Emergency Quality ImprovementAgus BarmawiDepartment of SurgerySardjito General Hospital/GMUYogyakarta

IntroductionEmergency Departments (EDs) are a crucible of the healthcare system, where quality, accuracy and efficiency are tested to the extreme. The current economic climate, coupled with a cultural mentality of instant gratification, contributes to further strain on EDs. High rates of unemployment mean more people without insurance and with less access to routine preventive care from primary care doctors end up in EDs. And everyone expects immediate attention.

Basic achievement of quality improvementHospital visionHospital mission

Dasar Strategik/Strategic FoundationTerdapat Pelayanan Gawat DaruratMasayarakatDukungan Klinis

Strategi dalam pencapaian tujuanKualitas (quality)Akses (Access)Pemeliharaan Pencapaian (Sustainability)

Arah Strategik (Strategic Direction)Fokus dalam pelayanan pasien/Patient centered careKualitas Pelayanan Rumah Sakit/Quality Hospital CareKepemimpinan/Leadership Persekutuan/perkongsian/Kebersamaan/Partnership.Integrasi/integration

Instalasi Gawat Darurat adalah pintunya rumah sakitKeberhasilan IGD tergantung pada setiap orang.Berusaha terus menerus memperbaiki hasil pelayanan Gawat Darurat (Quality). Fokus dalam rangka mengurangi waktu tunggu di Gawat Darurat (Access).Berusaha mengintegrasikan pelayanan pada tingakatan yang paling memadai (Sustainability)

Quality Improvement Plan (QIP) was tailored to fit plan already underway across organization and in ED.

Perencanaan Peningkatan MutuPengukuran kepuasan pelangganPerencanaan:Memepercepat waktu Penilaian Awal Dokter (initial AssessmenMeningkatkan mutu Penanganan NyeriMeningkatkat komunikasi mengapa pasien harus menungguMemperkuat Proses Hubungan dengan Pasien Menerapkan Seluruh Janji Program untuk meningkatkan Kepemimpinan dan ketrampilan pelayanan pelanggan untuk tiap dan setiap anggota dan dokter

Perencanaan Peningkatan Mutu

IndikatorPresentasi Tahun ke 1Presentasi Tahun ke 2Presentasi Tahun ke 3PresentasiTahun ke 4Instalasi Gawat Darurat Presentasi Kenyamanan Untuk Seluruh Pelayanan yang diterima 80 % ? ? ?

Hal-hal yang menjadi perhatian utamaUkuran yang StrategikKenyamanan Pelayanan Gawat DaruratWaktu tungguKepemimpinan yang StrategikTunjukkan bahwa setiap program adalah berhubungan, mempunyai peranan dan tanggung jawab dalam setiap masalah di Gawat Darurat

Hal-hal yang menjadi perhatian utamaKeterukuran yang StrategikTermasuk dalam Perencanaan Peningkatan Kualitas adalah Kompensasi EksekutifDimungkin untuk ditingkatkan setiap hal yang dianggap pentingMamajemen IGD harus fokus untuk membuat ukuran/peraturan untuk seluruh eksekutif.

Emergency Services have been working to reduce cycle times for ED discharge patients and admit times for ED-to-hospital admissions. Brockmeyer and her team began reviewing data related to ED wait times, measured in the hours to discharge or admission after the decision to admit is made. The benchmark in 2003 was to have the patient to a hospital bed within four hours after decision to admit.

Indonesia Concept of Emergency Services

Strategy Increase the quality of triage Increase the availability of drugs Improve and automate patient registry system Reduce time interval between decision and operation for trauma surgery Optimize output of new training center Improve compliance with Emergency guidelinesImprove response time for lab and x-ray results

Discovered and addressed several issues across the system where improvements could be made, notes, and steps, such as better central census of all hospital discharges and potentially available beds.

In 2004 2005, Roper St. Francis invested in a TeleTracking board that electronically monitors the status of every bed in the hospital from one centralized screen. This addition resulted in more efficient hospital discharge communication, which created greater inpatient bed capacity, thus ED patients to be admitted are moved out of the ED more efficiently, and ED beds are opened up more quickly for those waiting.

Dispatchers and other personnel at Life EMS Ambulance had to become accustomed to trusting the Predictive Deployment Software technology over years of gut instincts. Shown here covering the city of Kalamazoo at about 2:02 p.m. Wednesday, the darkest colors on the system's computerized graphic are the areas with the greatest likelihood for an emergency call

Together GPS (global positioning system) technology with CAD (computer-aided dispatching to help manage scheduling of work crews, vehicle fleet maintenance, human resources and quality assurance.