CURRICULUM VITAE DATA PRIBADI Nama : dr.ADIB ABDULLAH YAHYA,MARS Pangkat : Brigjen TNI (Purn) Tempat/tanggal lahir : Magelang,16 Februari 1949 Jabatan : President Asian Hospital Federation (AHF) Agama : Islam ALAMAT : Jl. Punai H-24,Kel.Tengah,Jakarta Timur – 13540 Telp : (021)8404580 Fax : (021) 8408047 HP : 08161803497 E-MAIL : [email protected]PENDIDIKAN UMUM 1 PENDIDIKAN UMUM SMA Negeri Magelang 1966 S1 : Fakultas Kedokteran Universitas Gajah Mada (UGM), Yogyakarta, 1973 S2 : Fakultas Kesehatan Masyarakat, Universitas Indonesia (UI), Jakarta, Program Kajian Administrasi Rumah Sakit ( KARS ) PENDIDIKAN MILITER Sekolah Staf dan Komando TNI Angkatan Darat (SESKOAD), 1987/1988 PELATIHAN Combined Humanitarian Assistance Response Training, oleh Singapore Armed Forces (SAF), Singapura, 2000 Health as a Bridge for Peace Workshop, oleh World Health Organization (WHO), Yogyakarta, 2000
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CURRICULUM VITAEDATA PRIBADI
Nama : dr.ADIB ABDULLAH YAHYA,MARSPangkat : Brigjen TNI (Purn)Tempat/tanggal lahir : Magelang,16 Februari 1949
Jabatan : President Asian Hospital Federation (AHF)Agama : IslamALAMAT : Jl. Punai H-24,Kel.Tengah,Jakarta Timur – 13540
SMA Negeri Magelang 1966S1 : Fakultas Kedokteran Universitas Gajah Mada (UGM),
Yogyakarta, 1973S2 : Fakultas Kesehatan Masyarakat, Universitas Indonesia (UI), Jakarta,
Program Kajian Administrasi Rumah Sakit ( KARS )
PENDIDIKAN MILITER
Sekolah Staf dan Komando TNI Angkatan Darat (SESKOAD), 1987/1988
PELATIHAN
Combined Humanitarian Assistance Response Training, oleh Singapore Armed Forces (SAF), Singapura, 2000Health as a Bridge for Peace Workshop, oleh World Health Organization (WHO), Yogyakarta, 2000
PENGALAMAN JABATANKomandan Detasemen Kesehatan Pasukan Pengamanan Presiden (DanDenkes Paspampres), 1987-1991Kepala Rumah Sakit “Muhammad Ridwan Meuraksa”, Jakarta, 1992Kepala Kesehatan Daerah Militer (Kakesdam) Jaya, Jakarta, 1993Komandan Pusat Pendidikan Kesehatan TNI – AD,1995 – 1999Wakil Kepala Pusat Kesehatan TNI, 1999 – 2000Kepala RSPAD Gatot Soebroto, 2000 – 2002Dekan Fakultas Kedokteran UPN, Jakarta, 2000 – 2002Wakil Ketua Tim Dokter Kepresidenan RI, 2000 – 2002Direktur Kesehatan TNI Angkatan Darat (Dirkesad), 2002-2004Wakil Ketua Tim Pemeriksaan kesehatan untuk calon Presiden dan calon Wakil Presiden RI Th.2004DOSEN Pasca Sarjana FKM UI, Kajian Administrasi Rumah Sakit (KARS)
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DOSEN Pasca Sarjana FKM UI, Kajian Administrasi Rumah Sakit (KARS)DIREKTUR UTAMA RUMAH SAKIT MMC
ORGANISASIKetua Ikatan Rumah Sakit Jakarta Metropolitan (IRSJAM), 2000-2003Ketua Umum Perhimpunan Rumah Sakit Seluruh Indonesia ( PERSI), 2003-2009Anggota Komnas FBPI. Ketua Komtap Bidang Kebijakan Kesehatan KADIN IndonesiaAngggota TNP2K.Ketua Divisi Kemahkamahan Majelis Kehormatan Etik Kedokteran (MKEK) IDI Pusat Tim Konsultan Institut Manajemen Risiko Klinis ( IMRK )Koordinator Bidang 1 : KAJIAN KESELAMATAN PASIEN, KKPRSInstruktur HOPE ( Hospital Preparedness for Emergencies and Disasters}PRESIDENT OF ASIAN HOSPITAL FEDERATION ( AHF ) 2009 – 2011
PATIENT SAFETY IS A KEY COMPONENT OF PATIENT SAFETY IS A KEY COMPONENT OF RISK MANAGEMENTRISK MANAGEMENT
Dr. ADIB A YAHYA, MARSPRESIDENT
ASIAN HOSPITAL FEDERATION( AHF )
WORKSHOP KESELAMATAN PASIEN DAN MANAJEMEN RISIKO KLINIS DI RUMAH SAKIT
1. What?
3. How?
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2. Why?
3. How?
What ?What ?
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DEFINISI RISIKODEFINISI RISIKO
RISIKO ADALAHRISIKO ADALAH ::
“ “ POTENSI TERJADINYA KERUGIANPOTENSI TERJADINYA KERUGIANYANG DAPAT TIMBUL DARI PROSESYANG DAPAT TIMBUL DARI PROSES
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YANG DAPAT TIMBUL DARI PROSESYANG DAPAT TIMBUL DARI PROSESKEGIATAN SAATKEGIATAN SAAT SEKARANGSEKARANG ATAUATAUKEJADIANKEJADIAN DIMASA DATANGDIMASA DATANG.”.”
ERM, Risk Management Handbook for Health Care OrganizationERM, Risk Management Handbook for Health Care Organization
Risiko di Rumah SakitRisiko di Rumah Sakit
RISIKO KLINISRISIKO KLINIS ::SEMUA ISU YANG DAPAT BERDAMPAK SEMUA ISU YANG DAPAT BERDAMPAK
TERHADAP TERHADAP PENCAPAIAN PELAYANAN PASIENPENCAPAIAN PELAYANAN PASIENYANG BERMUTU TINGGI,AMAN DAN EFEKTIF.YANG BERMUTU TINGGI,AMAN DAN EFEKTIF.
Medical staffMedical staff--related risksrelated risks
EmployeeEmployee--related risksrelated risks
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EmployeeEmployee--related risksrelated risks
PropertyProperty--related risksrelated risks
Financial risksFinancial risks
Other risksOther risks
Risiko yang berhubungan dengan perawatan pasienRisiko yang berhubungan dengan perawatan pasien((Patient care related risksPatient care related risks))
Direct association with Direct association with patient carepatient careConsequences of inappropriate or incorrectly performed Consequences of inappropriate or incorrectly performed
medical treatmentsmedical treatmentsConfidentiality Confidentiality and appropriate release of informationand appropriate release of informationProtection from Protection from abuseabuse, , neglectneglect and assaultand assault
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Protection from Protection from abuseabuse, , neglectneglect and assaultand assaultWas patient Was patient informed of risksinformed of risks??NondiscriminatoryNondiscriminatory treatmenttreatmentAppropriate Appropriate triage and transfertriage and transfer of patients from ERof patients from ERPatient participation in Patient participation in research studiesresearch studies and use of experimental and use of experimental
drugs drugs -- was consent obtained?was consent obtained?Was Was patient dischargedpatient discharged appropriately?appropriately?
Risiko yang berhubungan dengan tenaga medisRisiko yang berhubungan dengan tenaga medis
((Medical staff Medical staff -- related risksrelated risks))
-- Credential Credential terhadap staf medis ?terhadap staf medis ?
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-- Tindakan medis sesuai Tindakan medis sesuai kompetensikompetensi dan dan prosedur bakuprosedur baku ??
-- Was patient Was patient properly managed properly managed ??
-- Do we have adequately Do we have adequately trained staff trained staff ??
Risiko yang berhubungan dengan karyawanRisiko yang berhubungan dengan karyawan
((Employee related risksEmployee related risks))
-- Risiko Risiko keselamatan dan kecelakaan kerjakeselamatan dan kecelakaan kerja
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-- Risiko Risiko keselamatan dan kecelakaan kerjakeselamatan dan kecelakaan kerja
-- Maintaining a Maintaining a safe environmentsafe environment -- Employee Health PolicyEmployee Health Policy ::
. reducing risk of . reducing risk of occupational illness and injuryoccupational illness and injury
. providing for the . providing for the treatment and compensationtreatment and compensation of of workers for workworkers for work--related illnesses or injuriesrelated illnesses or injuries
Risiko yang berhubungan dengan propertyRisiko yang berhubungan dengan property((Property related risksProperty related risks))
Protect assets from losses due to Protect assets from losses due to firesfires, , floodsfloods, etc, etc
Paper and/or electronic recordsPaper and/or electronic records -- patient, business patient, business
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Paper and/or electronic recordsPaper and/or electronic records -- patient, business patient, business and financial and financial -- protected from damage or protected from damage or destructiondestruction
Procedures for Procedures for handling cashhandling cash and safeguarding and safeguarding valuablesvaluables
Bonding and Bonding and insuranceinsurance to protect facility from to protect facility from losseslosses
-- EXPOSURE AVOIDANCEEXPOSURE AVOIDANCE-- LOSS PREVENTIONLOSS PREVENTION-- LOSS REDUCTIONLOSS REDUCTION
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-- SEGREGATION (SEPARATION OR DUPLICATION)SEGREGATION (SEPARATION OR DUPLICATION)-- CONTRACTUAL TRANSFER FOR RISK CONTROLCONTRACTUAL TRANSFER FOR RISK CONTROL
RISK FINANCINGRISK FINANCING ::
-- RISK RETENTIONRISK RETENTION-- RISK TRANSFERRISK TRANSFER
Fully trained staff to interpret and Fully trained staff to interpret and report on testsreport on tests
Clinically important results to be Clinically important results to be
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Clinician not aware of Clinician not aware of ward ward observationobservation
Clinician fails to Clinician fails to understand test understand test resultresult
Inappropriate Inappropriate use of testsuse of tests
relayed to clinician urgentlyrelayed to clinician urgently
Ward tests to be supervised and Ward tests to be supervised and results discussed with cliniciansresults discussed with clinicians
Aware of the limits of their Aware of the limits of their competencecompetence
Senior staff to check repeatedlySenior staff to check repeatedly
Careful supervisionCareful supervision
Reducing the risks of Reducing the risks of invasive proceduresinvasive procedures
Consider The Consider The risk : benefit ratiorisk : benefit ratio
Discuss theDiscuss the procedure with the patientprocedure with the patient
Carrying out the procedure including coping with Carrying out the procedure including coping with potential difficultiespotential difficulties
Ensure that the equipment is in good working order Ensure that the equipment is in good working order
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Ensure that the equipment is in good working order Ensure that the equipment is in good working order and that and that back up equipmentback up equipment is availableis available
If the procedure is not going well obtain If the procedure is not going well obtain help / be help / be prepared to give upprepared to give up
Ensure that the operator has Ensure that the operator has sufficient skillsufficient skill
Reducing the risks of Reducing the risks of invasive proceduresinvasive procedures
Consider The Consider The risk : benefit ratiorisk : benefit ratio
Discuss theDiscuss the procedure with the patientprocedure with the patient
Carrying out the procedure including coping with Carrying out the procedure including coping with potential difficultiespotential difficulties
Ensure that the equipment is in good working order Ensure that the equipment is in good working order
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Ensure that the equipment is in good working order Ensure that the equipment is in good working order and that and that back up equipmentback up equipment is availableis available
If the procedure is not going well obtain If the procedure is not going well obtain help / be help / be prepared to give upprepared to give up
Ensure that the operator has Ensure that the operator has sufficient skillsufficient skill
COMMON SPECIFIC FACTORS ASSOCIATED WITH COMMON SPECIFIC FACTORS ASSOCIATED WITH DRUG DRUG ADVERSE EVENTSADVERSE EVENTS
FAILURE TO TAKE ACCOUNT OF DECLINING FAILURE TO TAKE ACCOUNT OF DECLINING RENAL / HEPATIC FUNCTIONRENAL / HEPATIC FUNCTION
FAILURE TO CHECK FOR POSSIBLE FAILURE TO CHECK FOR POSSIBLE ALLERGIC ALLERGIC RESPONSESRESPONSES
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RESPONSESRESPONSES
USING THE USING THE WRONG DRUG NAMEWRONG DRUG NAME OR MEANS OF OR MEANS OF ADMINISTRATIONADMINISTRATION
MISCALCULATION OF MISCALCULATION OF DOSAGEDOSAGE
REDUCING THE RISKS OF ONGOING REDUCING THE RISKS OF ONGOING WARD CAREWARD CARE
POTENTIAL ERRORSPOTENTIAL ERRORS
Failure to Failure to monitormonitor clinical clinical progressprogress
Failure to recognise that a Failure to recognise that a patient is patient is not making not making satisfactory progresssatisfactory progress
Failure to provide Failure to provide appropriate appropriate treatmenttreatment
ShiftShift workingworking
Use spesialist staff Use spesialist staff –– clinician clinician from appropriate unit, nurse from appropriate unit, nurse spesialist, physiotherapistspesialist, physiotherapist
PATIENT SAFETY,QUALITY OF CAREPATIENT SAFETY,QUALITY OF CARE
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PATIENT SAFETY,QUALITY OF CAREPATIENT SAFETY,QUALITY OF CARE
AND RISK MANAGEMENTAND RISK MANAGEMENT
The basic principles for safety The basic principles for safety and quality of careand quality of care
The basic principles for patient safety are The basic principles for patient safety are the the principles for quality of careprinciples for quality of care: :
-- to to do the right thingdo the right thing
for the for the right patientright patient
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for the for the right patientright patient
using the using the right methodright method and and
at the at the right timeright time, and , and
-- to to communicate wellcommunicate well with thewith the patient patient and the rest of the and the rest of the clinical teamclinical team
“It’s easy gettin’ good players.“It’s easy gettin’ good players.The hard part is gettin’ them to play The hard part is gettin’ them to play
with each other”with each other”
(Casey Stengel)
(Casey
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Communicating Team ???Communicating Team ???
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Quality in HealthcareQuality in Healthcare
…. begins with …. begins with ensuring patient safetyensuring patient safety
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Key reasonsKey reasons
Patients are Patients are more at riskmore at risk than nonthan non--patientspatients
Medical interventions are, by their nature, Medical interventions are, by their nature,
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highhigh--risk procedures risk procedures -- small error marginssmall error margins
Medicine remains an Medicine remains an inexactinexact, hands, hands--on on endeavourendeavour
Patient safety in contextPatient safety in context
Patient safetyPatient safety is an important component of is an important component of
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risk managementrisk management, , clinical governanceclinical governance, and , and quality improvementquality improvement. .
4343Australian Patient Safety Foundation
I. Risk management is not primarily about avoiding or mitigating claims; rather, it is a tool for
improving the quality of care.II. Incident reporting is only one aspect of the identification of
risk. Incident reporting is on the reactive side of risk management. More emphasis needs to be placed on
CONCLUSIONSCONCLUSIONS
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management. More emphasis needs to be placed on
the proactive side.III. Risk management is actually
the business of all stakeholders in the organisation, clinicians and nonclinicians.
IV. The primary focus of risk management should now be clinical governance and patient safety.
FINAL WORDFINAL WORD
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……Safe care is not an option.It is the right of every patient
who entrusts their care to our Healthcare systems…Sir Liam Donaldson,
Chair, WHO World Alliance for Patient Safety, Forward Programme, 2006–2007