Standart Quality Hospital Service

Standard
From the definition it is clear that hospitals need to learn what the standards applicable to the RS as well as for each service eg: Services (Yan) Medical, Yan Nursing, Administration & Management, Medical Records, Emergency Yan, etc..
These standards consist of elements of structure, process and results (outcomes).
Structure is the physical facilities, organization, human resources, financial systems, medical equipment and non-medical, AD / ART, policies, SOP / SOP, programs, etc..


The process is all the operational implementation of the staff / unit / section Hospitals to patients / families / people who use hospital services.
The results (outcomes) is the change in the patient's health status, changes in knowledge / understanding and behavior that affect health status in the future, and patient satisfaction. Results are usually measured by indicators of hospital or clinical indicators. The results (outcomes) are different outcomes (output), eg the number of patients the operation (PO) is superficial, while the result is the number of patients who have surgery Wound Infection Surgery (Pilo) divided by the number of patients operated (Pilo / PO times 100%). Of more importance are the results / outcome, since it determines the quality of a service.
Applying these standards is not a short-term effort, but long-term efforts and of all time. Accreditation is essentially a process of assessing the extent to which hospitals have implemented the standard. Hospital Accreditation in Indonesia undertaken by KARS (Hospital Accreditation Committee) Department of Health.

Preparation
Hospital Accreditation Preparation begins by establishing a working group (Working Group) for each service area, for example: Working Group Emergency Yan, Yan Working Group Medical, Nursing Working Group, etc.. These working groups will prepare a variety of standards to be applied to the unit / part, led to its application and then perform the assessment, which is referred to as self-assessment.
Assessment carried out by using the instruments of KARS. The instrument is contained in a book available at KARS bound at once to 16 services. The book title is Hospital Accreditation Survey Report, mainly contains the Special Guidelines / survey of each service, this guide is none other than the instruments used to assess or "measure" the extent to which hospitals are already implementing the standard. This specific guidelines for each service contains seven standards, there are parameters that each number is different, then there are scores, and the DO statement (Operational Definition) and CP (Method of Proof). It is recommended that this working group studying the instrument carefully and try to make an assessment of each ministry.

Service Type
This type of service that is accredited is (along with the number of parameters):
* Five Yan: 1.Administrasi & Management (24), 2.Yan Medical (18), 3.Yan Emergency (31), 4.Yan Nursing (23), 5.Rekam Medical (16), (5 Yan total = 112 parameters).
* Twelve Yan: 6.Yan Pharmacy (16), 7.Keselamatan Work, Fire Precautions disaster-K3-(27), 8.Yan Radiology (18), 9.Yan Laboratory (23), 10.Yan Operating Room (25 ), 11.Yan Infection Control (17), 12.Yan Perinatal High Risk (16), (12 Yan total = 254 parameters).
* Sixteen Yan: 13.Yan Rehablitasi Medical (16), 14.Yan Nutrition (17), 15.Yan Intensive (17), 16.Yan Blood (15), (16 Yan) = 319 parameters.
Hospital accreditation at something must be done for five services, called the Accreditation of Basic Level of services numbers 1 s / d 5. Three years later the hospital to improve themselves and are accredited for 12 services, called the Advanced Accreditation (service number 1 s / d 12). And three years later, the RS can be accredited for a total of 16 services (Accreditation Levels Complete).
If in applying these standards, improvement standard elements of structure, process and outcome has been pretty good, namely through the Assessment Self Assessment, such as the value obtained has reached 80-85%, then it can apply for surveyed by KARS.

Benefit
Based on overseas literature and KARS experience in Indonesia, the benefits gained RS because accreditation is as follows.:
1. Service improvement (as measured by clinical indicators),
2. Improved administration & planning,
3. Improved coordination of patient care,
4. Improved coordination of care,
5. Improved communication between staff,
6. Improved systems & procedures,
7. Safer environment,
8. Risk minimization,
9. The use of resources more efficient,
10. Stronger collaboration from all parts of the organization,
11. Decrease in patient complaints & staff,
12. Increased staff awareness of their responsibilities,
13. Improved morale and motivation,
14. Re-energized organization,
15. Satisfaction of stakeholders (stakeholder).
Accreditation decision. Assessment of results by the surveyor and submitted to the KARS, and accreditation decisions can be as follows.:
Not Accredited (Disqualified)
Conditional accreditation: the total value of> 65% - <75%, no value <60%, 1 year surveyed / Yan whose value is another value below 75%.
Full Accreditation: the total value of> 75%, no value <60%, 3-year validity period.
Special Accreditation: 5-year validity period, obtained after 3 X consecutive pass.