• Nama : Hindra Irawan Satari

• Posisi : Divisi Penyakit Infeksi dan Pediatri Tropis, Departemen IKA, FKUI-RSCM
Ketua, Pokja Pencegahan Pengendalian Infeksi, KemenKes RI, 2018-sekarang
Ketua, Pengurus Pusat Perkumpulan Pengendalian Infeksi (Perdalin), 2017-sekarang
Anggota, Komite Pengendalian Resistensi Antimikroba, KemenKes RI, 2017-sekarang
Anggota, Tim Pencegahan Pengendalian Resistensi Antimikroba, RSCM, 2007-sekarang
Ketua, Komite Pencegahan dan Pengendalian Infeksi (PPI) RSCM,2007-2017
• Pendidikan
– Dokter, FK UNPAD, 1981
– Spesialis Anak, FKUI, 1992
– Master of Tropical Pediatrics, School of Tropical Medicine, Liverpool University, United
Kingdom 1995
– Konsultan, Penyakit Infeksi Tropis, Kolegium IDAI, 2002
– Doktor, FKUI, 2012
• Email: hsatari@ikafkui.net
HOSPITAL ACCREDITATION AND
INFECTION CONTROL IS IT
NEEDED OR BLESS IN DISGUISE
Hindra Irawan Satari
Perkumpulan Pengendalian Infeksi (Perdalin)
AGENDA
• PENDAHULUAN
• INFECTION CONTROL
• HOSPITAL ACCREDITATION
• NEEDED OR BLESS IN DISGUISE
• CONCLUSION
 INFECTION CONTROL PROGRAM
• Modern hospital infection control programs first began in the 1950s in
England, where the primary focus of these programs was to prevent and
control hospital-acquired staphylococcal outbreaks.
• In 1968,
• the American Hospital Association published "Infection Control in the Hospital," the
first and only standards available for many years.
• At the same time, the Communicable Disease Center, later to be renamed the
Centers for Disease Control and Prevention (CDC), began the first training courses
specifically about infection control and surveillance.
• In 1969, the Joint Commission for Accreditation of Hospitals--later to
become the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO)--first required hospitals to have organized infection control
committees and isolation facilities.
 Association for Practitioners in Infection
Control (1972)
• In the 1970s, infection control underwent a growth spurt. In 1970,
fewer than 10% of US hospitals had an infection control program.
• By 1976, more than 50% of US hospitals had a version of an infection
control program, including trained nurses to perform active
surveillance.
• In 1972,
• the Hospital Infections Branch at the CDC was formed and the Association for
Practitioners in Infection Control was organized.
• By the close of the decade, the first CDC guidelines were written to answer
frequently asked questions and establish consistent practice.
Fixed-price prospective payment system based
on diagnostic-related groups (DRGs)
• Infection control underwent a midlife crisis in the early 1980s. The cost value of infection control
programs (e.g., surveillance) was questioned.
• Then in 1983, a combination of factors affecting healthcare impacted common infection control
practice. The first was the adoption of a fixed-price prospective payment system based on
diagnostic-related groups (DRGs), which resulted in widespread cost-containment initiatives to non-
revenue producing hospital services. Infection control was often included. Quickly it was
discovered that 56% of DRGs did not allow for any complications or comorbidity. Further analysis
demonstrated that only 5% of costs to treat nosocomial infections would be reimbursed to
hospitals. The fallout from prospective payment meant sicker patients were admitted into
hospitals since less ill patients were treated on an outpatient basis or discharged earlier--a trend
in healthcare we continue to see today.
• The second and certainly most significant factor influencing infection control at the time was the
advent of acquired immunodeficiency syndrome (AIDS). The human immunodeficiency virus (HIV)
has taken an enormous toll in terms of loss of life and productivity. For infection control
professionals (ICPs), HIV has been a challenge for education, risk reduction and resource
utilization.

Karen Hoffmann, RN, MS, CIC

 Cost-benefit of infection control programs
• 1985: the Study of the Efficacy of Nosocomial Infection Control
(SENIC) : validating the cost-benefit of infection control programs.
Data collected in 1970 and 1976-1977 suggested that one-third of all
nosocomial infections could be prevented if all the following were
present:
• One infection control professional (ICP) for every 250 beds.
• An effective infection control physician.
• A program reporting infection rates back to the surgeon and those clinically
involved with the infection.
• An organized hospital-wide surveillance system.
 Extension of infection control program
• 1990: Infection control influenced by the reform of the healthcare system
when managed care networks became the preferred method for delivery
of healthcare.
• Infection control programs had to encompass not only hospitals but also
• the long-term care facility,
• home health/hospice,
• rehabilitation facilities,
• free-standing surgical centers, and
• physician office practices.

• A dramatic shift in patient care practices occurred as greater than

65% of surgery cases were operated on in an outpatient setting.
 INFECTION CONTROL CONSULTANT
• In large community hospitals,
• infection control consultation is usually provided by an infectious diseases
specialist who is knowledgeable about appropriate drug treatment,
prophylaxis and pathology but is not formally trained in epidemiology or
infection control.
• The small community hospital
• often does not have an infectious disease physician at all.
• In these cases, the infection control committee chairperson will usually be
from a specialty area such as pathology/laboratory, surgery or medicine.
• In all areas, it is the ICP who must critically lead the infection control
program through day-to-day activities.
 GOAL FOR INFECTION CONTROL PROGRAM
• The JCAHO Standards state the goal for healthcare organizations'
infection control programs is
• to identify and reduce risks of infections in patients and healthcare
workers.
• there must be a functioning program coordinating all activities
related to surveillance, prevention, and control of infections.
• The goal of an effective infection control program must be to then
improve clinical outcomes using
• a multidisciplinary team approach.
 INFECTION CONTROL PRACTITIONER (ICP)
• ICP has been the central figure in the infection control program.
• The Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) has surveyed
ICPs approximately every five years with a task analysis to determine the scope of practice for
developing a national infection control certification exam.
• Today's ICP needs
• knowledge of epidemiology statistics, patient care practices, occupational health,
sterilization, disinfection, and sanitation, infectious diseases, microbiology, education and
management.
• The major responsibilities for ICPs to oversee include surveillance, specific environmental
monitoring, continuous quality improvement, consultation, committee involvement,
outbreak and isolation management, regulatory compliance and education. To plan,
coordinate, and succeed in fulfilling these responsibilities, many ICPs have to redefine their
roles.
• More ICPs are becoming managers by creating multidisciplinary support teams to carry out
many of the functions.
 HOSPITAL ACCREDITATION
JCI
JOINT COMISSION INTERNATIONAL
HOSPITAL ACCREDITATION
• Sudah 1084 Rumah Sakit didunia
terakreditasi JCI
List of current JCI-accredited organizations in
Indonesia
Sembilan RS di Indonesia terakreditasi Delapan Belas RS di Indonesia terakreditasi
Academic Medical Center Hospital Program Hospital Program
JCI Accreditation Standards for Hospitals, 6th Ed
 JCI ACCREDITATION 6th edition for Hospitals
HEALTH CARE ORGANIZATION
PATIENT-CENTERED STANDARDS MANAGEMENT STANDARDS
• International Patient Safety Goal • Quality Improvement and Patient
(IPSG) Safety (QPS)
• ACC (Access to Care and Continuity of • Prevention and Control Infection
Care (ACC) (PCI)
• Patient and Family Rights (PFR) • Governance, Leadership, and
• Assessment of Patients (AOP) Direction (GLD)
• Care of Patients (COP) • Facility Management and Safety
• Anesthesia and Surgical Care (ASC) (FMS)
• Medical Management and Use • Staff Qualifications and Education
(MMU) (SQE)
• Patient and Family Education (PFE) • Management of Information (MOI)
 Academic Medical Center Hospital Standards

• Medical Professional Education (MPE)

• Human Subjects Research Programs (HRP)
 AKREDITASI RUMAH SAKIT NASIONAL
• AKREDITASI RUMAH SAKIT
• Proses kegiatan peningkatan mutu
pelayanan yang dilakukan terus menerus
oleh rumah sakit, merupakan pengakuan
terhadap mutu pelayanan RS.
• Komisi Akreditasi RS, Agustus 2017, Standar
Nasional Akreditasi Rumah Sakit edisi 1
(SNARS 1)
 AKREDITASI NASIONAL
• KOMITE PPI
• Organisasi nonstruktural
pada Fasilitas Pelayanan
Kesehatan yang mempunyai
fungsi utama menjalankan
PPI serta menyusun kebijakan
pencegahan dan
pengendalian infeksi
termasuk pencegahan infeksi
yang bersumber dari
masyarakat berupa
Tuberkulosis, HIV dan infeksi
menular lainnya.
 KELOMPOK STANDAR DALAM SNARS
• Sasaran Keselamatan Pasien
• Standar Standar Pelayanan Berfokus Pasien
• Standar Standar Manajemen Rumah Sakit
• Integrasi Pendidikan Kesehatan dalam Pelayanan Rumah
Sakit
 KELOMPOK STANDAR DALAM SNARS
STANDAR PELAYANAN BERFOKUS PASIEN
1. Hak pasien & keluarga (HPK)
2. Akses ke Rumah Sakit & Kontinuitas
pelayanan (ARK)
3. Asesmen Pasien (AP)
4. Pelayanan & Asuhan pasien (PAP)
5. Pelayanan Anestesi & Bedah (PAB)
6. Manajemen Komunikasi & Edukasi
(MKE)
7. Pelayanan Kefarmasian &
Penggunaan obat (PKPO)
8. Program nasional (PN)
STANDAR MANAJEMEN RUMAH SAKIT
1. Peningkatan mutu &
keselamatan pasien (PMKP)
2. Pencegahan dan pengendalian
infeksi (PPI)
3. Tata kelola Rumah Sakit (TKRS)
4. Manajemen fasilitas &
keselamatan (MFK)
5. Kompetensi & kewenangan staf
(KKS)
6. Manajemen informasi & rekam
medik (MIRM)
 What is a blessing in disguise ?

• Something that seems bad or unlucky at first, but results in

something good happening later:
• Losing that job was a blessing in disguise really.
 CONCLUSION
• HOSPITAL ACCREDITATION AND INFECTION CONTROL IT IS NEEDED,
NOT BECAUSE OF BLESS IN DISGUISE
THANK YOU