Prasanti, Ira (2019) Implementasi Clinical Risk Management: Faktor Pendukung Dan Hubungannya Dengan Mutu Dan Keselamatan Pasien Rumah Sakit. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang: Clinical Risk Management (CRM) sangat penting dalam manajemen rumah sakit dalam menghadapi berbagai risiko organisasi yang kompleks seperti; risiko finansial, politik, operasional dan legal. Penelitian ini bertujuan untuk mengidentifikasi faktor pendukung CRM terhadap implementasi CRM dan hubungan antara implementasi CRM dengan mutu pelayanan dan keselamatan pasien. Metode: survei cross-sectional dilakukan di 20 unit pelayanan klinis di rumah sakit swasta yang dimiliki oleh Badan Usaha Milik Negara (BUMN) dengan 234 tempat tidur. Implementasi CRM dievaluasi menggunakan kuesioner dan pelaksanaan mitigasi risiko berdasarkan data laporan. Kuesioner menggunakan skala Likert 1-5 disebarkan kepada 225 responden yang tersebar dalam 20 unit. Mutu pelayanan diukur dengan menggunakan persentase capaian indikator mutu, begitu pula dengan keselamatan pasien diukur dengan menggunakan persentase capaian indikator sasaran keselamatan pasien. Untuk mengidentifikasi faktor pendukung CRM digunakan independent t-test, sedangkan hubungan antara implementasi CRM dengan mutu dan keselamatan dianalisis dengan tabulasi silang. Untuk memperkuat hasil penelitian dilakukan Focus Group Discussion (FGD). Hasil: Tingkat implementasi CRM di rumah sakit belum mapan ditunjukkan dengan hasil kuesioner dan capaian mitigasi risiko. Tidak semua unit melakukan prosedur risk register dan dari seluruh unit yang telah melakukan risk register, hanya 9 unit yang melakukan mitigasi risiko. Uji t menunjukkan hasil bahwa faktor sistem organisasi; kepemimpinan; pemahaman dan budaya; komunikasi dan sistem informasi; pelatihan; dan pemantauan analisis, evaluasi dan pengendalian risiko mendukung pelaksanaan CRM. Faktor pendukung yang memiliki skor terendah adalah kepemimpinan dan komunikasi dan yang tertinggi adalah faktor pemantauan analisis, evaluasi dan pengendalian risiko. Analisis tabulasi silang menunjukkan unit dengan implementasi CRM baik memiliki capaian mutu yang baik pula. Tingkat implementasi CRM tidak mengindikasikan adanya hubungan dengan capaian sasaran keselamatan pasien karena pengaruh dari jumlah indikator yang berbeda-beda. Kesimpulan: Belum mapannya implementasi CRM berhubungan dengan lemahnya faktor kepemimpinan dan komunikasi. Tingkat implementasi CRM berhubungan dengan tingkat capaian mutu tetapi hubungan antara implementasi CRM dengan capaian keselamatan pasien perlu dilakukan penelitian lebih lanjut.
English Abstract
Background: Clinical risk management is critical for hospital management that exposed to the complex organizational risk such as: financial, politics, operational and legal. This research aimed to identify the supporting factors of CRM implementation and explore the relation of CRM implementation with quality and safety. Methods: A cross sectional survey was performed in 20 patient service unit at a state-owned managed hospital with 234 bed capacity. The implementation of CRM was evaluated using questionnaire and risk mitigation practice documented in hospital report. A five Likert scale questionnaire was distributed to the 225 respondents to measure the CRM supporting factors. The level of hospital unit quality was measured as percentage of quality indicators that meet the target, while the patient safety practice was measured based on the percentage achievement of patient safety goals indicators. To identify the CRM supporting factors, an independent t-test was performed while for exploring the relation between CRM with quality and safety a cross tabulation analysis was performed. Three sessions of focused group discussion were performed with senior vice president, supervisor, risk agent and hospital manager as the participant were carried to confirm the study findings. Results: The level implementation of CRM in the studied hospital still in immature stage as represented by survey finding and risk mitigation practices. Not all unit has performed the risk register procedures, and of the unit that already has risk registers only 9 units (53 %) were continued with risk mitigation. T-test result show that organization system, leadership, knowledge and safety culture, communication and information system, and monitoring of analysis, evaluation and risk control were related with CRM implementation, while the descriptive analysis reveals a varied score of those supporting service among hospital unit. The CRM supporting factors that has lowest score are leadership and communication while the highest score is in monitoring of analysis, evaluation and risk control. The cross-tabulation analysis indicating that unit with good supporting tend to have a better quality indicators achievement. The level of CRM does not indicate a relation with the achievement of patient safety goals that might influence by the varied number of indicators in each unit. Conclusions: The immature implementation of CRM is related with the weakness leadership and communication supporting factors. Unit CRM implementation level is related with quality performance but it relation with patient safety goals need further investigation.
Other obstract
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| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/362.106 8/PRA/i/2019/041905784 |
| Uncontrolled Keywords: | Clinical Risk Management, Faktor pendukung, Indikator Mutu, Sasaran Keselamatan Pasien,-Clinical Risk Management, Supporting factors, quality indicators, patient safety goals, hospital’s unit |
| Subjects: | 300 Social sciences > 362 Social problems of and services to groups of people > 362.1 People with physical illnesses > 362.106 8 Management |
| Divisions: | S2/S3 > Magister Manajemen Rumah Sakit, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 30 May 2022 06:43 |
| Last Modified: | 30 May 2022 06:43 |
| URI: | http://repository.ub.ac.id/id/eprint/190782 |
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