Manajemen Praktik

PDKI Pusat

Cakupan
1.
2.
3.
4.
5.
6.
7.
8.

Rational prescribing
Medical audit
Portfolio and CPD
Emergency in primary care setting
Home visit and palliative care
Medical negligence, malpractice, and accident
Health insurance and financial management
Health insurance, utilization review, and financial
management

Rational Prescribing
A word of warning
Even if you do not always agree with the
treatment choices in some of the
examples it is important to remember
that prescribing should be part of a
logical deductive process, based on
comprehensive and objective
information. It should not be a knee-jerk
reflex, a recipe from a 'cook-book, or a
response to commercial pressure.

Rational Prescribing
Step 1: Define the patient's problem
Dont make another problem

Step 2: Specify the therapeutic objective

What do you want to achieve with the treatment?

Step 3: Verify the suitability of your P-treatment

Check effectiveness and safety

Step 4: Start the treatment

Step 5: Give information, instructions and warnings
Step 6: Monitor (and stop?) treatment

Audit Medis
1.
2.
3.
4.
5.
6.

Jaminan mutu
Jaga mutu
Peningkatan mutu
Pertanggungjawaban
CPD
Yang paling sederhana adalah
mengaudit rasionalitas pelayanan
secara periodik dan random
7. Jangan ditafsirkan sebagai mencurigai

Portofolio
1. Dapat menjadi sarana CPD yang efektif yang
mencakup paket ABCD
2. Contoh:

Kegawatdaruratan di layanan
primer
1.
2.
3.
4.
5.
6.
7.

Jabang bayi
Bayi
Anak
Remaja
Dewasa
Lansia
Reproduksi

Kunjungan rumah dan layanan

paliatif
1. Diperlukan tetapi tetap selektif
2. Perlu persiatan dan antisipasi
3. Perlu koordinasi
1. DSp/RS
2. Keluarga pasien

4. Jangan sampai disalahgunakan oleh pasien

5. Tetap obyektif dan profesional

Medical negligence, malpractice, and accident

1. Nama lainnya: Medicolegal
2. Medical mistake:
1.
2.
3.
4.

Diberi obat yang diketahui pasien ybs alergi

Salah dosis
Overdiagnosis
Dsb

3. Haruskan disampaikan?
4. Bagaimana jika kita tahu bahwa sejawat kita salah?
5. Kelalaian, kesengajaan, dan kecelakaan harus dihindari

Health insurance, utilization review, and financial

management
Sangat diperlukan dalam
Struktur sistem pelayanan
Pengembangan klinik
Peningkatan mutu pelayanan

Dapat diabaikan dalam

penyelesaianmasalah medis

Penerapan tanpa asuransi. Dapatkah?

The principles of Family Medicine

Status

1. Comprehensive care and holistic approach

Done?

2. Continuous care

Done?

3. Prevention first

Done?

4. Coordinative and collaborative care

5. Individual care as the integral part of his/her family

Done?
Done?

6. Family, community, and environment consideration

Done?

7. Ethics and law awareness

Done?

8. Cost effective care and quality assurance

Done?

9. Can be audited and accountable care

Done?

10 Juni 2007

Wawasan DK

11

Riset di Ranah Pelayanan

Primer

Cohort (prospective, no intervention)

Case-contror (retrospective, no intervention)
Cross-sectional (momen opname)
Experimental (RCT, prospective with intervention)
Descriptive
Epidemiological
Kerjasama dengan Dinkes BP2KB (IDI) untuk
SKP IDI