The Evaluation of Clinical Pathway Implementation on Cerebral Infarction in the Inpatient Care Unit of Bantul X Hospital

Duane Ayu Fitri, Sri Sundari

Abstract


Stroke remains one of the major health problems, not only in Indonesia but also in the world. The improvement of stroke service process is expected to support better outcomes of stroke service quality. One of the clinical management uses is the implementation of clinical pathway  (CP). The purpose of this study was to explore the implementation of clinical pathway cerebral infarction in the inpatient unit of Bantul X hospital. A convergent parallel mix-method design with case study approach. The quantitative sample is the patient’s total cerebral infarction medical record (June 2016-November 2016, n=27) and ICPAT checklist. Qualitative samples are doctors, nurses and people involved in the implementation of CP cerebral infarction obtained from deep interview with purposive sampling technique. The result of this study, ICPAT dimensio 1 (CP format) content and quality are good. Dimension 2 (CP documentation) moderate content and good quality. Dimension 3 (CP development) moderate content and good quality. Dimension 4 (CP implementation) content and quality are poor. Dimension 5 (CP maintenance) content and quality are moderate. Dimension 6 (role of organization) content and quality are good. Compliance rate of completeness of CP form is 22% and compliance of filling clinical pathway is 0 %. Most contraints due to busyness of the officer and time constraints. To improve the cerebral infarction CP implementation need more socialization, training, regular evaluation and full time facilitator.

Keywords


Implementation; Clinical Pathway; Cerebral Infarction

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References


Hatta, G. . (2010). Pedoman Manajemen Informasi Kesehatan di Sarana Pelayanan Kesehatan. Jakarta: UI Press.

Djasri, O. H. (2013). Peran Clinical Pathways dalam Sistem Jaminan Sosial Nasional Bidang Kesehatan 1, 3–7.

Donnan, G. A., Fisher, M., Macleod, M., & Davis, S. M. (2008). Stroke. Lancet. https://doi.org/10.1016/S0140-6736(08)60694-7

Badan Penelitian dan Pengembangan Kesehatan. (2013). Riset Kesehatan Dasar (RISKESDAS) 2013. Laporan Nasional 2013, 1–384. https://doi.org/1 Desember 2013

Whittle, C. (2009). ICPAT: Integrated care pathways appraisal tool. International Journal of Care Pathways. https://doi.org/10.1258/jicp.2009.009012

Cheah, J. (2000). Clinical Pathways – An Evaluation of its Impact on the Quality of Care in an Acute Care General Hospital in Singapore, 41(7), 335–346.

Firmanda, D. (2006). Clinical Pathways Kesehatan Anak, 8(3), 195–208.

Rivany, R. (2009). Indonesia Diagnosis Related Groups. Kesmas: National Public Health Journal, 4(1), 3. https://doi.org/10.21109/kesmas.v4i1.194

Middleton, S.,Roberts, A., 2000, Integrated Care Pathways; A Practical Approach to Implementation, Butterworth-Heinemann:Reed Educational and Professional Publishing.

Vanhaecht, K., De Witte, K., Depreitere, R., & Sermeus, W. (2006). Clinical pathway audit tools: A systematic review. Journal of Nursing Management. https://doi.org/10.1111/j.1365-2934.2006.00705.x

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, 6–12.

De Luc, K. (2000). Care pathways: An evaluation of their effectiveness. Journal of Advanced Nursing. https://doi.org/10.1046/j.1365-2648.2000.01500.x

de Chernatony, L., & Dall’Olmo Riley, F. (1998). Modelling the components of the brand. European Journal of Marketing. https://doi.org/10.1108/03090569810243721

Kinsman, L., Rotter, T., James, E., Snow, P., & Willis, J. (2010). What is a clinical pathway ? Development of a definition to inform the debate, 8–10.

Cui, Q., Tian, J., Song, X., Yang, K., & Zhang, P. (2014). Effectiveness of Clinical Pathway in Breast Cancer Patients : A Meta-Analysis, 1–7.

Rejeki, V. M. M. (2014). Cost of Treatment Demam Berdarah Dengue ( DBD ) di Rawat Inap Berdasarkan Clinical Pathway di RS X Jakarta. Jurnal Ekonomi Kesehatan Indonesia, 2, 66–74.

Olsson, L. E., Hansson, E., Ekman, I., & Karlsson, J, 2009, A cost-effectiveness study of a patient-centred integrated care pathway, Journal of Advanced Nursing. https://doi.org/10.1111/j.1365-2648.2009.05017.x

Devitra, A. (2011). Analisis Implementasi Clinical Pathway kasus Stroke berdasarkan INA-CBGs di Rumah Sakit Stroke Bukit Tinggi. Universitas Andalas.

Bjurling-sjöberg, P., & Student, D. (2014). Preprint Prevalence and Quality of Clinical Pathways in Swedish Intensive Care Units : A National Survey, 20, 48–57.

Healthcare, N. L. and I. A. for, & Iechyd, A. G. A. ac A. dros O. (2005). Integrated Care Pathways. https://doi.org/10.1258/jicp.2009.009012

Chawla, A., Westrich, K., Matter, S., Kaltenboeck, A., & Dubois, R. (2016). Care pathways in US healthcare settings: Current successes and limitations, and future challenges. American Journal of Managed Care, 22(1), 53–62.

Abrahams, E., Balch, A., Goldsmith, P., Kean, M., Miller, A. M., Omenn, G., … Westrich, K. (2017). Clinical pathways: Recommendations for putting patients at the center of value-based care. Clinical Cancer Research, 23(16), 4545–4549. https://doi.org/10.1158/1078-0432.CCR-17-1609

Huang, D. (2015). Effects of clinical pathways in stroke management : A meta-analysis, 20(4), 335–342.

Aljunid, syed mohamed. (2012). Clinical Pathways : Development and Implementation at a Tertiary Hospital in Malaysia. International Journal of Public Health Research, 2(2), 153–160.

Evans-lacko, S., Jarrett, M., Mccrone, P., & Thornicroft, G. (2010). Facilitators and barriers to implementing clinical care pathways.

Mater, W., Ibrahim, R., & Ph, D. (2014). Delivering Quality Healthcare Services using Clinical Pathways, 95(1), 12–15.




DOI: https://doi.org/10.18196/jmmr.7268

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