.1111/j.1365-2753.1996.tb00028.x
Lehman, H. (1990). The system approach to education, spesial presentation conveyed in the international seminar on educational innovation and technology. Manila Innotech Publication, 20(5).
Midleton, & Robert. (2000). Integration clinical pathways: A practical approach to implementation. McGraw-Hill, 1(1).
Neubauer, S. (2020). Clinical pathways: Reducing costs and improving quality across a network. The American Journal of Managed Care, 26(Spec. No. 2), SP60–SP61. https://doi.org/10.37765/ajmc.2020.42550
Phillippi, J., & Lauderdale, J. (2018). A Guide to Field Notes for Qualitative Research: Context and Conversation. Qualitative Health Research, 28(3), 381–388. https://doi.org/10.1177/1049732317697102
Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). The Cochrane database of systematic reviews, 3, CD002213. https://doi.org/10.1002/14651858.CD002213.pub3
Roberts, R. R., Zalenski, R. J., Mensah, E. K., Rydman, R. J., Ciavarella, G., Gussow, L., Das, K., Kampe, L. M., Dickover, B., McDermott, M. F., Hart, A., Straus, H. E., Murphy, D. G., & Rao, R. (1997). Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: A randomized controlled trial. JAMA, 278(20), 1670–1676.
Roeder, N., Hensen, P., Hindle, D., Loskamp, N., & Lakomek, H.-J. (2003). Instrumente zur Behandlungsoptimierung. Der Chirurg, 74(12), 1149–1155. https://doi.org/10.1007/s00104-003-0754-z
Rotter, T., Kinsman, L., James, E., Machotta, A., Gothe, H., Willis, J., Snow, P., & Kugler, J. (2010). Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. The Cochrane database of systematic reviews, 3, CD006632. https://doi.org/10.1002/14651858.CD006632.pub2
Rotter, T., Kinsman, L., Machotta, A., Zhao, F. L., van der Weijden, T., Ronellenfitsch, U., & Scott, S. D. (2013). Clinical pathways for primary care: Effects on professional practice, patient outcomes, and costs. Cochrane Database of Systematic Reviews, 2013(8). https://doi.org/10.1002/14651858.CD010706
Schrijvers, G., van Hoorn, A., & Huiskes, N. (2012). The care pathway: Concepts and theories: An introduction. International journal of integrated care, 12(Spec Ed Integrated Care Pathways), e192. https://doi.org/10.5334/ijic.812
Tachdan. (2006). Implementasi kebijakan publik. AIPI Bandung-Puslit KP2W Lemlit UNPAD, 1(1).
Uchiyama, K., Takifuji, K., Tani, M., Onishi, H., & Yamaue, H. (2002). Effectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery. Surgical endoscopy, 16(11), 1594–1597. https://doi.org/10.1007/s00464-002-9018-0
VANHAECHT, K., WITTE, K. DE, DEPREITERE, R., & SERMEUS, W. (2006). Clinical pathway audit tools: A systematic review. Journal of Nursing Management, 14(7), 529–537. https://doi.org/10.1111/j.1365-2934.2006.00705.x
Wijono, D. (2000). Manajemen mutu pelayanan kesehatan teori, strategi dan aplikasi (1 ed.). Airlangga Unniversity Press.
Zhang, W., Wang, B.-Y., Du, X.-Y., Fang, W.-W., Wu, H., Wang, L., Zhuge, Y.-Z., & Zou, X.-P. (2019). Big-data analysis: A clinical pathway on endoscopic retrograde cholangiopancreatography for common bile duct stones. World journal of gastroenterology, 25(8), 1002–1011. https://doi.org/10.3748/wjg.v25.i8.1002
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2022-02-12
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